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PostPosted: Tue Jan 31, 2017 7:46 pm 
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I have read some others experiences in here and they have been very helpful, just wanting to get some personalized advice. I am about to have major dental surgery, extracting all of my remaining top teeth and one bottom tooth for a total of 14 teeth. I will be sedated in the office for the surgery itself and will have a immediate upper denture put in place before I leave. Some of the extraction will be complicated extractions, meaning he will have to cut at my gum as the teeth have broken off below the gum level. I am very nervous about the whole thing and my main concern is pain management afterwards. My oral surgeon is aware that I am on Subutex and has had a brief conversation with my sub doctor to be sure he could prescribe me pain medication. I have mentioned my concerns to my sub doctor but he seemed to brush it off and not really give me much advice. So I am not sure what to do and as my appointment gets closer I get more and more worried.

First of all, I have tapered down to a low dose of Subutex, currently taking .75 mg a day. My question is at this low of a dose will any prescription pain medication work? I really don’t want to go off my Subutex just to try to take pain medication as that seems like it would even farther complicate matter, but I can if that’s advisable. Would it be better for me just to up my Subutex dosage and spread it out through out the day to help with pain? My doctor has me prescribed more than I take at the moment so I can use it for my dental pain as needed so I will have enough to do this. I also plan on utilizing Ibuprofen and really hope I can try to get along with just that but after extracting so many teeth I am really worried I will need something more than that, at least for the first couple days. I have been in recovery for 3 years now and have a very supportive husband who will be in control of the medication for me and will dispose of any remaining pain medication once this is over so I am not really concerned about it causing a relapse. I just don’t want to be in terrible pain.

Also, one other question. Will my Subutex interfere with my sedation? I tried looking on the website to see what they use for sedation but it doesn’t say. I am worried that it either won’t work or that the combination of what they give me in addition to my Subutex will cause an overdose. Is that possible? For this reason if for no other, would it be better to try to go off for a few days before hand?

Any help or advice is much appreciated. Thanks!


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PostPosted: Wed Feb 01, 2017 12:50 am 
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Hi Issa- I had implant surgery in October. Bone graphs and all. Like yourself, I worried a lot about the anesthesia. I was on 16mg/day and I was out the entire time of the procedure. That is what I paid him to show up for!! They watch you very, very closely and as long as the dr is aware of what you are taking-I wouldn't worry at all about that. As for pain management afterward-I can't speak too much on that. I was prescribed Tylenol 3 and tramadol-but they did nothing to touch the pain. I took them before I tried the ibuprofen because I thought I would need them for the pain. But I will tell you-splitting the Subutex up into multiple doses a day and staying ahead of the pain with ibuprofen worked like a charm. I was still sore but nothing like what I had imagined. What really helped was that my doctor and I made a plan (I know you said your dr brushed it off). Good luck and others will chime in too


Edit-I pressed submit before I was finished reading/proof reading!! Ugh


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PostPosted: Wed Feb 01, 2017 1:24 am 
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i've heard that even being put under can cause a relapse. no info on someone on subs though.
i've had a total of 14 teeth pulled in my life. 8 was the most i had out at one time and involved only 10 stitches total.
this was many years ago when drs and big pharma weren't pill happy, but i was never advised to take anything stronger than tylenol. i was young and bounced back quicker than an adult would i would think.

could you try to take motrin for the pain and see how it goes?
and take more of your subs?

i would think that the pain meds wouldn't have much effect being on an opiate blocker.

good luck with your surgery. mashed potatoes with obscene amounts of butter is still a favorite. it was the first time i ever had instant potatoes!

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Get your shit together and live your life." Black Snake Moan


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PostPosted: Wed Feb 01, 2017 12:33 pm 
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Hello Issa,

That you've tapered down to below 1 mg is excellent. I'm far from an expert but you're well below the "ceiling effect" at that dosage. I'm guessing the best thing to do would be to take an increased dose of
subs on divided schedule....rather than have to take relatively large doses of an opiate. Again I'm no expert,
but even though you're below the ceiling effect my guess is you'll have to take more drug than "normal" to overcome the subs.

I've had some fairly substantial tooth pain after dental procedures and tylenol has always worked well for me. But you're having a lot more done than I ever have. Another guess is that the pain won't last more than a couple days. Hope so anyway.

Others should drop by with more advice/suggestions. And if I've made a mistake above I'M hoping someone will correct me.

Best wishes,
Godfrey

P,S. No problem going under while on buprenorphine as long as doctor knows about it. I've never heard that general anesthetic puts addicts at risk, but that doesn't mean it's not true. I've just never seen it proposed or discussed. In any case you've got no choice. I'm sure you'll be fine, because just about every post I read like yours turns out well!


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PostPosted: Thu Feb 02, 2017 2:31 am 
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Good Luck ISSA. I don't think think that sub will interfere with anesthesia, but could complicate pain control after. I had oral surgery while on 2 mg and was RX 5 mg hydrocodone pills. Three pills worked well for the pain. I noticed that although the pain was controlled I didn't have any mood altering effects.


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