Pain Management - Quo Vadis?

Pain is one of the most commonly experienced symptoms in dentistry and, as such, is a major concern to the dentist. It is often spoken of as a protective mechanism, since it is usually manifested when an environmental change occurs that causes injury to the responsive tissue. An efficient patient management in endodontic pain is founded with the accurate diagnosis, specific dental treatment as well as application of drug therapy. As a matter of fact, the management of pain should focus on removal of peripheral mechanisms of hyperalgesia, which normally requires treatment that removes or reduces etiologic factors like bacterial immunologic factors. While managing endodontic pain, treatment plan must be modified according to the requirements as per the situation, mechanism of hyperalgesia, complementing the general principles of endodontics and not to forget the medical history and contemporary medications of the patient. For the successful management of endodontic pain, universal principles of pain mechanisms and management must be fully understood and applied to careful treatment development.