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.

Jellybean- otc co-codamol can be given up to 12.5mg per tablet with paracetamol 500mg. The BNF does state avoid dihydrocodeine as we have insufficient research on it. Previous posters claiming they were told it is safe may not be in the UK , as there has been some info on the slower metabolising into morphine, something I wouldn't be prepared to risk in the doses it currently comes in. I'm sure there's a lurking pharmacist who can give more info than me on that though!

Thanks hunkydory and betty. I honestly am trying to be sensible and reasonable - as much as a sleep-deprived person with toothache can be!

And red, if you read my OP I said that I'd been advised against taking co-codamol and ibuprofen, so at the time I posted the only pain relief I was able to take was paracetamol which made no difference at all. I did feel a bit like painkillers were being withheld from me because I knew that there were painkillers that I could take but my dentist had said I could only take paracetamol (not that he could only prescribe paracetamol, but that paracetamol was the only thing available at all). Plus I'd been awake most of the night and my teeth were horribly painful so I admit I may not have crafted my title with much care and attention!

The only person who suggested co-codamol was the GP, who then called back about ten minutes later to tell me that actually I should not take co-codamol and he was arranging a prescription for another painkiller. I plan to take the advise of my dentist, pharmacist and GP and not take co-codamol.

I was prescribed dihydrocodeine (60mg 4 times a day) in hospital following a c section, which I assume is because the benefit outweighed the risks - for example without pain relief I would have found it almost impossible to have got out of bed and being immobile would have increased my risk of DVT (which was already higher due to having surgery). I'm not a medical professional, but I assume that avoid unless benefit outweighs risk is something that has to be decided on a case by case basis. Whereas my understanding is that the current advice is that co-codamol should always be avoided.

Anyway, thanks again everyone for the advice and sympathy.

It's a tough one. All about benefit of treatment outweighing (often tiny) risk. As has been discussed, it isn't ethical to test the potential adverse effects on infants of breast feeding mothers so most evidence is quite patchy.

You may find 2-3 50mg caps a day is effective so stick to the lowest effective frequency. Continue with paracetamol (unless advised otherwise) and if you have got any stored breasmilk it might be worth using it every other feed or so and avoiding feeding 1-2 hours after taking a dose if you can (easier said than done, I know!).

Posters are right about potential side effects- sounds a bit obvious but read the leaflet, don't drive for first couple of days taking it and only then if you're not feeling at all drowsy/mentally impaired, avoid alcohol and only take it for as long as absolutely necessary.

I'm a pharmacist but also have been prescribed tramadol for back pain. I found it I was quite disorientated and had minor withdrawal symptoms when I stopped after only a few days (low mood, irritability).

Hope you feel loads better!

You do not sound a nightmare at all op, how very dare you be asthmatic and two painkillers set you off and then be worried about passing another in your milk
Id take the tramadol, you may not get dizzy or drowzy, not everyone does! Just get rid of your pain has the gp said to carry on taking the paracetamol too?

Have they checked tor infection also?because if tooth are damaged infection come easier.therefore pain trippled.then antibiotics will kill so much of the pain because often this is the source of it pumping in ur roots.and painkillers will only ease raging infection to a point.xx

I found tramadol amazing. I took some after a wisdom tooth extraction and I felt like I was floating with pleasure. I wasn't out of it or anything, just very happy, content and more importantly pain free.

You can not help the fact you have asthma and have been told not to take codeine.
Like I said before im in the same situation as im bf and can only take paracetamol as ibuprofen has given me a stomach ulcer! So I do apologise if im another patient that doctors etc hate!
Im waiting on having the offeneding tooth out, and I have literally been rolling on the floor in agony!
I have had 6 children and I would rather have another then have this pain so I very much sympathise with you op.

I do think people forget how horrendous tooth ache can be. I've given patients gauze soaked in local anaesthetic before which works incredibly well but unfortunately it's a very short term solution! Op you must be absolutely shattered, I hope you are experiencing some relief now! Sounds daft but if you are bf during the night please be aware of the possibility of being more sleepy and ensure baby is put back to bed in a separate cot to your bed.

DO NOT USE HEAT! God people on here keep advising this with toothache. Please please do not use heat it makes the infection spread and can draw it out into th facial tissue. My dentist was emphatic about telling me this when I had an infection. Ice packs will help to reduce and swelling and numb the pain.

Haven't RTFT but surely you could call into the chemist? They're probably the most suitable people to advise you.

In the OP's defence, I had no idea that dentists were limited in which painkillers they could prescribe. I absolutely thought they had the full range on offer - so if I were in the OP's shoes I would have felt very similarly. And if you've had it drummed into you that Doctors Don't Do Teeth, your GP really wouldn't be your first thought with toothache.

the OP's defence, I had no idea that dentists were limited in which painkillers they could prescribe. I absolutely thought they had the full range on offer

They can prescribe the full range if they feel competent to do that but not on an NHS prescription. They would have to write a private one.

Your dentist could remove the nerves from the teeth and place a sedative dressing inside the tooth with a temporary filling until your extraction appointment, this will remove any infection and the nerve so no further pain ( ask them to access and dress the teeth) it's very similar to the first stage of a root canal treatment but more basic.

Hey op how are you feeling today?

livefrommysofa yes I thought this too.i no op is waiting for specialised treatment but an extraction is something every dentist should be able to do.
op I was also thinking have you tried emergency dentist you have to pay a one off fee but you phone them and they see you emergency apt on the day.im just wondering why no level of relief from this root has been done.

Thanks again for the advice everyone, I'm glad itsaninlawsone and betty warned me about the medicine making me drowsy etc. I ended up not taking it last night as I knew I'd be up in the night feeding and I was really worried about being drowsy or disoriented. I didn't get much sleep, I kept trying the Orajel and ice packs which helped a bit, but still really painful.

Then this morning I took one capsule and went back to bed. It seemed like it didn't do anything for about half a hour then it definitely kicked in and for the first time in ages my tooth didn't hurt! I was so tired I fell asleep almost straight away, probably a combination of the medicine making me sleepy and not having slept properly in days. I'm still feeling a bit woozy now and it must be starting to wear off as I can feel my tooth hurting again.

I'm going to carry on with the paracetamol, Orajel, ice packs etc, and try to only take the tramadol when I need it to get some sleep. Also planning to phone first thing Tuesday to see if there's any chance of getting a cancellation slot sooner than my appointment.

daffodils, I'm sending you lots of sympathy, it really is awful. I hope you don't have to wait too much longer for your treatment.

live and kate, I have been for an emergency appointment (on Friday), but they don't want to do anything until I see the dentist I've been referred to. I'm not sure exactly why, I'm quite nervous at the dentist so I tend to just trust that they know what's best and not worry too much about why they're advising me to wait for this appointment.

Its probably a combination of lack of sleep, pain and the tablet.
Try taking it when you've had some sleep and keeping taking the paracetamol.
If you feel worried, take it when dh is there. You may not be a drowzy after you've taken the first few, or at all.

My dentist prescribed dihydrocodine 2 weeks ago?!
I must have a rookie one!
Go back and ask for it!
I was in a similar position as the op, although in pain after having the teeth removed.
It took almost a year after the referral to finally get the bastards removed.
That was down to a hospital fault though and my dentist harassed them relentlessly in the end.
Good luck op.

I went to a private dentist when my NHS one wanted me to wait weeks for a root canal. Cost was hard to bear but absolutely worth it. I guess this may not be possible if you've needed a referral but is it worth looking at?

Dental pain is the WORST. I don't know how you're coping. But glad you have somehow so far!

Hope you don't have to wait long for treatment, dental pain is absolutely horrid! And not being able to take NSAIDs really sucks, I can't take them because of a history of gastric ulcers (and asthma now but that was diagnosed after I stopped taking them so don't know if it triggers attacks in me), often find medical professionals still tell me to take them/don't bother to think of an alternative.

"Why do your teeth need extracting? Normally when there is tooth pain it's because of an infection. Most dentists will drill a hole to ease pressure and prescribe antibiotics before eventually doing whatever work needs doing. Getting them extracted seems very drastic. I would just go see a different dentist."

Usually if there's severe toothache it means the dental pulp is infected and the treatment for that is a root canal. A few reason an extraction might be chosen rather than a root canal. The tooth is severely decayed and could not practically be restored. The mouth is crowded or the tooth 'impacted' (not correctly oriented) so it would be helpful to extract it anyway. The patient is poor; an extraction is cheaper than a root canal and much cheaper than a root canal and crown. The NHS dentist doesn't want to do the root canal they're legally obliged to because the NHS contract means they'd lose money on it.

(Since the current NHS terms, which are a total ripoff for dentists, were introduced a decade ago the quality of NHS dentistry has taken a nosedive. Go private if you can afford it.)