To not understand why I have to suffer instead of being given painkillers

[Anon8604]

Background: I'm on a waiting list to have two teeth removed as I've been told by my dentist that it's complicated and not something they can deal with at their practice. It's another three weeks until my assessment with the dentist I've been referred to and then it'll be another wait to have the treatment.

So this week I've been in lots of pain with my teeth, to the point where I'm getting almost no sleep because of it. I made an emergency dental appointment yesterday and explained the situation. Dentist looked at my teeth and confirmed I need two removing and that I'll have to continue waiting for my referral appointment.

I said I understand that but I'm in so much pain I cannot sleep at night, paracetamol isn't helping at all so what can I do in the meantime. I can't take NSAIDs (ibuprofen, disclofenac etc) as I have asthma and they trigger wheezing and I can't take co-codamol as I'm breastfeeding and codeine is not recommended when breastfeeding.

Dentist says there's nothing they can do about it, I'll just have to wait for my appointment and try to cope with the pain until then. I asked if there's a reason they couldn't prescribe me painkillers that are safe when breastfeeding (which I know exist as I was prescribed them after having a c section) and the dentist said they don't prescribe painkillers as ibuprofen is the most effective for toothache. I say I understand that but I can't take ibuprofen as last time I did I ended up in A&E. Dentist says in that case just continue taking paracetamol. I said paracetamol wasn't helping and I've barely slept for days. Dentist said just keep taking the paracetamol and hopefully I won't have to wait too long for the referral. I left almost in tears because I just can't cope with this for weeks longer.

So, I'm now awake at night again, crying and trying to distract myself from pain by moaning on mumsnet wondering how I'm going to get through tomorrow (and the day after, etc) on two hours sleep and with horrible toothache.

So....AIBU to:

1. Not understand why my dentist won't give me any painkillers, despite agreeing that my teeth are causing me pain and need treatment.
2. Ask if anyone has miracle cures for toothache that I can try to get through the next few weeks.

I know I probably sound pathetic but it hurts so much and I literally don't know how I can manage weeks more of this before my appointment. I don't get why they would not prescribe painkillers when I'm in so much pain and there are safe and effective painkillers that I could be prescribed.

I was in a similar situation a few weeks ago and was prescribed dihydrocodeine by my dentist.

And agree with op that oragel is good. Completely numbs the area, even took the edge off when I had an abscess. I was vomiting solidly when pregnant with dc1 and spent the next 2 years getting my teeth repaired from the damage.

Just to make clear, advice now is not to use codeine, so see your gp.

(In case anyone is worried I work in a specialty where I will never be treating breastfeeding mothers!)

You could try baby Anbesol teething liquid (it comes in a little glass jar) either rubbed on our soak a cotton wool pad and put it between your gum and your cheek.

I was prescribed codeine after my c-section, and was breastfeeding. Totally off thread, but has this changed?

As a quick fix get some oragel it's really effective

I second Oragel. It's not a miracle worker but it helps a lot in conjunction with paracetamol. I put it on a little bit of cotton wool and hold it between my teeth as well as rubbing it on the tooth/gum. It numbs quickly though so be careful you don't bite your tongue.

I would ask for a short course of tramadol and pump and dump for a few days if I were in your position.

Erm, I was discharged with this 14 days after having DS in 2015 - EBF

Was this bad? (Was in ICU, HDU and specialist ward after having him so they definitely had the whole picture!)

Last night tbh I have seen codeine being prescribed to pregnant and bfing mums up til quite recently in hospital - I think it is a theoretical risk to baby so may be used with clinical judgement in some circs.

Probably best to stick to dihydrocodeine however as op is not in hospital

God toothache is AWFUL, I feel for you OP. It makes your whole face hurt. Hope the GP gives you something, the dentist should have suggested it instead of giving you dead end responses.. not very sympathetic.

But dihydrocodeine and codeine phosphate are essentially the same thing. The issue is the codeine itself that some physicians are reluctant to prescribe during pregnancy/ while breastfeeding.

If you go onto Boots website and type in Paramol, you can either buy it online or if you put in your postcode it shows you which Boots branches nearest you have it in stock. I took it after I has DS and they sold it over the counter. I wasn't breastfeeding but you can take it if you are.

Thanks Random !

I think there was a case report of a baby who died from morphine excess after the breastfeeding mother was taking a recommended dose of codeine. She was found to be a very rapid metaboliser of codeine. For most breastfeeding women prescribed amounts of codeine are fine and won't affect their baby but given that prescribers don't have prior knowledge of a woman's genetically determined metaboliser status codeine isn't prescribed as often.

There's lots of worries over codeine here and it's use in breastfeeding. The risk to babies is small but it has been linked to respiratory depression and death - this depends on how the body metabolises the codeine. The amount purchased over the counter is incredibly small, max is 12.5mg codeine with 500mg of paracetamol per tablet where as prescribed is up to 60mg. I do prescribe it in some bf mothers having weighed up risks and other options.
If your teeth are affecting the nerves codeine is not a good option as there's a risk it can exacerbate the pain.
As others have suggested without seeing you face to face I would suggest oragel first , anything that will numb the area.
Also worth noting that if you take codeine long term (more than a few days) your tolerance to it increases requiring a higher dose, coming off it can be problematic and it causes constipation.
Hopefully I've missed an update and you've had some GP advice, tooth ache is absolutely miserable.

With the nsaid/asthma problem, have you tried different nsaids? I'm allergic to ibuprofen and asthmatic, but I'm fine with naproxen

Second the recommendation for oragel too - I had a particularly bad TN attack and it helped that when even morphine wasn't touching it :)

Mother - codeine and dihydrocodeine are metabolised slightly differently, but the end product is the same, essentially morphine.

Very rarely people metabolise codeine in a way that produces very high levels of morphine in the blood. But dihydrocodeine is metabolised differently, so doesn't carry this added risk. Still could cause sedation though.

Have you tried orajel/oragel (sp).

It's a super strength teething gel that got me through weeks of excruciating pain when I was waiting for removal of a molar.

Please also note that although dihydrocodiene is metabolised differently it's actually very difficult for a prescriber to gage this. I would rather prescribe a low dose of codeine if it was appropriate.

My DP has had a dreadful few days after having a wisdom tooth out on Tuesday and ended up with a dry socket. The clove oil has really helped and the GP prescribed some painkillers on Thursday which have helped incredibly.
Good luck, it's the most awful pain.

Also OP , are you sure ibuprofen causes YOU to weeze? Because it's a real shame you can't alternate paracetamol and ibuprofen 2 hourly.

I ask because I'm asthmatic and avoided ibuprofen for years at doc's advice but then a nurse advised me to try it to see if it effected me. It didn't.

Mothertroubles, yes it is although dihydro is a stronger preparation. It makes me feel quite uncomfortable seeing advice given to a bf mother about taking these when there is no face to face consolation.

Breastfeeding Network have the best info on what is safe to take while BF. Dr Wendy Jones does their factsheets - she's superb. She's a pharmacist, rather than a medical Dr, adn her knowledge is amazing.

This is the factsheet on analgesia
breastfeedingnetwork.org.uk/wp-content/dibm/analgesics%20and%20breastfeeding.pdf

This is the dental treatment one
breastfeedingnetwork.org.uk/wp-content/dibm/dental%20treatment%20and%20breastfeeding.pdf

This one is specifically on codeine
breastfeedingnetwork.org.uk/wp-content/dibm/codeine%20and%20brestfeeding.pdf

If you google Breastfeeding Network drugs or similar it'll take you to the factsheets.

Second the clove oil.

Pingu- thankyou for posting those links, I tried and failed. As a prescriber I can absolutely confirm they are accurate and used by people like me!!