I’m having my wisdom teeth pulled on Wednesday, and the dentist is only sending me home with some antibiotics, no painkillers. He said that that I don’t need them. I said that I’ve had four teeth pulled before and I KNOW that there’s going to be loads of pain involved, especially since my lower wisdom teeth are hooked into the bone and part of my mandible will need to be cut out.
So I need to attempt to find something over-the-counter. Any advice is appreciated as I’m a wimp and completely terrified.
Don’t be scared. Last summer I had my last wisdom tooth pulled. Not fun as they couldn’t put me under and how they did the sutures (anchored it to my cheek). As for the pain, I would suggest just getting some iprobufen 500 mg, which is over the counter. That should really keep the pain to a min. I used it and didn’t have any problems.
OTC pain meds are all really soft-core. Try something with two active ingredients, like an aspirin codeine mix, or paracetamol (acetaminophen) with codeine. Ibuprofen is a lot like aspirin in effects and level of pain relief. Any stronger pain medication is going to be hard to find OTC. The next level is minor opiates, like propoxyphene, dextropropoxyphene, and codeine, or unrelated things like tramadol (again only by prescription). Doctors here seem much more reluctant (than their Western counterparts) to prescribe pain relief to outpatients, perhaps from a long culture of drug represssion and erroneous association of minor opiates with drug abuse.
Some people get really good effects with mefenamic acid, a period pain medication, but I have no idea what brand names you’ll find it packaged as here in Taiwan.
OTC pain meds are all really soft-core. Try something with two active ingredients, like an aspirin codeine mix, or paracetamol (acetaminophen) with codeine. Ibuprofen is a lot like aspirin in effects and level of pain relief. Any stronger pain medication is going to be hard to find OTC. The next level is minor opiates, like propoxyphene, dextropropoxyphene, and codeine, or unrelated things like tramadol (again only by prescription). Doctors here seem much more reluctant (than their Western counterparts) to prescribe pain relief to outpatients, perhaps from a long culture of drug represssion and erroneous association of minor opiates with drug abuse.
Some people get really good effects with mefenamic acid, a period pain medication, but I have no idea what brand names you’ll find it packaged as here in Taiwan.[/quote]
Good luck. I agree with Namahottie: ibuprofen is an excellent pain reliever. It’s value is increased in my book by being psychoactively inert. No buzz, no fun, but more importantly no pain.
If you decide on paracetamol, don’t consume it too near any consumption of alcohol. Doing so can cause fatal liver damage (it’s a particularly gruesome way to croak).
[quote=“Wikipedia”]Paracetamol is contained in many preparations (both over-the-counter and prescription-only medications). In some animals, for example cats, small doses are toxic. Because of the wide availability of paracetamol there is a large potential for overdose and toxicity.[9] Without timely treatment, paracetamol overdose can lead to liver failure and death within days. It is sometimes used in suicide attempts by those unaware of the prolonged timecourse and high morbidity (likelihood of significant illness) associated with paracetamol-induced toxicity in survivors.
In the UK, sales of over-the-counter paracetamol in pharmacies are restricted to packs of 24 tablets per customer per occasion (only 16 tablets in non-pharmacy stores). In Ireland, the limits are 24 and 12 tablets respectively. In Australia, the limits appear to be 100 and 24 tablets respectively.[citation needed]
[…]
Chronic excessive alcohol consumption can induce CYP2E1, thus increasing the potential toxicity of paracetamol.[12] For this reason, other analgesics such as aspirin or ibuprofen are sometimes recommended for hangovers.
If you’re looking for OTC, just go to Cosmed or Watson’s instead of a pharmacy. If you go to a pharmacy and can communicate to them your situation, they might be able to fill the prescription you need. You might be able to get something that is not technically “OTC”.
If you’re stuck with OTC, paracetamol tablets with small amounts of codeine are OTC here. Paracetamol is toxic in high doses; don’t try to take more than the suggested dosage. As a note of interest only, not as medical advice, paracetamol is fairly easy to extract from the tablets. On Wikipedia’s Cold Water Extraction article, they mention that you can grind up a tablet, mix it in hot (not boiling) water, and then cool the liquid to lower than 40 degrees C (in a refrigerator). Then use a coffee filter to strain out the paracetamol, and the codeine that remains in the water can then be ingested.
Alternately, you could get a sleeping pill and sleep it off. My dentist suggested I could have gone back to work after my wisdom teeth were removed, but I was too scared my class might suffer if I were to try teaching with a numb face. I took that day off work instead.
My boss made a joke about getting my wisdom teeth removed. She said: “Don’t forget to brush the empty holes.”
You guys are awesome - thanks for the advice! I’m going to stock up on ibuprofen tonight, and get a package of paracetamol (just in case). And good to know about the how-to for codine separation.
I don’t suppose dentists here use nitrous oxide during extractions? When I was 14 I remembered being offered it when i had some premolars out and it was …dreamy. Was able to completely shift my focus from the hacking/griding/wrenching going on in my mouth to the floral patterns of the ceiling tiles. But they probably don’t offer such an extravagance here…
The reason that codeine is available OTC is that it is not very strong. Extracting more codeine will not necessarily give you a higher pain relief ceiling, just make you more constipated and depress your breathing. Don’t do it. The method you have described is for desperate junkies who can’t find any heroin.
People have died from less than a bottle of 20 pills of paracetamol. that’s Tylenol for you Americans out there. It is a nasty way to commit suicide, and is often the drug at fault in young women’s suicides, where they don’t actually want to commit suicide but just to look like it… and then their liver shuts down five days later and they can only be rescued with a liver transplant. That is why paracetamol is now only available in blister packs, not free-packed bottles in Australia and NZ for example.
Paracetamol is very variable in its toxicity as it really depends on how much of a detoxifying molecule called glutathione is present in the liver to prevent toxicity in the person taking it. Glutathione had been previously depleted in many of the cases of low-dose toxicity. Women with smaller bodies have smaller livers, thus less glutathione, and hence are more susceptible. Eating less sulfur-containing foods also limits the amount of glutathione you make.
I always prefer aspirin anyway, as it has a higher ceiling of effect, it has a better toxicity profile, it is much more anti-inflammatory, and it has a better pain relief profile. Paracetamol has gained ground on aspirin as it is better for children for one reason only: a very small number of children given aspirin develop Reyes syndrome, a nasty hypertemperature disorder that can kill them quickly, but pretty much only presenting on top of a bad fever anyway. This is not a concern for people over 15 years old.
Ibuprofen is an analogue of aspirin so the exact same reasoning applies. Another analogue is naproxen. Do not add any of these pain meds together!
COX-2 specific inhibitors like celebrex and Vioxx have been withdrawn from market for causing rather than relieving heart attacks.
Ha, ok. I did a very bad job of kidding up there. I doubt I’ll be desperate enough to extract codeine on my stovetop. Unless… (also kidding)
You also said you have a preference for aspirin, but I personally worry about its anti-clotting effect. This is especially prevalent in women, for some reason. I worry that if I take straight aspirin my poor little sockets’ll never close up and I’ll be spitting blood for the next week to the wide-eyed horror of my kindy class.
I ended up buying a couple boxes of ibuprofen (granules. for some reason they didn’t have tabs) and a just-in-case-it’s-so-bad-i-want-to-risk-death box of Remedol (paracetamol).
the ibuprofen also stops clotting… like i said, it is basically a congener of aspirin! don’t let that stop you using it, there are more ways to clot than just relying on platelets (which is what aspririn and other NSAIDs block). you will still clot OK, just half as fast.
sorry i missed your irony with the extraction.
might i suggest some acupuncture? it has worked for pain relief for me in the past.
So I went in expecting to come out completely wisdom toothless, but no. Is it really mandatory here to only take out one at a time? My local friend who went with me says that’s the way it’s done because a little boy once had multiple teeth extracted and died as a result. Thus, one out today, one out on Friday, and repeat for next week. How strange.
I’d like to say thanks for all your advice on this. It wasn’t nearly as scary as I expected, and they even gave me my tooth as a souvenir. The novacaine’s still in effect so I’m not sure how crappy the pain’ll be in a bit, but I downed a couple packs of ibuprofen granules to head it off.
I’d also like to say that the dentist who did it -it was at Tai-Da- was much, much better than the dentist back home who did my previous extractions. There was only a little bit of pain, whereas in Minnesota they seemed to have completely missed my nerve with that damn needle and I left me writhing in agony until they (slowly) refilled the syringe. It was also much quicker here, just some drilling and some hammering and it was out, as opposed to those bastards in MN who practically pulled me out of the chair with that damn wrench.
Yes. So if you need your wisdom teeth pulled, go to the Tai-Da hospital down at gungguan, along Keelung Rd. And I can’t believe that what would’ve costed US$8,000 in the states is going to be 150NT a pop here. Amazing.
This might be too late…but there are drugstores that sell prescription drugs … well without prescriptions. I had gotten some stuff for viral infections in those places before, drugs that would require a prescription in the states. Yes, it’s the real stuff, and no they don’t ask you for any documents. I was amazed. I assume they have all kinds of other meds like codeine, xanax, vicodine. However that’s just an assumption. They seemed like they had everything, it was a very large, non-shady pharmacy.
I thought it was common knowledge that you don’t need a prescription for anything in taiwan, no?
Unfortunately I don’t member the name of that store, or even where it is sorry. Try asking your local friends, they might know. Be careful tho, there are small ghetto stores that scam you. But there are also legit ones.
