Dental uses: Codeine is a narcotic analgesic (pain-relieving drug) that is most effective for dental pain when given in combination with acetaminophen (as in Tylenol #3) or aspirin (as in Empirin #3). It is most commonly prescribed for relief of pain following dental surgery, and for temporary relief of toothache. It occasionally is prescribed for chronic pain of the jaw (temporomandibular joint pain) or face. Codeine preparations are available in four strengths: #1 is 7.5 mg, #2 is 15 mg, #3 is 30 mg and #4 is 60 mg.
Dosages for dental purposes: Examples of generally effective prescriptions include 300 mg acetaminophen plus 30 mg codeine (Tylenol #3), two tablets every four to six hours as needed for pain; or 325 mg aspirin plus 30 mg codeine (Empirin #3), two tablets every four to six hours as needed for pain. Patients take the codeine combinations for varying lengths of time, but it usually is fewer than five days following surgery.
Concerns and possible side effects: Codeine and other oral narcotics such as hydrocodone, oxycodone and propoxyphene produce a relatively high incidence of dizziness, drowsiness, nausea, vomiting and constipation in dental-surgery patients.
Dental patients prescribed drugs containing oral narcotics should not be operating dangerous machinery or driving automobiles. Alcohol also must be avoided while taking narcotics because the combination greatly increases the risk of drowsiness, impaired thinking and unconsciousness. Alcohol consumption also increases the risk of stomach bleeding and ulcers from aspirin/codeine combinations and liver damage from acetaminophen/codeine combinations.
Short-term use of narcotic analgesics (a few days) for post-surgical dental pain does not lead to drug addiction. Concern among some health professionals about the ability of chronic narcotic therapy (of weeks or months duration) to cause addiction in some patients is largely unfounded, but is still the subject of debate.
Patients with allergies to acetaminophen should not consume preparations of Tylenol with codeine, and those with allergies to aspirin should not consume preparations of Empirin with codeine. Allergic reactions can range from a mild rash to life-threatening closure of the airway and a fall in blood pressure.