Evidence-Based Recommendations for Analgesic Efficacy to Treat Pain of Endodontic Origin

Dr. Anita Aminoshariae, Director of Predoctoral Endodontics in the School of Dental Medicine at Case Western Reserve University, spoke to Dr. Chiraz Guessaier regarding evidence-based recommendations with respect to the analgesic efficacy when treating pain of endodontic origin.

Third molar extraction usually serves as the pain model for evaluating analgesic efficacy. However, these patients are usually young without any comorbidities or significant health risks or issues. Endodontic patients, typically, are older individuals who may be taking medications for existing conditions and have periapical infection and/or pulpal inflammation.

Key Findings
• NSAIDS are the drug of choice unless there are clear contraindications
• NSAIDS + Acetaminophen can be used if NSAIDs alone are not reducing the pain
• Steroids are useful in reducing pain related to irreversible pulpitis
• The oral surgery pain model may be helpful in alleviating pain of endodontic origin but, it is inconsistent and further research is required.