Dental Pain During COVID-19? Here are Two Strategies.
During the current pandemic, most people are left without access to their dental office. Sadly, some of my patients are going to experience varying degrees of dental pain during this crisis, and will wonder what to do. Guidelines state that if dental pain can be managed by over-the-counter pain medications (also known as OTC analgesics), then a patient should not be seen in the dental office for now. And even if they are seen in a dental office for something urgent, our current menu of treatment options is very limited.
So how can someone safely use OTC drugs to their maximum effect if they are experiencing mild-to-moderate dental pain? I'd like to outline two strategies using Advil and Tylenol to answer that question.
But first let's get some context by talking about the safety limits for these two medications.
1) Advil (Ibuprofen): An otherwise healthy adult without allergies or other complicating factors can safely take up to 2400mg within 24 hours.
2) Tylenol (Acetaminophen): That same healthy adult can also take up to 4000mg of acetaminophen each day from all sources. That last part is really important. If you're taking any other medications, check if they include acetaminophen as part of their formulation. Acetaminophen is part of what's in NyQuil, Norco, and many other medications people take on a regular basis.
Many patients don't know that Advil and Tylenol can safely be taken together as long as there are no underlying problems with either drug.
The two drugs work on different receptors and in different parts of the body, so they don't interact. When taken together as outlined below, the effect is just about as strong as taking a weak opioid.
Okay, so let's talk strategies. Again, these assume: a) adult age, b) that there are no other health problems, and c) that there are no other medications on board that will interfere with or add to either drug dose.
If you are unsure, talk to your dentist, pharmacist, or other qualified health professional. You can always reach out to us at Quest Dental by text, email, phone, Instagram (@dr.lassen.dds), Facebook, etc.
Hit it hard, knock it down. Take the drugs together for maximum effect.
Take 600mg ibuprofen and 500-1000mg acetaminophen at the same time. Repeat every 6 hours as needed.
This strategy might be best if your pain is on the higher end of "moderate" and you just need to get on top of it, now. Some examples of when this strategy might be useful are right before bed to help you sleep through a night, or for significant post-operative pain following a surgery as your anesthesia is starting to wear off.
This approach will ensure maximum OTC pain reduction, while balancing the need to take pain medications relatively frequently.
You could take 800mg of ibuprofen every 8 hours, but ibuprofen often wears off sooner than 8 hours, so I don't really recommend this. There also doesn't seem to be a big difference in pain reduction between 600 and 800mg of ibuprofen. The down-side to Strategy #1 is that dental pain sometimes returns one or two hours before your next dose, which means you could feel pain again before you can safely take another dose.
Stagger the drugs for a more continuous effect.
a) Take 600mg ibuprofen at the onset of your pain.
b) 3 hours later, take 500-1000mg acetaminophen.
c) 3 hours later, take 600mg ibuprofen
d) 3 hours later, take 500-1000mg acetaminophen
Repeat as needed until pain is resolved.
This is the strategy I most frequently advise patients to employ. Obviously, the downside here is that you don't get to hit the pain as hard with two separate drugs at the same time. But the upside is that you get to take an analgesic every 3 hours, which may keep you more continuously comfortable.
Stay on top of your pain the best you can. Even if you think you can tough it out, if dental pain gets away from you, it can be really hard to get under control again (ask me how I know...) Don't try to be a hero if something significant is going on.
Take comfort in knowing that the above dosages have been studied extensively. If you under-dose yourself and the pain becomes too intense to manage with OTC medications, you might end up being prescribed another drug you may not have otherwise needed, like an antibiotic or an opioid.
Antibiotics and opioids carry their own significant sets of potential risks and adverse reactions, so if they can be avoided, they should.
My final parting thoughts: treating dental problems with pain medications is never a good long-term solution.
Obviously, as a dentist, I want to solve dental problems for my patients in a definitive way, like doing that filling a person needs, or covering a broken tooth with a crown. Unfortunately, the current pandemic has made both of those procedures temporarily illegal to perform.
As such, I want everyone to have the tools necessary to keep themselves as healthy and comfortable as possible.
Please also remember that if you are experiencing severe pain despite using the strategies described above, or if you have some other significant dental or mouth-related problem, please reach out.
We're still here for you, and we'll find some way to get you through this crisis. You don't have to suffer needlessly. Visit us at questdental.com/contact or call 541-688-7278 for instructions on how to connect with us.
And in the meantime, stay happy, healthy, and safe. We at Quest Dental are very much looking forward to the privilege of seeing you in our office again as soon as it's safe to do so.