Pain free dentistry

[zippydedodah]

they do a very poor job at numbing the mouth here as they are scared of giving proper painkillers during operations. worst case, you can take some of the strongest OTC painkillers (I think codeine is available/legal?) preemptively and that should help. NOS will work but its probably very costly; imagine bumrungrad or similar in bangkok would offer it.

Only available from a hospital.

but if tramadol works for you (it doesn't work for everyone)... try one or more of those, about an hour before your appt... that MIGHT help

Thanks from your suggestion. I do appreciate it. But FYI, it's close to impossible to get Tram without a perscription in Thailand. This is a relatively recent development. Again, everyone should be an Arahant who can be beyond the realm of pain here in Thailand. If you need pain meds, well, you are somehow a lowlife, deficient human being - maybe a rice farmer or someone from the rural part of Thailand <if you don't get the sarcasm and totaly disregard of HiSo bigotry, then your just plain ignorant>, but than again, I'm sure the HiSo level of Thai society can aquire opiates.. By the way, I have about 1000% more respect for rice farmers, then say, the CEOs of major corporations, or completely deficient Health Care Co-Op and insurance companies based either here in the LOS or elsewhere. . .

To me, not perscribing readily available opiates is a complete disregard of the ability to alleivate suffering in humans by using what God put on this planet - Poppies - but then again, I'm not your normal Buddhist. And I'm obviously not a Thai doctor - I actually have a sense of empathy for the sufering of other beings, something that seems to be devoid in the Thai healthcare system.

not responding to whether or not tramadol works for you, but as to availability, i was in the pharmacy on saturday and my friend bought a box of 40 (maybe it was 50) milligram tramadols... i have not used them in years, but when i did, it was 100 mgs on a time-release basis... i asked the pharmacist what happened to those, then she launched into a discourse on govt. requirements for the manufacturers of those doses and basically told me that sale of them was to high to bear the cost... i asked it they had been declared "illegal" or only available at hospital, and her reply was "no"... cost was the limiting factor... i have used this pharmacy for over 5 years and always found their info to be right on... but anyways... tram is available, at least in Meechok plaza pharmacy...

[Diplomatico]

Yeah, I too have purchased Tramadol OTC within the last month....first time trying it, don't find it that effective but it's available.

[BigBadGeordie]

I have a chronic back injury and I find Tramadol in Buriram at most Pharmacies. Yes I know it's adictive.

[connda]

Yeah, I too have purchased Tramadol OTC within the last month....first time trying it, don't find it that effective but it's available.

My regular pharmacist indicated the she no longer carried it after her stock was gone. This was about a month after every other pharmacist I contacted had already said 'Mai Mee". I know one phrmacist that was selling Ultram 4 weeks ago, but considering the supply has dried up, I guess chronic pain is just a fact of life if you continue to live in the LOS.

I just use Ibuprophine, but it sucks rocks. Back to a topic I keep harping on: Pallative care in Thailand is non-existant. As a Buddhist, you're suppose to have attained the level of an Arahant and simply let the pain flow through you -- well, unless you're a BKK HISO, Politically connected, or have a doctor in the family -- then maybe you can obtain the type of pain meds you can get in the West.

And these folks allude to themselves as Buddhists. Yeah. "May you be free from suffering" well as long as you are connected, have money, and have pallative meds accessible to you. Sorry rural folk! You're out of luck.

Edited December 29, 2014 by connda

[northernjohn]

_{Just wondering if the OP has considered going back to the states to get his dental work done. I just find it hard to believe that they can not kill the pain. If it was me I would not let them start until the area was pain free. I how ever am not that susceptible to pain. I used to sleep through it in North America. Here the first filling they put in I didn't realize they had done it. and I was able to eat right after it.}

_{Laugh if you want but there has been studies showing that 1/3 of the time a clothespin on the ear will stop the pain. Maybe it hurts more than the drilling.}

[connda]

_{Just wondering if the OP has considered going back to the states to get his dental work done. I just find it hard to believe that they can not kill the pain. If it was me I would not let them start until the area was pain free. I how ever am not that susceptible to pain. I used to sleep through it in North America. Here the first filling they put in I didn't realize they had done it. and I was able to eat right after it.}

_{Laugh if you want but there has been studies showing that 1/3 of the time a clothespin on the ear will stop the pain. Maybe it hurts more than the drilling.}

If I sat down with you and related nevertihing, you'd shake your head <Dang!> Like I said, we're not done with this. My Thai wife isn't a run-of-the-mill, feel-free-to walk-all-over-me-and-my family type. I did not tell her that the last appointment with my dentist just about made my piss my pants (literally). We have another appointment to talk with the dentist and owner. We'll see what shakes. I will not go thought this again -- ever. My wife is going to sit in the room with me, and if the pain issue cannot be resolved, we'll start with the owner of the business and start working thought any dentist in the staff the can actually perform pallative care. Have you ever seen a pissed off Thai woman? She's there. The next appointment should be interesting.

Thanks to all who offered words of support.

[BigBadGeordie]

Yeah, I too have purchased Tramadol OTC within the last month....first time trying it, don't find it that effective but it's available.

My regular pharmacist indicated the she no longer carried it after her stock was gone. This was about a month after every other pharmacist I contacted had already said 'Mai Mee". I know one phrmacist that was selling Ultram 4 weeks ago, but considering the supply has dried up, I guess chronic pain is just a fact of life if you continue to live in the LOS.

I just use Ibuprophine, but it sucks rocks. Back to a topic I keep harping on: Pallative care in Thailand is non-existant. As a Buddhist, you're suppose to have attained the level of an Arahant and simply let the pain flow through you -- well, unless you're a BKK HISO, Politically connected, or have a doctor in the family -- then maybe you can obtain the type of pain meds you can get in the West.

And these folks allude to themselves as Buddhists. Yeah. "May you be free from suffering" well as long as you are connected, have money, and have pallative meds accessible to you. Sorry rural folk! You're out of luck.

Athiest myself, also find ganja helps ;-)

[connda]

_{Just wondering if the OP has considered going back to the states to get his dental work done. I just find it hard to believe that they can not kill the pain. If it was me I would not let them start until the area was pain free. I how ever am not that susceptible to pain. I used to sleep through it in North America. Here the first filling they put in I didn't realize they had done it. and I was able to eat right after it.}

_{Laugh if you want but there has been studies showing that 1/3 of the time a clothespin on the ear will stop the pain. Maybe it hurts more than the drilling.}

I've seen the studies. You could probably push a kniting needle though my bicept with less discomfort then drilling on an under-anestitisize tooth. But you are not me, so you don't have a clue what I feel. So please don't go there. I understand your point.

[connda]

Yeah, I too have purchased Tramadol OTC within the last month....first time trying it, don't find it that effective but it's available.

My regular pharmacist indicated the she no longer carried it after her stock was gone. This was about a month after every other pharmacist I contacted had already said 'Mai Mee". I know one phrmacist that was selling Ultram 4 weeks ago, but considering the supply has dried up, I guess chronic pain is just a fact of life if you continue to live in the LOS.

I just use Ibuprophine, but it sucks rocks. Back to a topic I keep harping on: Pallative care in Thailand is non-existant. As a Buddhist, you're suppose to have attained the level of an Arahant and simply let the pain flow through you -- well, unless you're a BKK HISO, Politically connected, or have a doctor in the family -- then maybe you can obtain the type of pain meds you can get in the West.

And these folks allude to themselves as Buddhists. Yeah. "May you be free from suffering" well as long as you are connected, have money, and have pallative meds accessible to you. Sorry rural folk! You're out of luck.

Athiest myself, also find ganja helps ;-)

Dude - I'm totally with you on that. If I was back in WA State, I'd ganja up prior to the appointment. But here in the Land of Sadistic (LOS) medical practitioners, and BIB Shakedowns, ganja gets you jail time. Just saying.

Edited December 29, 2014 by connda

[connda]

Yeah, I too have purchased Tramadol OTC within the last month....first time trying it, don't find it that effective but it's available.

My regular pharmacist indicated the she no longer carried it after her stock was gone. This was about a month after every other pharmacist I contacted had already said 'Mai Mee". I know one phrmacist that was selling Ultram 4 weeks ago, but considering the supply has dried up, I guess chronic pain is just a fact of life if you continue to live in the LOS.

I just use Ibuprophine, but it sucks rocks. Back to a topic I keep harping on: Pallative care in Thailand is non-existant. As a Buddhist, you're suppose to have attained the level of an Arahant and simply let the pain flow through you -- well, unless you're a BKK HISO, Politically connected, or have a doctor in the family -- then maybe you can obtain the type of pain meds you can get in the West.

And these folks allude to themselves as Buddhists. Yeah. "May you be free from suffering" well as long as you are connected, have money, and have pallative meds accessible to you. Sorry rural folk! You're out of luck.

Athiest myself, also find ganja helps ;-)

Athiest myself, also find ganja helps ;-)

Really. Dig a little deeper into true Theravada Buddhism. Follow me on this.

Atheism: a + theos.

a = without

theos = deity

There is no 'deity' in the core Theravada Buddhism. Siddhārtha Gautama, Shakyamuni who is referred to as 'The Buddha' was a man. Not a god. I won't go beyond that in this topic. Is Buddhism a religion? It depends how you define religion For me, Buddhsim is a pragmatic solution to end suffering. It's a paradox. It often is.

[elektrified]

You shouldn't have too much trouble finding Tramadol. All of the pharmacies around my home stock it regularly. No restriction, don't have to show ID or anything like that. Neighborhood pharmacies tend to stock most things but the larger, chain stores don't.

[northernjohn]

_{Just wondering if the OP has considered going back to the states to get his dental work done. I just find it hard to believe that they can not kill the pain. If it was me I would not let them start until the area was pain free. I how ever am not that susceptible to pain. I used to sleep through it in North America. Here the first filling they put in I didn't realize they had done it. and I was able to eat right after it.}

_{Laugh if you want but there has been studies showing that 1/3 of the time a clothespin on the ear will stop the pain. Maybe it hurts more than the drilling.}

I've seen the studies. You could probably push a kniting needle though my bicept with less discomfort then drilling on an under-anestitisize tooth. But you are not me, so you don't have a clue what I feel. So please don't go there. I understand your point.

No I am not you. I was simply stating that if I was in your position I would not let them work on me until the pain killer had kicked in. If it didn't kick in I would not have let them work on me. I mentioned that I have a high tolerance or shall we say less sensitivity to pain. I am in no way suggesting you should too. The clothespin was a real study. You say you have seen the studies have you tried them?

[hmficc]

A team approach should work for you. A clinic is called for. An oral surgeon to block the pain "higher up" the nerve pathway , they are trained for this,and and operative dentist for fillings or a prosthodontist if crown or bridge. The clinic will have to coordinate the two docs for your appointment.

I think this will work well for you.

Good luck.

[elektrified]

A team approach should work for you. A clinic is called for. An oral surgeon to block the pain "higher up" the nerve pathway , they are trained for this,and and operative dentist for fillings or a prosthodontist if crown or bridge. The clinic will have to coordinate the two docs for your appointment.

I think this will work well for you.

Good luck.

When I would go to my dentists in California, they would mix up 3 different anesthetics ; a mixture of short and long acting anesthetics and the most important thing is injecting the drugs properly into the nerves, i.e. the Inferior alveolar nerve block. Many recently graduated, inexperienced dentists don't hit the nerve just right as it take some experience to accomplish this.

The dentist by Taphae where I had a terrible experience, had about 12 years experience and he showed me a large diagram of the nerves in the mouth and exactly where he was injecting. He was confident and had a very steady hand. But he admitted that he only stocked one anesthetic which was "not very strong". He said that Thais don't like much anesthesia, many don't want it at all, and don't want to pay high prices for imported dental anesthetics. So in his case he had the experience but was not prepared with the anesthetics - and he let me down as he assured me at the first meeting that he would be prepared.

OP maybe check with RAM Dental Dept. if they could administer Versed or even Propofol during your procedure. I recently had a medical procedure at RAM where they administered Propofol. I was only out for about 15 minutes and there was absolutely no "hangover" afterwards. It was really effective.

Best of luck!

[xylophone]

_{Just wondering if the OP has considered going back to the states to get his dental work done. I just find it hard to believe that they can not kill the pain. If it was me I would not let them start until the area was pain free. I how ever am not that susceptible to pain. I used to sleep through it in North America. Here the first filling they put in I didn't realize they had done it. and I was able to eat right after it.}

_{Laugh if you want but there has been studies showing that 1/3 of the time a clothespin on the ear will stop the pain. Maybe it hurts more than the drilling.}

I've seen the studies. You could probably push a kniting needle though my bicept with less discomfort then drilling on an under-anestitisize tooth. But you are not me, so you don't have a clue what I feel. So please don't go there. I understand your point.

I sympathise with you because I seem to have the same problem with blocking pain when I have dental work done, and just recently I had some bridges made and the nightmare went on for 4 months, and is still not complete, but I won't go into that right now.

Due to extremely bad childhood experiences with dentists, just walking into the surgery and seeing the white coat sets my pulse racing and I even feel the injections so badly as to want to scream.

Because of the pain I was experiencing even after many injections (14 one morning) I enquired as to why they don't use nitrous oxide anymore to be able to put me in "lala land" whilst the injections etc were underway and I was informed that this is available but only at the hospital dentist department because it is now regulated, so perhaps you could try there?

I had a great dentist back home who would give me a little shot of valium in the back of the hand before he started his work and that was fantastic, however I think that has been discontinued now, but that was exactly what I would be seeking now.

Good luck with your search.

Edited December 30, 2014 by xylophone

[cloudhopper]

connda has my sympathy. Any surgeon will tell you that there is a wide range of anatomical shapes and locations for all the body structures just as we all are different in exterior form. There is also a wide range of techniques available to get around these not uncommon difficulties, if there is interest enough to practice and master them. Try the hospital dental clinic at Ram where there are no doubt anesthesiologists that can be consulted. I agree that the concept of dukkha is widely abused by the health care professionals here...

[connda]

Yeah, I too have purchased Tramadol OTC within the last month....first time trying it, don't find it that effective but it's available.

I first had Tram while in a very wiell known BKK hosptial. I had Dengue, also known as 'break-bone fever'. Get the drift about pain? My arrogant SOB doc refused to give me something as simple as paracodeine for the pain. Only Para. So a friend of mine gave me some Tram. Life-saver!!. In my humble opinion, most Thai doctors are sadistic MFs who only work in Thailand because they can not get licensed in a Western country. They have an absolute brutal lack of apathy for human suffering. And claim to be Buddhist. But - there are a few out there that break the mold -- but they are rare.

Edited December 30, 2014 by connda

[connda]

connda has my sympathy. Any surgeon will tell you that there is a wide range of anatomical shapes and locations for all the body structures just as we all are different in exterior form. There is also a wide range of techniques available to get around these not uncommon difficulties, if there is interest enough to practice and master them. Try the hospital dental clinic at Ram where there are no doubt anesthesiologists that can be consulted. I agree that the concept of dukkha is widely abused by the health care professionals here...

Cloudhopper. You are one of the first individuals who actually understands what I'm talking about. Anybody here take statistics in high school or university? Do you understand the variability, the statistical significance of anything? Take pain threshold. I could ram a needle completely though the arm of one individual, and they would feel discomfort. Penatrate the skin of another individual and they are in agony. You can plot this on a statistical curve. But to the average individual who has been completely indoctinated by there mediocore school system, if you even attempted to learn something - well, you can not concieive anything beyond yoiur personal experiences in life. "Well, I don't feel pain at the dentist. You must be an idiot." Look in the mirror. You don't have a clue, do you?

Cloudhopper nailed it. That is exactly what my point is.

For everyone else: Isn't Ignorance Bliss?

[connda]

_{Just wondering if the OP has considered going back to the states to get his dental work done. I just find it hard to believe that they can not kill the pain. If it was me I would not let them start until the area was pain free. I how ever am not that susceptible to pain. I used to sleep through it in North America. Here the first filling they put in I didn't realize they had done it. and I was able to eat right after it.}

_{Laugh if you want but there has been studies showing that 1/3 of the time a clothespin on the ear will stop the pain. Maybe it hurts more than the drilling.}

I've seen the studies. You could probably push a kniting needle though my bicept with less discomfort then drilling on an under-anestitisize tooth. But you are not me, so you don't have a clue what I feel. So please don't go there. I understand your point.

No I am not you. I was simply stating that if I was in your position I would not let them work on me until the pain killer had kicked in. If it didn't kick in I would not have let them work on me. I mentioned that I have a high tolerance or shall we say less sensitivity to pain. I am in no way suggesting you should too. The clothespin was a real study. You say you have seen the studies have you tried them?

Thanks. Appreciate the reply and clarification.

[Bill97]

...most Thai doctors are sadistic MFs ....They have an absolute brutal lack of apathy for human suffering. .

You are sadly one very sick person and the luck you need is not likely to be found here. For your sake we hope you leave soon.

[hmficc]

"OP maybe check with RAM Dental Dept. if they could administer Versed or even Propofol during your procedure. I recently had a medical procedure at RAM where they administered Propofol. I was only out for about 15 minutes and there was absolutely no "hangover" afterwards. It was really effective.

Best of luck!"

Versed is " the mother of all Valium". It does not inhibit pain but you may enjoy amnisia and forget the agony.

Profonol will work but should require an anesitist- not the Dentist! In Thailand anything is possible.

[hmficc]

propofol. Sorry dyslexia attack.

[connda]

...most Thai doctors are sadistic MFs ....They have an absolute brutal lack of apathy for human suffering. .

You are sadly one very sick person and the luck you need is not likely to be found here. For your sake we hope you leave soon.

May you be free from fear. May you be free from afflictions. May you be happy. May you be filled with loving kindness. May you be free from suffering.

[connda]

propofol. Sorry dyslexia attack.

Yeah, this is one of a couple of drugs used in conscious sedation. Good info. Given what you've said, I may go talk to RAM. My issue is beyond pain - it's abject fear. Thanks much.

[hmficc]

A dental surgeon ( not regular dentist) does a 4 month rotation in anesthesia in the USA and would be qualified in intubation if there were a problem. In thailand?

[uptheos]

propofol. Sorry dyslexia attack.

Yeah, this is one of a couple of drugs used in conscious sedation. Good info. Given what you've said, I may go talk to RAM. My issue is beyond pain - it's abject fear. Thanks much.

Michael Jackson liked it.

Under supervision it is excellent for sedation.

Who do you talk to at Ram about receiving this, dentist, anaesthetist, management?

[purushanti]

I also need more than the usual care with regard to painkillers, and my dentist is careful in this regard. Dentist is also excellent in every other way imaginable, so much so that I fly to BKK 2x a year just for checkups. PM me if you want contact. info.

[connda]

I have never been to a dentist where I do not suffer pain of some sort whether is be from the drilling,prodding, injections etc.

I only ever go as a last resort,usually with six months of meditation prior to making an appointment. Could never understand how anyone could choose dentistry as a profession, apart from the money aspect.

Dentists and pain, they go together.

Bit like bones and fish. I am often told there are no bones in this fish and in the next instant I have a bone stuck in my gums.

Rarely eat fish and hardly ever go to the dentist. ( I do clean and floss well) (- The teeth I mean!

Drilling causes pain ? If you had injections first I don't believe you can have pain. Just can't believe it.

I really feel for your immense sense of of ignorance and self-righteousness. If I push a needle through your bicep and you feel no pain, than or course, no other person in the world will feel pain either. Let me parrot you: "Just can't believe it."

[connda]

Mod. I've been in contact with some good sources of info. The rest is just troll bait. Please close this thread.
And thanks to all who offered positive, caring suggestions.
Thanks!

Edited December 31, 2014 by connda

[connda]

I have had extensive dental work done in the last 30 years. Honestly never had to endure pain. NEVER. Unless your an alien novacaine should work for everyone. Perhaps the pain is only in his head?

Perhaps you have few if any pain receptors in your month, or for that matter your head. Your one of these people who are, "If it doesn't hurt me, then it shouldn't hurt you. It's all in your head." That's an idiotic response. I'd explain it to from the standpoint of statistic analysis, but I don't it would penetrate that pain-free brain. BTW And novacaines isn't used anymore. There are a large selection of different anesthetics and I understand what is happening: virtually every dentist is using the mildest dosage possible (I've been told so). So even when I complain, they don't change tactics which is loss of face.

I'm going to contact my dentist in the US and get the type of anesthetics he used for general filling vs root canals vs what my US dental hygenist used while doing periodontal cleaning. Neither my dentist nor my hygenist ever hurt me during the 14 years I went to them. I'm now on dentist number 9 and looking for number 10. Once I get the info back from my old dentist in the US, I'll pass the dosages and drug names to my next dentist.

Duration Generic Name Brand Name Short Mepivacaine HCI Injection Plain 3% Scandonest^® 3% Plain - Septodont

Carbocaine^® - Cook Waite (Carestream)

Polocaine^® - Dentsply Pharmaceutical, Various Private Label Brands Short Prilocaine HCI Injection USP, Plain 4% Citanest^® Plain - Dentsply Pharmaceutical Intermediate Articaine HCI with Epinephrine USP, 4% 1:100,000 Septocaine^® with epinephrine 1:100,000 - Septodont

Articadent™ 1:100 - Dentsply Pharmaceutical

Orabloc™ - Perriell

Zorcaine™ - Cook Waite (Carestream) Intermediate Articaine HCI with Epinephrine USP, 4% 1:200,000 Septocaine^® with epinephrine 1:200,000 - Septodont

Articadent™ 1:200 - Dentsply Pharmaceutical

Orabloc™ - Perriell Intermediate Lidocaine with Epinephrine Injection USP, 2% 1:100,000 Lignospan Standard^® - Septodont

Lidocaine HCI 2% with Epinephrine 1:100,000 - Hospira, Cook Waite (Carestream), Various Private Label Brands

Xylocaine - Dentsply Pharmaceutical Intermediate Lidocaine with Epinephrine Injection USP, 2% 1:50,000 Lignospan Forte^® - Septodont

Lidocaine HCI 2% with Epinephrine 1:50,000 - Cook Waite (Carestream), Various Private Label Brands

Xylocaine - Dentsply Pharmaceutical Intermediate Mepivacaine HCI Levonordefrin Injection USP, 2% 1:20,000 Scandonest^® 2% L - Septodont

Carbocaine 2% with Neo-Cobefrin 1:20,000

Mepivacaine + Levonordefrin - Various Private Label Intermediate Prilocaine with Epinephrine Injection USP 4% 1:200,000 Citanest Forte^® - Dentsply Pharmaceutical Long Bupivacaine with Epinephrine Injection USP, 0.5% 1:200,000 Vivacaine^® - Septodont

Marcaine^® HCI 0.5% – Cook Waite (Carestream)

Table 2. American Dental Association Color Code Format for Anesthetic Cartridge Banding.

Product PMS Color Code* Lidocaine 2% with Epinephrine 1:100,000 Red: 185, 186, 199 or 200 Lidocaine 2% with Epinephrine 1:50,000 Green: 347, 348, 355 or 356 Mepivacaine 2% with Levonordefrin 1:20,000 Brown: 471, 477, 478, 498 or 499 Mepivacaine 3% Plain Tan: 466, 467 or 468 Prilocaine 4% with Epinephrine 1:200,000 Yellow: 108, 109, 110, 115 or 116 Prilocaine 4% Plain Black Bupivacaine 0.5% with Epinephrine1:200,000 Blue: 300 or 301 Articaine 4% with Epinephrine 1:100,00 Gold: 871, 872, 873, 874, or 875 Articaine 4% with Epinephrine 1:200,000 Silver: 877C