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PostPosted: Sun Dec 26, 2010 1:15 pm 
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Ok this is what's going on. Been on Suboxone for 6 months DOING GREAT! finally able to take care of my teeth financially lol. On my 4 front teeth i already had the root canals and caps, but that was 25 years ago, well the caps are coming out, and since that is the only teeth i have in the front. The dentist is going to remove the 2 left and take out the remainder of teeth pcs left in the front, so i can get dentures.........I have not had any surgery/pain since being on SUB. I'm only on 4 mgs a day....But still need that to stay off the Opiates.......Is their any preparation or anything i need to know before going in for this teeth removal????????.....I did mention on the inital paperwork that i was on Suboxone, but he didn't mention anything. I go back Tuesday for the prep., so i will mention it to him about the Sub. just in case he just looked over it....Just want feedback from my freinds on this forum, about this issue....thanks


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PostPosted: Sun Dec 26, 2010 1:44 pm 
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Well jlfinfo,

From what I have learned here, you can stop the subs 24 to 36 hrs. before and get on opiates for pain. Then, I beleive you can go back on the subs. Wait for others to reply, they can give you details on what I have just said.

I have also read here that some were able to do it without stopping the subs. Seems the sub controlled their pain well enough.

Either way, good luck. Dental work is always uncomfortable as it is. Make sure the dentist addersses the Suboxone issue. It's as if as thought they don't want to deal with it. But, they have to. It's improtant.
I, myself have to go for dental work & I am afraid of the pain.
Let me know how it works out. Again please wait for more details from the other members.

Love, Queenie


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PostPosted: Sun Dec 26, 2010 2:30 pm 
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If you are going to require full agonist opiates, then you can go off the sub 2-3 days before the procedure. You will need more than the average amount of pain meds, however, since you are on suboxone. You might want to have your sub doctor consult with your dentist so the dentist knows how best to treat your pain. Beware though, some people have tapered down their dose and stopped the sub 2-3 days before the procedure and still were unable to get decent pain control. Don't underestimate the power of ibuprofen when it comes to tooth pain, you're probably going to need to take that as well. Hope this helps.

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PostPosted: Mon Dec 27, 2010 5:28 pm 
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ABSOLUTELY! Ibuprofen can be taken in doses of 800 mg, three times per day-- or 600 mg four times per day. It has anti-inflammatory actions that make it more valuable than opioids in many cases.

Also don't forget my e-book (shameless plug!). This is the type of thing that the book is about-- surgery, pregnancy, etc. Buprenorphine 'holds' one's tolerance at a level of about 60 mg of oxycodone per day, so it generally takes doses of oxycodone higher than that in order to get pain relief. My usual approach is to have the person cut the dose of buprenorphine to 4 - 8 mg about a week before the surgery (you can stop the day before, but the half-life is LONG). Then I have the person continue the 4 or 8 mg dose of buprenorphine and give oxycodone, shooting for a total dose of about 60 - 180 mg per day, depending on how painful the surgery is. I prescribe, for example, 15 mg of IR oxycodone, and have the person take one or two tabs every 4 hours-- two would be 180 mg of oxycodone per day. Some docs shudder at that dose, but I have found that it simply takes that much in some cases.

If the person stays on some small amount of buprenorphine throughout the entire period of time, then there is no need to go through a period of withdrawal before increasing the buprenorphine. But if the surgery is very significant-- for example a total knee replacement, or coronary bypass surgery (I've had patients who had those operations while taking buprenorphine), it works best to stop the buprenorphine completely-- that way the agonists can have their effect without being blocked by buprenorphine. But in such cases, the person has to do the 'induction' thing over again, i.e. go into withdrawal before restarting buprenorphine-- otherwise the person will have precipitated withdrawal to the Suboxone.


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PostPosted: Sun Mar 13, 2011 9:51 am 
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Wow thank you Doctor! I currently am shuddering at the thought of pain from my upcoming dental surgery. I got to have a full mouth extraction! Gum disease is the culprit. I need both upper and lower dentures too so first all my teeth must go and I still have ALL of then with the exception of my upper wisdom teeth so as you might expect I'm nervous. My dentist is aware of mu suboxone and I just mad my Dr. aware of my procedure so I'm going to attempt to get these two to communicate over what to do about aftercare. I can take a substantial amount of pain but dental surgery makes me a little "weak in the knees" lol I been on Suboxone (8mg per day) for a little over 8 years now. Fentanyl lollipops have been suggested but I have no idea about anything related to this topic so it's nice to see a post like the above ones. I think I'll just start a new thread so I hijack this one..lol


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PostPosted: Sun Mar 13, 2011 10:04 am 
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CCrider - Check out the "Links" section on the main index. There are a couple of articles/papers on treating acute pain in suboxone papers. After reading them, you might want to even give copies to both your sub doc and your dentist. You'd be surprised how many sub docs are happy to have them. Good luck.

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PostPosted: Mon May 02, 2011 7:35 pm 
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I'm in the same boat, but less concerned I guess.

I've had plenty or root canals etc, and never even filled the vicodin prescriptions. Everyone's pain level is different though.

I'm going in for a root canal Thursday and having a dental implant to replace a lost tooth next week. I know that only the highest amount of opiates would help so I'm not even bothering. I also know that ibuprofen helps headaches but has never helped me in particular with pain aside from that.

I do know that alcohol helps. No, it's not the best idea, no it's not healthy but when I have no other choice, a few scotches post dental surgery will get me through the first night and I'll deal with the rest the next day.

Maybe you could go in for an additional novicain (sp?) shot the next day to numb things up and buy you time? no idea here but just a thought?

I mentioned that I was on Suboxe to the doc and they said there were some meds I could work with but I didn't bother considering my tolerance anyway to meds. Just gotta deal I guess. One word of advice though, never put of dental needs. And if you have exhausted your ideas, stop worrying about it and deal with it when the times comes. Often that anticipation is far worse than the pain.

Ice may help to some degree of course and over the counter tooth numbing solutions.

Just trying to help by adding ideas. not sure if it will though. Be calm and remind yourself it'll only last a little while. Hardly the pain you've dealt with from the meds we've taken and the withdrawels we've experienced. JMHO.


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PostPosted: Tue Jul 05, 2011 5:43 pm 
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Yeah, I think your tolerance to medication has a lot to do with your reactions to them. If your body has built up quite a bit of resistance, then you may have a more difficult time feeling the effects. The important thing is to make sure your doctors always know what medications you are on. That way, they will be more able to provide you with options.


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PostPosted: Tue Aug 05, 2014 12:31 am 
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There will not be more problem with post operative pain when placing implants.To the point that if there is swelling or pain a day or two after placement you generally have a problem which should be dealt with infection based.

In some cases, moderate to severe pain usually does not last longer than 24-72 hours, sometimes peaking on the 3rd postoperative day. Relief should begin on the 4th post-operative day.

Get the best advice of your best dentists in the cosmetic dentistry upon the implant surgeries and it's post care procedures.

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