Description

Pain is one of the main reasons why patients seek dental treatment and many painful teeth will require root canal treatment. The fear of having pain during root canal treatment is one of the major factors that concerns patients about root canal treatment. In addition, the presence of pre-operative pain is one of the main factors that contributes to patients experiencing pain during and after treatment. Hence, dentists must take care to ensure that the patient does not have any pain during treatment but this can be a significant challenge at times – such as when the tooth has acute irreversible pulpitis and acute apical periodontitis, particularly when the tooth is a mandibular molar where standard local anaesthetic techniques are not very effective. Hence, Dentists must have strategies to overcome this problem and typically a series of cascading steps need to be followed. Dentists should be familiar with alternate (or supplementary) anaesthetic techniques that can be used in conjunction with the standard inferior alveolar block or infiltration techniques. The choice of which supplementary technique should be used will depend on the specific tooth being treated.  Other strategies such as pre-operative medication may also help in some cases. In this lecture, comprehensive strategies to achieve successful anaesthesia of problematic teeth will be outlined together with some new injection techniques. These strategies are based on research by the presenter’s group, particularly for acute irreversible pulpitis.

Learning Outcomes

On conclusion of this session, participants should be able to:

• Describe the sequence of steps to follow to improve local anaesthesia for mandibular teeth with acute irreversible pulpitis
• Describe the sequence of steps to follow to improve local anaesthesia for maxillary teeth with acute irreversible pulpitis
• Outline post-operative pain management strategies following the emergency management of irreversible pulpitis

Prof. Paul Abbott

Prof. Paul Abbott is the Winthrop Professor of Clinical Dentistry at The University of Western Australia. The Specialist Endodontist currently works in private practice on a part-time basis. Prior to taking a full-time University position in 2002, he spent 17 ...