pattie asked
I was directed by my dentist to take 600mg of ibuprofen and 1,000 Tylenol (acetaminophen) for pain. 5 hours later, I am in pain again. At a previous visit, he gave me hydrocodone/acetaminophen to take. Could I still take this?
Answer
If you have a previous prescription for hydrocodone/acetaminophen left over from a prior appointment from the same dentist, I would recommend you reach out to the office to check if the dentist would recommend you take it if needed. Depending on the dose, the age and specific directions of the old prescription, they may want to change it to something that better fits your current needs.
Some dentists would prefer to give you a prescription specific to your most current procedure so they have your medication history properly documented and the correct directions on the bottle based on how they would want you to take the medication now.
Hydrocodone For Dental Pain?
Depending on the procedure you got, they may not recommend hydrocodone as an option at all as safe and effective management of acute dental pain can often be accomplished with nonopioid drugs. In fact, the pain relieving ability of non-opioid drugs is very much underestimated in many cases.
There are multiple studies that show non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, are actually more effective at managing acute dental pain than two popular opioids, hydrocodone and oxycodone, at conventional doses. Another positive of NSAIDs is that they contain anti-inflammatory properties that can help with swelling. For this reason, NSAIDs are commonly considered a first-line agent for most types of dental pain.
Often times, dentists will recommend the combination of an NSAID with acetaminophen as they provide greater analgesic efficacy than either drug alone and are considered synergistic when used in combination. This is why your dentist recommend both ibuprofen and acetaminophen.
Regardless of how severe your pain is, it is often recommended to try and optimize your dosages of acetaminophen and ibuprofen 'around the clock' and only add an opioid such as hydrocodone as needed for breakthrough pain. For routine procedures, it would be extremely uncommon and perhaps irresponsible to prescribe or recommend hydrocodone as your first line option.
You mentioned in your question that you are taking the ibuprofen and acetaminophen, but you don't say how you are taking them. If you are taking them together, at the same time, it may be more prudent to offset your dosages to optimize the pain relieving effects of the medications. Many practitioners will recommend alternating doses of the two medications every 2-3 hours to provide better pain coverage.
As we mentioned above, we recommend you speak with your dentist about options for your specific situation and to determine if you need hydrocodone for possible breakthrough pain.
