Prevention and management of pain after endodontic treatment

• Main Authors: K. V. Vetkova, E. V. Elohina, L. M. Lomiashvili, A. V. Chekina, S. M. Gorev
• Format: Article
• Language: Russian
• Published: LLC "Endo Press" 2021-05-01
• Series: Эндодонтия Today
• Subjects: endodontics; pain; inflammation; nonsteroidal anti-inflammatory drugs; side effects; gastritis; peptic ulcers
• Online Access: https://www.endodont.ru/jour/article/view/937

Aim. Medical therapy optimization for the prevention and management of pain after endodontic treatment.Materials and methods. A clinical study, in which 68 patients with sequelae of dental caries were examined. The following methods were used:clinical method, roentgenological method, pharmacoepidemiological method, expert judgements, mathematical statistics.Results. A spectrum of analgesics for self-medication of dental pain included 8 medications; 92.6% of which are nonsteroidal anti-inflammatory drugs. Pathology of gastritis in the past medical history was identified in 39.7 ± 5.9% of the patients. Pain was recorded in 79.4 ± 5.4% of the patients. After having finished the treatment analgesic was prescribed in 42.6 ± 4.2% of the cases. Analgesics were taken by 73.5 ± 5.4% of the patients with postendodontic pain. The connection between the analgesic's “strength” and the subjective assessment of its efficacy was identified: r = +0.31 p = 0.035.Conclusions. In most cases pain severity before and after endodontic treatment can be evaluated as moderate. Ketorolac (51,9%) is used as a preferred medication for self-help by the patients with dental pain. Ibuprofen (56,4%) and ketorolac (33,3%) are prescribed by doctors as an analgesic after endodontic treatment in most cases.However, patients often do not follow doctors' orders and choose other nonsteroidal anti-inflammatory drugs as a selfmedicating for preventing the pain. A prescription pattern of analgesic drugs for the prevention and management of pain after endodontic treatment is introduced: for moderate pain - ibuprofen or paracetamol, for severe pain - ketoprofen for the patients with somatic system disorder or ketorolac for the patients without somatic symptom disorder.