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Ask Mark Bornfeld, DDS Your Own Question
Mark Bornfeld, DDS
Mark Bornfeld, DDS, Dentist
Category: Dental
Satisfied Customers: 5990
Experience:  Clinical instructor, NYU College of Dentistry; 37 years private practice experience in general dentistry, member Academy of General Dentistry, ADA
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I before I ask my questions I think I need to give you

Customer Question

Hello, I before I ask my questions I think I need to give you some history...
Approximately 2 weeks ago I have both sinuses lifted with 4 bone grafts by an oral surgeon which cost me, what I think, was a tremendous amount of money...approxitmately 12K!
Last Monday, just over a week post-op, I had to board a plane for work to South America from Houston. The pain experienced on that flight I can't even describe. Anyway, my return flight was last night and I'm still in a lot of pain and haven't slept. I have swelling, intense sinus headaches all week, my upper teeth are all sensitive, including the ones that have had root canals and caps on them. Also, while working last week I've been experiencing what I believe to be vertigo. I fell on several occasions after getting up from a seated position.
Anyway, my oral surgeon is out of town until Tuesday and my pain is unbearable at this point. With all the new restrictions on pain meds I'm not sure what the easiest way is to get a prescription for a couple of days of pain medications to help me until I can get into his office the first thing Tuesday morning.
What would be your recommendation at this point?
Submitted: 1 year ago.
Category: Dental
Expert:  Mark Bornfeld, DDS replied 1 year ago.
Hello-- I'm Mark Bornfeld, DDS. Welcome, and thank you for putting your trust in me!
Let me lead by saying that you're not going to be able to obtain a prescription for prescription pain medication without being personally in the presence of a prescribing doctor-- regulatory agencies have become much more restrictive in allowing doctors to provide access to controlled substances. However, you can take advantage of recent research, which shows that the simultaneous use of particular combinations of over-the-counter analgesics provides pain relief on par with prescription opioids like hydrocodone or codeine. More specifically, ibuprofen and acetaminophen work by different pain relief mechanisms, and their respective actions are synergistic. The recommended regimen is to take 600 milligrams of ibuprofen (3 Advils) with 1000 milligrams acetaminophen (2 extra-strength Tylenol tablets) every 6 hours, as needed. Please note that this regimen is not recommended for patients with a history of peptic ulcer or liver disease, and should not be taken in combination with other medications that are toxic to the liver, including alcoholic beverages. This is the regimen we use in the urgent care clinic of the dental school, where the provision for opioid medications is not permitted, and it is quite effective.
The onset of pain while on your flight is also a known phenomenon-- a result of fluctuations in cabin air pressure , and known as "barodontalgia". It is more likely, though, that considering your recent surgical intervention, you currently have sinus inflammation. You should also consider taking an over the counter nasal decongestant to promote dissipation of pressure gradients in your sinuses, which will help with pain relief.
Hope this helps...

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