Opioid Free Pain Management

Are you looking for Opioid Free Oral Surgery?

Our Doctors provide of the option of having an Opioid free experience. This allows patients to go back to normal activities in less time because therapy includes using long-lasting analgesic techniques. 

COSDI Pain Medication Policy

We are concerned about our patients’ health.  We do not want our patients to become drug dependent.  For this reason, we have formulated the following policy;

  1.  Medication is not ordered for patients who come to the office for second surgical opinions.
  2. Opioid medication is not ordered for patients with normal evaluations.
  3. Opioid medications will be ordered for post-operative patients only.  This dosage will be tapered. Opioid medication is not necessary for all surgery patients. 
  4. Prescriptions will only be renewed from 8:00 a.m. to 4:00 p.m. Monday thru Friday.  No prescriptions are issued for non-hospitalized patients during evenings, weekends or holidays.
  5. Sleeping medications, tranquilizers, or similar medications must come from the patients’ primary care or referring doctor.

No drug will totally eliminate pain.  Our goal is for you to be able to tolerate the pain enough to allow adequate rest and recovery from your surgery.


How will I feel after my surgery? — If you’re having surgery, you probably wonder how you’re going to feel afterwards. Many people worry that they will have pain. The amount of pain you will have, and how long it will last, depends partly on what kind of operation you are having. For example, deeply impacted wisdom teeth may have more discomfort than a single tooth removal or biopsy. How you feel after surgery also depends on your age, health, and other medical problems. Your doctors and nurses will work together with you to keep you as comfortable as possible after surgery.

How is pain prevented? — Our doctors use different medicines to make sure you do not feel any pain during your surgery. This is called “anesthesia.” Our doctors will always “numb” the area of your mouth being treated to help with after surgery pain.

Along with anesthesia, your doctor can give you pain medicines before, during, and after your surgery. The exact medicines you will get, and how much of each, depends on your situation. Your doctors will decide how to treat you based on what type of surgery you are having, what kind of anesthesia you need, and your age and overall health.

During surgery, doctors can do different things to help control the pain you might have later. The goal is for you to be comfortable after the operation, although it’s not possible to avoid all pain. These are some of the things doctors can do:

  • EXPAREL ® is a long acting numbing medicine that is an alternative to opioids that offers long-lasting pain control. EXPAREL® starts working during your surgery— before you feel pain. EXPAREL® is an option to manage pain with fewer opioids. In clinical trials, patients who received EXPAREL® were compared with those who didn’t. The results: Patients who received EXPAREL® did not have to take as many opioids. Patients who received EXPAREL® went a longer time before opioids were needed. It works directly at the surgical site, unlike opioids, which affect the whole body. It provides pain control for the first few days after surgery, when you need it most. It is proven to help reduce the need for opioids (narcotics). It is only 1 dose and administered by your doctor, so you have one less thing to manage. Ask your doctor if EXPAREL® is right for you.

Please click on the link below for more information on EXPAREL


  • Ketorolac is a medication similar to Advil®, Motrin®, ibuprofen, or Aleve® that is given either through an IV or as a shot in your arm for long lasting pain control.
  • Socket! Gel which is a  Hydrogel Wound Dressing 5 – 10gm Syringes. Approved by FDA for management of oral wounds. Drug-free, all-natural, non-toxic. Provides fast, constant pain relief without causing a numb sensation. Protects from chemical and microbial contamination. Promotes optimal wound healing. After professional application in the office, it is sent home with the patient to use as often as needed for safe, continuous pain relief and wound management.

Different medicines and procedures have different side effects. Your doctors will work with you to figure out the best plan for your situation. Often, more than 1 pain medicine is used in addition to good home care.

How long will I have pain? — It depends. After a minor operation, you might feel fine a few hours afterwards. After major surgery, you might need pain medicine for days or even a week.

Additional measures for pain control can include: rest, heat, ice, stretching, good hygiene, hydration, and mindfulness practices. These non-medication measures are very effective in lessening the pain after surgery.

How do I take my medication? – The first line pain reliever for mild to moderate pain for most patients is ibuprofen (Motrin®), available over the counter or by prescription. Take the recommended dose every 6-8 hours with a full 8 ounces of water or with food. Don’t sleep for longer than 8 hours the night following surgery without waking up to take this medication.

For moderate to severe pain, add over-the-counter Tylenol®/acetaminophen according to the package directions. You may take the Tylenol® following ibuprofen if needed. But, for more involved procedures, you will be advised to take Tylenol® along with ibuprofen for the first few days.

In the rare instance that you are prescribed an opioid pain medication, this is to be taken only for severe pain not managed with other measures. Some opioid medications contain Tylenol® / acetaminophen, in which case you’ll be advised about the maximum combined dose of the prescription opioid and over-the-counter Tylenol® in each 24 hour period.

It’s important to take pain medications exactly as recommended. Taking too much of any medicine can be dangerous. In particular, opioids can cause serious problems if you take too much or mix them with other medicines including anti-anxiety medications, sleeping pills, or alcohol. Opioids can also lead to addiction in some people. Only take the amount your doctor tells you to and stop taking the medicine as soon as your pain gets better.