Orthos & PK's

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#1 Post by **breal87** » Tue Feb 05, 2008 7:42 pm

How come orthodontists CAN'T perscribe painkillers like vicodin or percocet to patients? I thought they were licensed dentists, is it different in any other places than the United States?

#2 Post by **gabi** » Tue Feb 05, 2008 8:39 pm

I don't know if orthos can perscribe the painkillers, but your primary physician should be able to. I usually call mine when I'm out of vicodin. My ortho doesn't like the fact that I am able to get the meds from my physician - he feels ibuprofen should be enough...too bad. I don't know if he is 'able' to prescribe them if he wanted to.

#3 Post by **markuhde** » Tue Feb 05, 2008 11:10 pm

More curious why would you NEED narcotics for ortho? Should we start prescribing every teenager and pre-teen kid in braces narcotics? If not, why should we get them as adults.

So far (8 months in, on a square wire on the bottom - thick round wire with a power chain on top) I've had two ibuprofen - and that was for spacers on top.

I won't claim it's been painless, it hasn't. But I've been able to tough it out with only a little ibuprofen at first. The whole concept of narcotics seems ridiculous. No offense, but narcotics are supposed to be reserved for pain so severe in interferes with your daily life.

I strongly suggest you get off the narcotics NOW before you become addicted and that you see a counselor if you are addicted. Ibuprofen *should* be enough.

P.S. Lest you think I'm being too hard on you. It's in love, I've seen what can happen - a good friend of mine's dad got addicted to narcotic painkillers and turned into a totally different person - almost a monster of sorts. Eventually walking out on his family :'( I don't want to see you in the same place.

#4 Post by **breal87** » Wed Feb 06, 2008 10:30 am

Hi, i never said i was "on" narcotics. It was just a question about whether orthodontists are licensed to prescribe such medications. I've never had to take pain killers to ease my pain with braces other than simple ibuprofen, it was just an innocent question and i didn't see that anyone has brought it up in the forum and meryaten answered with a short and sweet answer!

Thanks for your concern though

#5 Post by **gabi** » Wed Feb 06, 2008 10:42 am

My narcotic use is for TMJ PAIN, not ortho.

#6 Post by **breal87** » Wed Feb 06, 2008 10:43 am

just out of curiousity gabi, does your ortho specialize in TMJ or do you have a separate doctor who deals with TMJ who prescribes your medication?

#7 Post by **Lisa65** » Wed Feb 06, 2008 10:57 am

In the UK, all orthodontists are dentists, and dentists are allowed to prescribe certain drugs and preparations from an approved list on a special dentist prescription form. I've just looked at the list and it does contain some of the milder narcotic pain relievers, although not the more potent ones.

Anyway, there's a big difference between a few pills of vicodin when you have a bad toothache, or having morphine IV post-surgery, and being a narcotics "addict". It's like saying that everybody who enjoys a can of beer while watching the football on TV is in danger of becoming alcoholic.

#8 Post by **breal87** » Wed Feb 06, 2008 11:03 am

thanks lisa, i was especially interested how the process works over seas in such places like the UK, since I am in Washington D.C.

that was really helpful!

#9 Post by **gabi** » Wed Feb 06, 2008 2:20 pm

My ortho does specialize in TMJ - he has come highly recommended - but I am yet to have any relief from him. I was better before the braces, but I have to keep thinking that things will get better. He does not prescribe the meds, I get them from my internist/primary physician, who has been very...patient with me. I had been off Vicodin for several years due to a really good TMJ dr, but since the braces were put on, I have had days where I would take ANYTHING to get through the pain. I told my internist that Vicodin had helped in the past and he called in the rx. I have been doing pretty good, needing it only every few days, until last week. I don't know what happened. I've had to take a couple V a day and my splint isn't helping.
I am always aware that V is addictive (I have a family history of addiction), but it is the only thing I have found that can allow me to function at work. I hate that I have to have it, that I panic if I think I've forgotten it at home. I suppose I already have an emotional addiction to it, like a security blanket, but I don't want to end up in the position I was before- being willing to take other peoples meds (they offered) to get relief.

Sorry if my first post to on this thread made me sound like a junkie. Heck, this one sortof does too. *sigh*

#10 Post by **Beckster** » Wed Feb 06, 2008 2:29 pm

Gabi,

To me you do not sound like a junkie at all...When pain is so severe that it prevents you from functioning that is when it is time to turn to the most powerful medication. And it looks like you have made that distinction....To me, you just sound like someone trying to improve your TMJ condition, and from what I hear the process to get rid of it can be painful...Good luck w/everything hun!

~Becky

#11 Post by **markuhde** » Wed Feb 06, 2008 3:12 pm

For the TMJ I can understand the mild narcotics, I know that's very severe functional pain. I was under the mistaken impression that they were for orthodontic pain. For ortho pain, narcotics would be insanely overkill. I just know what those drugs can do to a person... and it's incredibly scary.

"Mark - I think it is important to realise that just because one person's experience with braces may be relatively (or entirely) pain-free, this does not mean it will be the same for everyone. There are times when it is better to pop one or two doses of Vicodin (or similar) to sort pain out once and for all, than it would be to take prescription strength ibuprofen for several days, and perhaps still not get adequate relief. "

Meryaten, I'm sorry but I cannot imagine narcotics EVER being appropriate for pain from braces. They're incredibly dangerous, mind-altering drugs.

Before you argue with me, do you think it would ever be appropriate to provide a more "traditional" (say 10-16 year old) orthodontic patient with narcotics? I didn't think so... And it shouldn't be different for us because we're a little older.

#12 Post by **breal87** » Wed Feb 06, 2008 3:34 pm

Mark -

My original post was not about prescribing narcotics such as vicodin and percocet to teennagers. I thought this was an adult braces site - I believe it is appropriate to have PK's prescribed for orthodontic/TMJ pain through the primary physician as needed. People who abuse these drugs are not responsible enough to have them prescribed for this situation. People who have addictive personalities are not recommended to take these drugs in any case regardless of ortho pain - or if they are they need to be monitored for the drug use

Thanks for listening

#13 Post by **markuhde** » Wed Feb 06, 2008 3:39 pm

No, my point is that why would adults be any different from teens. We're facing the same pain they are. Why would narcotics be justified for us?

#14 Post by **gabi** » Wed Feb 06, 2008 3:43 pm

Meryaten - thankyou for sharing your viewpoint - I have the same. I know I shouldn't take things so personally on messageboards, but I do and took Mark's post hard...the vicodin had warn off.

Ibuprofen doesn't work anymore and taking 4+ OTC at a time was affecting my stomach. I had originally written a whole lot more than 'My narcotic use is for TMJ PAIN, not ortho.' But then I read my previous post and I did forget details.

Becky -thankyou for your words of encouragement. The kindness I have seen on this board is amazing. I am glad to have found it.

Mark - I understand your viewpoint and can agree that narcotics can be overkill, but I think there are exceptions. Narcotics affect people differently. For me, they relieve pain and make me happy/energetic. For my boss, they make her extremely drowsy and she cannot function. For my sister, she gets 'bugs'. As weird as it may be, I dont' mind the orthodontic pain and somewhat welcome it, as it is at least different than what I usually deal with. I do agree that it is hard to imagine giving a tween/teen a Vicodin, but it would really depend on the child.

#15 Post by **breal87** » Wed Feb 06, 2008 3:43 pm

like meryaten said - everyone's situation is different. Some people/teens don't have as much pain as others. Some people don't encounter painful TMJ problems like others do so I think if it hurts that bad, it doesn't hurt asking the doc what types of pain reliever options you have whether you are a teen/adult. If you are under 18 and are prescribed narcotics, they should be closely monitored by the parent/guardian

i can totally understand your concerns though