Pain and analgesic use in endodontics

Abstract

Dental pain is an undesirable situation for both the clinician and the patient. Clinician should overcome this discomfortable situation. Understanding of the pain system, a good endodontic dental procedure and the use of appropriate analgesics are important steps in management of dental pain. Pain system starting with the signal detection of tissue damage in the periphery, ongoing processing of data at the level of the spinal cord, perceived at the high brain regions such as cerebral cortex is a multilevel and complex system. A clinician who understands all levels of the pain system basically can perform effective methods of pain control by getting the opportunity of using therapeutics. There are thin, unmyelinated C fibers and Aδ fibers which is small and less myelinated in the pulp for the pain perception. Non-narcotic and narcotic analgesics are prefered to manage endodontic pain. Acetaminophen and non-steroidal antiinflammatory drugs or opioid analgesics and combinations of these drugs are frequently used in endodontic pain management. In this review information will be given about the mechanism of endodontic pain, transmission paths and analgesics used for pain management. Keywords: Analgesic, dental pain, endodontics, non-steroidal antiinflammatory, pulpitis.

Keywords

• Analgesic, dental pain, endodontics, nonsteroidal antiinflammatory, pulpitis

Endodontide ağrı ve analjezik kullanımı

Abstract

Dental ağrı hem hekim hem de hasta için istenmeyen bir durumdur. Hekim bu durumun üstesinden gelebilmelidir. Ağrı sisteminin anlaşılması, iyi bir endodontik prosedür ve uygun analjeziklerin kullanımı dental ağrının kontrolünde önemli adımları oluşturmaktadır. Ağrı sistemi, periferde doku hasarı yapan uyaranın tespiti ile başlayan, verinin omurilik düzeyinde işlenmesiyle devam eden, serebral korteks gibi yüksek beyin bölgelerinde algılanan, çok seviyeli ve kompleks bir sistemdir. Temel olarak ağrı sisteminin her seviyesini anlayan bir klinisyen, terapötikleri kullanma fırsatını yakalayarak etkili ağrı kontrol metodlarını uygulayabilir. Pulpada ağrı algılanmasında ince ve myelinsiz olan C fibrilleri ile küçük ve daha az myelinli olan Aδ fibrilleri bulunmaktadır. Narkotik ve non-narkotik analjezikler endodontik ağrıyı yönetmek için tercih edilir. Endodontik ağrının yönetiminde asetaminofen ve non steroid antiinflamatuvar ilaçlar veya opioid analjezikler ile bu ilaçların kombinasyonları sıklıkla kullanılmaktadır. Bu derlemede endodontik ağrı mekanizması, iletim yolları ve ağrı yönetimi için kullanılabilecek analjezikler hakkında bilgi verilecektir. Anahtar Kelimeler: Analjezik, dental ağrı, endodonti, non steroid antiinflamatuvar, pulpitis.

Keywords

• Analjezik, dental ağrı, endodonti, non steroid antiinflamatuar, pulpitis

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