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Dental Bridge, Root Canal, Ibuprofen
Old 06-01-2012, 09:45 AM   #1
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Dental Bridge, Root Canal, Ibuprofen

I had a bridge put in by my family dentist a few months ago. Shortly after, I started experiencing discomfort/tooth pain. He tried a few "adjustments", and finally referred me to an Endodontist. The Endodontist says I need to have a root canal performed on the tooth under the bridge (did some reading and find that this happens occasionally with bridges - I assume there is no recourse with family dentist).

In the meantime, my family dentist said I could take 800mg of Ibuprofen 2x per day to ward off pain. This seems to be working, although I still can't chew on that side without minor discomfort, but the pain is in check.

As a result of the bridge, and some other dental work, my dental insurance/flex spending is maxed out. The root canal will cost ~$900 out of pocket.

So I have a few questions/thoughts:
I would like to wait until 2013 so my insurance/flex spending will cover the entire procedure.

Are there any hazards with taking this amount of Ibuprofen for 6-7 months?

I understand that the pain may get worse, and/or the Ibuprofen may lose effectiveness, but anyone see any issues with waiting to have this procedure, or any recommendations?
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Old 06-01-2012, 09:57 AM   #2
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I use ibuprofen for occasional discomfort but my understanding is that excessive or long term usage of it may contribute to liver and kidney problems, or at the very least make them worse if you already liver or kidney problems. I'd want to make sure my liver and kidneys were healthy and fully functioning since the evidence suggests that if these organs are impaired, ibuprofen has the potential to cause more problems.

Unless I was destitute, there's no way I wouldn't fork over the $900 to get this fixed the right way ASAP rather than trying to medicate your way through seven more months which may or may not even be sufficient until January. Just having this hanging over my head for seven months, and the worry and dread it would leave in my life for that long, would be worth paying to get rid of.
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Old 06-01-2012, 10:04 AM   #3
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Sorry to hear about dental pain. I had a bad tooth from many years ago. Had a root canal, then several crowns--that eventually would only last a year or two before falling out. About a couple of years ago, I the bad tooth became a toothache from hell. Finally, my dentist said, we could pull what's left of it (there was mostly just roots and little tooth left, yet plenty of pain). That'll stop the pain. After one attempt of trying to save it, I said no more, pull it.

Fast forward to today, for that bad tooth I decided to get an implant. (Takes about a year for the entire proceedure). On June 22, I'm scheduled to have the final part of the proceedure done. I can't wait. I wish I would have had that tooth pulled sooner.

As for the questions, I would be concerned about taking Ibuprofen for 6-7 months. Perhaps making sure to not exceed the daily dosage would be okay, but 6-7 months is a pretty long time.

As for the flexible spending account. Perhaps you can ask the dentist to spread out the payments in monthly installments? That way, only a part would not be covered by your FSA.
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Old 06-01-2012, 10:04 AM   #4
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Quote:
Originally Posted by tgotch View Post
I had a bridge put in by my family dentist a few months ago. Shortly after, I started experiencing discomfort/tooth pain. He tried a few "adjustments", and finally referred me to an Endodontist. The Endodontist says I need to have a root canal performed on the tooth under the bridge (did some reading and find that this happens occasionally with bridges - I assume there is no recourse with family dentist).

In the meantime, my family dentist said I could take 800mg of Ibuprofen 2x per day to ward off pain. This seems to be working, although I still can't chew on that side without minor discomfort, but the pain is in check.

As a result of the bridge, and some other dental work, my dental insurance/flex spending is maxed out. The root canal will cost ~$900 out of pocket.

So I have a few questions/thoughts:
I would like to wait until 2013 so my insurance/flex spending will cover the entire procedure.

Are there any hazards with taking this amount of Ibuprofen for 6-7 months?

I understand that the pain may get worse, and/or the Ibuprofen may lose effectiveness, but anyone see any issues with waiting to have this procedure, or any recommendations?
I read a couple of answers online (evidently GI bleeding and kidney damage are potential risks), but why wouldn't you ask your dentist/doctor and follow his/her advice instead of asking here?

Quote:
Is it safe to take 1600 mg of ibuprofen daily long term?

The over-the-counter maximum daily dose of ibuprofen is 1200 mg/day. Long term use of even the maximum amount is associated with certain health risks There are some disease states which require high doses of anti-inflammatory medications for treatment. If you are currently taking ibuprofen as directed by your doctor, you will probably be fine. If this is so, it is important that you see your doctor regularly so that he/she can monitor the effects of the drug on yourbody (i.e. blood tests to assess kidney function, etc). Your doctor may choose to prescribe a prophylactic dose of a proton pump inhibitor (Nexium, Prilosec, Protonix, Aciphex) or H2 antagonist (Zantac, Pepcid, Tagamet) to prevent an NSAID induced ulcer. If you have heartburn-like symptoms or notice that you bleed/bruise easily, feel exteremely fatigued, or have bloody or "black as coal" stools, see your doctor immediately.

If, however, you are taking 1600 mg/day longterm and are not under a doctor's care, your risk of eventually having these side effects is high. It is important that you let your doctor know that you are needing to take this much. Whatever problem is causing you to need to take this amount of ibuprofen on a regular basis should be addressed by a doctor.
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Old 06-01-2012, 10:07 AM   #5
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If the pain is caused by an abscess, I don't think you want to wait even if the pain is managed by the ibuprofen.
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Old 06-01-2012, 10:09 AM   #6
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If the pain is caused by an abscess, I don't think you want to wait even if the pain is managed by the ibuprofen.
Good point. Toothaches that become infected can cause serious health problems on their own.
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Old 06-01-2012, 10:59 AM   #7
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If the pain is caused by an abscess, I don't think you want to wait even if the pain is managed by the ibuprofen.
Good point as the ibuprofen would just mask to pain if the cause is more.

In the case of my terrible toothache. My dentist first prescribed an antibiotic and the pain stopped for a few weeks then came back. I tried again (another round of antibiotics) and the same, pain subsided for a bit then came back. Then I said, no more, I want an implant.
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Old 06-01-2012, 11:00 AM   #8
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I was told I needed to get a wisdom tooth pulled last year because it hurt a little bit and it had a cavity in it. I thought I didn't want to spend the $300 then and I would just blow it off for a while. Then a month later the pain became worse, so guess what I did that day? Money isn't as important as relief of pain is! Spread out the payments and get it done. Concerning teeth, just when something surely cant get more painful, you may find out it most certainly can.
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Old 06-01-2012, 11:04 AM   #9
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I still can't chew on that side without minor discomfort, but the pain is in check.
Knowing it won't get any better, and may very well get considerably worse, you want to put up with this for another seven months to save a little over four bucks a day?

Sounds to me like what my grandmother called "penny wise, pound foolish".
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Old 06-01-2012, 11:08 AM   #10
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You also have to remember that it is not a $900 decision, but only the taxes you would save on $900...

if in the 15% bracket, $135
25% = $225....


I would not wait to save a couple of hundred bucks...
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Old 06-01-2012, 11:20 AM   #11
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I would go ahead and get it done. The $900 will be minor in the long run and feeling well is the best life has to offer. The large dose of ibuprofen on a long term basis would concern me as I have only taken large doses like that for a few days at a time (pulled muscle in neck and wisdom tooth extraction). What if you find yourself in extreme pain on a weekend and end up getting emergency treatment that runs into the $1,000's then the $900 would seem like not a big deal. Only you can decide what level of pain/discomfort and risk you are willing to tolerate. I wish you well on your decision.
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Old 06-01-2012, 11:21 AM   #12
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Tgotch ... It sounds as if your pain level is under control right now. There is a good chance than in the next 8 months, one morning you will wake up in severe pain and need to begin the root canal that day. And if so, there is a higher chance that you will have more discomfort after it is completed for a while than if you have it done now. This is what gives root canals the assocaiation with pain: You are usually in pain when you need one, not while (you are numb) and it is being performed. Good luck !
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Old 06-01-2012, 11:26 AM   #13
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It's a long time to wait... Personally, I don't think that ibuprofen is an innocuous as most people think it is and I would not take it routinely for months at a time. In addition, pain is a sign that something is wrong and masking the pain with drugs could leave more serious problems like an infection go undetected.

I wouldn't wait.
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Old 06-01-2012, 11:38 AM   #14
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Are there any hazards with taking this amount of Ibuprofen for 6-7 months?

I understand that the pain may get worse, and/or the Ibuprofen may lose effectiveness, but anyone see any issues with waiting to have this procedure, or any recommendations?
I tried to wait on a cavity (6 months) and my insurance didn't kick in until Jan 2012. I never needed any pain meds and had no symptoms until I went in for my 6 month dental checkup in Dec 2011. The tooth just decided to explode on it's own the next day. The endodontist recommended Ibuprofen every 3 hours and switch to Naproxen (Aleve) every 3 hours before and after the root canal. They even had to give me more Novocaine after the procedure before I left the chair.

$900 for a root canal sounds pretty reasonable, my cost was $1200 out of pocket. I couldn't wait, turns out when he went to relieve the pain, blood gushed out and Dr. said I had an infection and I had to wait 10 days to get the root canal finished.

After having a few fillings redone, I had sensitivity issues with these teeth and found relief using a sensitive toothpaste like Sensodyne (or Crest and Colgate versions). I found using these helped with sensitivity after 3-4 weeks of use. You're not supposed to rinse for 20-30 mins after brushing for max. relief.

They also looked at an old root canal and recommended a redo of the old root canal for $1875! The endodontist I used charges more the farther back you go in the mouth. Good luck on whatever you decide, the pain caused by root canals is never good.
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Old 06-01-2012, 11:59 AM   #15
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They also looked at an old root canal and recommended a redo of the old root canal for $1875! The endodontist I used charges more the farther back you go in the mouth.
That's because back teeth (molars) have 3 or more roots, while front teeth usually have just one and sometimes two.
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Old 06-01-2012, 12:00 PM   #16
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okay okay who will teach the Dryer Sheet Aficionado the proper way to use quotes?
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Old 06-01-2012, 12:03 PM   #17
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$900 for a root canal sounds pretty reasonable, my cost was $1200 out of pocket. I couldn't wait, turns out when he went to relieve the pain, blood gushed out and Dr. said I had an infection and I had to wait 10 days to get the root canal finished.
I was thinking the same thing. I had a root canal in 2006 and I paid almost $700 out of pocket, and that was with insurance paying 50% of it! Less than a grand with no insurance at all seems pretty cheap to me.

As for the pain, though, I was pretty lucky: I was never in pain, either with the bad tooth or with the root canal. Apparently mine abscessed without pain at the roots, and I noticed it only when I started tasting pus in my mouth in one spot on the roof of my mouth (yuck). By the time I went to my dentist and he referred me to an endodontist for a root canal, the nerve was 100% necrotic (dead) and thus I felt *no* pain at all during the procedure.

Another thing to consider is this: Wouldn't you typically need a crown after doing a root canal? I would think that the combination of a root canal and a crown in the same calendar year would exceed your insurance benefit (usually $1000-1500 a year) anyway.
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Old 06-01-2012, 12:03 PM   #18
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okay okay who will teach the Dryer Sheet Aficionado the proper way to use quotes?
Fixed it for you.
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"Hey, for every ten dollars, that's another hour that I have to be in the work place. That's an hour of my life. And my life is a very finite thing. I have only 'x' number of hours left before I'm dead. So how do I want to use these hours of my life? Do I want to use them just spending it on more crap and more stuff, or do I want to start getting a handle on it and using my life more intelligently?" -- Joe Dominguez (1938 - 1997)

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Old 06-01-2012, 12:11 PM   #19
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Are there any hazards with taking this amount of Ibuprofen for 6-7 months?
I wouldn't continue at that level for so long without a Dr's consent. Ibuprofein can have serious side affects.

Ibuprofen Official FDA information, side effects and uses.

Quote:
Cardiovascular Risk
· NSAIDs may cause an increased risk of serious cardiovascular thrombotic events, myocardial infarction, and stroke, which can be fatal. This risk may increase with duration of use. Patients with cardiovascular disease or risk factors for cardiovascular disease may be at greater risk

· Ibuprofen tablets are contraindicated for treatment of peri-operative pain in the setting of coronary artery bypass graft (CABG) surgery
Gastrointestinal Risk
· NSAIDS cause an increased risk of serious gastrointestinal adverse events including bleeding, ulceration, and perforation of the stomach or intestines, which can be fatal. These events can occur at any time during use and without warning symptoms. Elderly patients are at greater risk for serious gastrointestinal events
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Old 06-01-2012, 12:17 PM   #20
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Thanks for the repair ziggy29. Usually root canaled teeth do require crowns, but this tooth has a bridge already on top of it (which is a number of crowns), so unless the bridge gets ruined in the procedure, it can continue to be used.
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