Apologies for any weird formatting. I'm a lurker with no idea how to post. For context, I live in the USA, asscrack of the planet.

I had a surgical extraction of a broken tooth at an oral surgeon in a town about an hour away from me. It was a little bit brutal, so I was told to load up on the prescribed ibuprofen/acetominophen and start antibiotics that evening after surgery. After the hour drive home, I went to the pharmacy that I had listed in my paperwork. They had no scripts for me since last year. I called the surgeon's office. The woman on the phone said she saw them in her system, had an hour left in her shift, and would call me if she saw them sent out. I told her not to worry, that the pharmacy would contact me as soon as they received it. I assumed there was no way they'd leave a patient without post-op meds. Well, I was wrong.

They never sent my prescriptions before closing up for the weekend.

The office doesn't have an emergency number of any kind. Voicemails or text messages can be left for them to check on Monday. What in the world do I do or even say to these incompetent assholes?

I'm managing my pain with my own medication, but it's expensive, and they sure as hell aren't antibiotics. I'm broke, if that helps.

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[–] 44 points 1 week ago* (last edited 1 week ago) (8 children)

First thing I'd do is call the pharmacy again, explain the situation, and ask if they can contact the doctor directly. This is not likely to work, but sometimes they have communication channels beyond the main office line. Pharmacies can sometimes override a prescription and offer enough of a med to get through the weekend, but not likely if this is a one-time prescription and not something you take regularly.

The only other approach is to try to get a prescription from elsewhere, like a telehealth service or an urgent care clinic, but that will require a consult which might come with a copay depending on your insurance (assuming they cover any part of it at all). You might be able to argue with your insurance that this was not your fault and they should cover it due to the circumstances, but they'll likely tell you that you should have gone somewhere in network anyways.

And this is all on top of the fact that you need pain medication, which could be interpreted as doctor shopping if you're not careful. If the original script was placed but not signed off and it shows up in an opioid control database (likely won't if it's just extra strength tylenol, but would if it's percocets), there's a good chance any other prescriber will say no and tell you that you have to follow up with that office when they reopen.

If you have no meds and the pain is unbearable, then you go to the ER. Depending on insurance, prepare for a high cost. Don't take an ambulance if you can help it.

Yes the USA is fucked.

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  • [–] [S] 6 points 1 week ago (7 children)

    The pharmacy has been as stumped as I am because the Rx was never placed, but those are great ideas. Ive been afraid of being labeled as a malingerer iin this process jsut because pain meds are involved. So sad! Thank you for your suggestions and feedback!

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  • [–] 8 points 1 week ago* (5 children)

    Ibuprofen/acetaminophen are not narcotics, they're prescription doses of over the counter medications (acetaminophen in particular can destroy a liver if overdosed, hence "prescription strength"). Go to the pharmacy, ask the pharmacist what their advice is and what options you have for OTC meds or emergency antibiotics, based on what you were told by the dentist/oral surgeon. Sorry your dentist office sucks U_U

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  • [–] [S] 4 points 1 week ago (3 children)

    Thank you, Sir! Boy is that the truth. Nothing over the counter was designed to do this amount of heavy lifting! They're terrible for your liver, kidneys, and are not nice to your stomach. My pharmacy doesn't want a shred of accountabillity, so I can only consult the pharmacist if I have a prescription to discuss. Womp womp U_U

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  • [–] 2 points 1 week ago*

    Yep, should be no issue with opioid checks if it's just a higher dose of normal OTC painkillers. Acetaminophen + oxycodone (Percocet) would likely trigger the check, but it'd be the oxycodone part they're tracking.

    Last time I had oral surgery though, they prescribed oxycodone, so might just be worth double checking in case the prescription was for more than just extra strength Tylenol.

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  • [–] 24 points 1 week ago (12 children)

    Urgent care or the ER, which ever is more affordable. Report that clinic.

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  • [–] [S] 6 points 1 week ago (11 children)

    Who to report to? I was thinking of going full Karen on their office manager, just on principle. I can't imagine how this would be for a patient coming out of a more intensive prcedure!!! But that feels like unsheathing a sword to find a limp cod in your hand...

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  • [–] 10 points 1 week ago (6 children)

    State dental board. https://www.ada.org/resources/careers/licensure/state-dental-boards

    Also, malpractice lawyers will often do free consultation.

    Get them fuckers.

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  • [–] 13 points 1 week ago (1 child)

    Call your insurance provider they might have an emergency solution for you.

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  • [–] 11 points 1 week ago

    urgent care. like asap.

    you need those antibiotics. infections in the mouth can set in within the first 48 hours.

    that surgeon could have been looking at a malpractice suit, but you decided to tell them not to worry about it, unfortunately for you. though it could still be argued by a lawyer.

    urgent care can prescribe medication or at the very least get in contact with an emergency contact at the office you had the operation done at.

    having an abscess or infection in your mouth is one of the worst pains I have ever felt. I would rather have my dick ripped off than feel that pain ever again, and my tolerance for pain is "concerning", as I have been told by several medical professionals.

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  • [–] 11 points 1 week ago

    My guy/gal/nonbinary pal, it's the antibiotics you need. I don't want to terrify you with why because there is a tiny, tiny chance of it happening, but trust me on this. Get those first.

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  • [–] 10 points 1 week ago (5 children)

    Call another dentist's emergency number if the pain necessitates it

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    [–] 8 points 1 week ago (2 children)

    I'm not a doctor, but I did have an extraction from an oral surgeon a few years ago. My understanding was the antibiotics are more of a precaution than a necessity. I'd definitely try some of the things other commenters suggest, but you'll likely be fine if you aren't able to start them until Monday.

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  • [–] [S] 2 points 1 week ago (1 child)

    Really appreciate you for sharing your wisdom on that! Thank you for reminding me about that fact. It's easy to get all kinds of freaked out with this pain and chaos. I didn't have a pre-existing condition that would make antibiotics necessary. Still, the audacity to take thousands of dollars from me and then... oopsie! Sheesh!

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  • [–] 3 points 1 week ago

    No worries! That does sound frustrating. And recovering from extractions is painful.

    As I understand it, the antibiotics are mainly because mouths are full of bacteria. You don't want bacteria breeding in the extraction site and turning into an infection. If your surgeon gave instructions for rinsing with warm salt water, that can keep bacteria from growing there too. Just make sure to be gentle until it starts to heal more.

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  • [–] 8 points 1 week ago (2 children)

    Fellow American so I know how much this suggestion sucks but... ER? Do you have insurance?

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  • [–] [S] 2 points 1 week ago (1 child)

    My insurance is garbage. I feel as though any ER department in my city is basically at its breaking point, so I can't really justify going unless I'm literally dying. That and the massive life-destroying bill I would incur. Thanks for understanding! It's never been more important to go vote, and get everybody we know to go do the same

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  • [–] 2 points 1 week ago

    do you have urgent care in your area? most insurance covers urgent care, ER is quite expensive, if er is your only choice go there. urgent care is far cheaper.

    also you can call your pcp for an emegency phone appointment.

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  • [–] 6 points 1 week ago* (last edited 1 week ago) (8 children)

    You can safely stack some types of pain medications because they work in completely slightly different ways. Ibuprofen + acetaminophen are much more effective than either one by itself. IMO the combination at maximum dose of each is just as effective as prescription pain medication.

    Cleveland Clinic: “Both ibuprofen and acetaminophen are pain relievers and fever reducers. They both can reduce inflammation, but they work in slightly different ways and are processed by different parts of the body,” says family medicine physician Amy Bernstein, DO. “It can be safe to take them together if taken as directed.”

    Also keep detailed notes. In the unlikely event that significant complications occur due to your surgeon's incompetence you may need them.

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  • [–] [S] 3 points 1 week ago (7 children)

    Thank you! I'm alternating between 800mg Ibuprofen and 500mg acetaminophen every 3 hours. Can confirm that it does the trick enough to get a few hours sleep at a time! Detailed notes are a great idea, just in case I do end up having complications without antibiotics. Great thoughts!

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  • [–] 6 points 1 week ago* (3 children)

    Don't alternate, take them together and take the maximum dose (on the label) of each. It makes a massive difference.

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  • [–] [S] 2 points 1 week ago (2 children)

    This is what I mean when I say alternating (just for clarity), devised by oral surgeons, not my vibes:

    800mg ibuprofen -> (wait 3 hours) -> 500mg acetominophen -> (wait 3 hours) -> Repeat

    This could be all I need for one surgery, or completely useless trash for another... but imo, If you take them both together, you'll feel more pain overall when they wear off. Overlap reduces that with a leapfrog effect. Or not. Just listen to your professionals

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  • [–] 2 points 1 week ago* (1 child)

    Acetaminophen is supposed to be taken every 4-6 hours while ibuprofen is 6-8 hours. When I've really needed serious pain relief I've waited maybe 5 hours between acetaminophen doses and 7 hours for ibuprofen. Because they're staggered there isn't a period where one of them wasn't working unless the maximum daily dose is hit. I made sure didn't happen by waiting longer between doses when I could.

    Just listen to your professionals.

    I wish. I've talked to my doctors dozens of times about sometimes needing something stronger for pain relief and not one of them has mentioned combining these two drugs. Instead I had to find out about them by coming across an article on pain relief.

    I hope you feel better fast.

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  • [–] [S] 2 points 1 week ago

    The crazy part is that I'm just following what they wrote in the aftercare instructions. I guess it's considered fine to go ham for a few days in extenuating circumstances? Thank you for the kind wishes!

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  • [–] 4 points 1 week ago (1 child)

    Forgot to mention that the important thing to keep in mind is the maximum daily dose - 4,000mg for acetaminophen and 3,200mg for ibuprofen.

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  • [–] [S] 2 points 1 week ago

    Yes! And if you're anything like me, expect your stomach to feel like raw hell during the 800ibuprofen/500acetominphen onslaught. I'm also on a liquid diet, please pray for me! Lol

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  • [–] 4 points 1 week ago*

    i would go to your urgent care, your PCP also can order antibiotics and a strong nsaid over the phone too. i recently had a tooth infection with fever and severe pain needing a root canal/ i contacted my pcp, urgent care to get meds asap.

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  • [–] 2 points 1 week ago (4 children)

    Generally an ER has to treat you if you show up and wait... it's america, so they will try to bill you and ultimately send it to collections but it's an option.

    Depending on how broke you are, where you are, and how desperate you are, nitrous oxide might be an option as well. Generally sold at "smoke shops" as either small whipped cream chargers — for which you will need something called a cracker and a balloon, or a variety of tanks. The tanks are generally a better value and range from $40-200, they generally come with a nozzle to attach a balloon to.

    Never underestimate the power of an ice pack, 10-15 minutes on, 5 minutes off, so you don't freeze your face.

    Lastly a super saturated salt water rince will help with potential bacterial growth.

    Please be careful with the nitrous if you're inexperienced. It's a heavier than air gas, so open windows/doors! Extract it slowly or the balloon will freeze — get a few extra.

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  • [–] [S] 3 points 1 week ago (3 children)

    You rock! I can't really play any nitrous games due to my tendency to win respiratory problem prizes, but that might be the most clever/productive application I've heard since whipped cream. Ice has been incredible. Your salt water idea makes me wonder if I could do an epsom salt compress on the site like an icepack. Thank you!

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  • [–] 3 points 1 week ago (2 children)

    Your very welcome, I'm glad it's working. I had a few terrible budget dental experiences over the years so I feel your frustration and pain. Hang in there! Report the fucker to your states "board of pharmacy" if they still have one... and make sure to let the office staff know you intend to — nothing puts the fear of god in them like the kinds of audit they will do :-)

    I'm not sure about a compress... the rinse comes directly from getting impacted wisdom teeth extracted, so I know that's solid... to much salenity might end up over-drying the area which could lead to a painful condition called a dry socket.

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  • [–] [S] 3 points 1 week ago (1 child)

    Dry socket comes from dislodging the ...(GORE DISCLAIMER) blood clot from the empty tooth socket before it can harden and heal. Epsom salt wont cause that, but the dehyration of the area via salts sure as hell wouldn't help. I totally get the conern, though! Had to look it up to be sure

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  • [–] 2 points 1 week ago

    I'm obviously not a dentist, just a guy who's had 3 teeth extracted over the years. So that's where the salt rinses came from... I should probably have included that the instructions were 3x per day.

    Somewhat obviously they used the giggle-gas... but that's more personal preference. Obviously that's generally done with medical supervision. The extraction I will never forget (~30 years later) was a sham dental plan where they ended up wanting an extra few hundred bucks for it that I couldn't afford.

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  • [–] 2 points 1 week ago

    I've had a tooth extraction or two before. The following advice is based on my memory and experience with that kind of surgery and being poor. I'm not a doctor. It's highly negligent for the surgeon to abandon you over the weekend after a surgery.

    You may not need pain meds beyond ibuprofen (you can take more than the recommended dose on the bottle for a short time). Acetaminophen is useless for treating the swelling and dental pain in my experience. Continue your other after care while you figure this out: rinse with warm salt water regularly, avoid foods with seeds, no drinking through a straw, apply ice packs regularly at intervals to keep the swelling down (ibuprofen will help with this also), whatever else they advised. Keeping the swelling down with ice packs, ibuprofen, and drinking cold water will do way more for your pain than whatever pain meds they prescribed. Sometimes I'd just keep a big glass of ice water nearby and hold the ice cold water in my mouth.

    You will absolutely need the antibiotics ASAP though! Call a doctor, any doctor, urgent care, ER, whatever you have to do to get the antibiotics. I wouldn't even mention the pain meds. When I've taken those pain meds, they did nothing for the pain in my mouth, but they did mean I didn't notice bumping into a table and cutting my leg badly. And there is the non-zero chance that as soon as you mention painkillers, you'll be labeled as drug seeking. Stay focused on the antibiotics, that's the important med. Oral infections can go from "Do I have an infection?" to life threatening emergency in a surprisingly short time.

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