Acute endodontic pain

Abstract

Dental pain is amongst the most common types of or ofacial pain, it significantly reduces quality of life in patients and is regarded as a serious public health issue in many countries, furthermore it is main reason of seeking emergency dental treatment. Usually dental pain is caused by pulp and periapical conditions and is inflammatory. The two key components of dental pain are the activity of nerve fibers and alterations in microciculation. Anatomical and neurophysiological differences affecting mentioned type of pain were presented in this paper as well as mechanisms of dental pain form ation, clinical implications of hyperalgesia, allodynia, reffered pain phenomena and therapeutic procedures. The most optimal way of preoperative pain management is implementation of causal treatment as soon as possible, which includes tooth extraction or endodontic intervention. During root canal treatment complete pulp removal is followed by exact chemomechanical preparation of the entire root-canal system with the use of instrumentation and plentiful irrigation and dense obturation. Endodontic therapy allows tooth preservation and periapical tissues healing. Intraoperative pain is controlled with the means of proper local anaesthesia, depending on clinical situation using not only first choice techniques as regional block and infiltrative anaesthesia but also additional methods like intraligammentary, intraosseus and intrapulpal injections. Postprocedural pain management starts during anaesthesia. In article additional pharmacological and non-pharmacological strategies helpful in treating these conditions, providing better effectiveness of local anaesthesia that is difficult in tissue inflammation and decreasing and even preventing development postendodontic pain – common complication of root canal treatment.