Microbial Causes of Inter Appointment Flare up-Review

Abstract

The inter-appointment flare may be defined as the occurrence of severe pain and swelling or both within few hours or days following endodontic treatment appointment, requiring an unscheduled visit. The current endodontic treatment is supposed to be a pain free during the procedure but still the patient may encounter the pain after the appointment. Although some patients may experience mild moderate pain some patients may end up with the flare up. The causative factors of inter appointment pain encompass mechanical, chemical, and/or microbial injury to the pulp or per iradicular tissues. Microorganisms can participate in causation of inter appointment pain in the following situations apical extrusion of debris; incomplete instrumentation leading to changes in the endodontic microbiota or in environmental conditions; and secondary intra radicular infections. This article is a review on the microbial cause and reason for the sudden inter-appointment flare up and steps to manage and prevent them.