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.

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.

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

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.

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

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

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.

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.

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

If it’s legal in your area, cannabis (get an indica strain that is noted as effective for pain) can help, when you take it with ibuprofen and acetaminophen, plus use ice packs. It’s not nearly as good as proper pain meds but will help a lot, and can help with sleep.