Professor Emeritus,
Dept. of Anesthesiology
University of Utah
Past President, American Pain Society
International Academy of Endodontics Annual Meeting
Long Essay Program
Saturday, January 30, 2016

“Chronic Pain after Endodontic Intervention: How Does Acute Pain Become Chronic?”

All surgical intervention incur risk for the development of chronic iatrogenic pain. Current estimates indicate that 3% - 7% of endodontic patients develop persisting post-treatment pain. Some chronic pain states come to exist independently of a peripheral driver and are therefore refractory. Hypotheses for chronic pain development include nerve injury, loss of endogenous inhibitory pain modulation, endogenous facilitatory pain modulation, central sensitization consequent to glial cell activation, and neuroplastic functional and structural changes in the central nervous system. This presentation will review current research in this field and consider the implications for endodontic practice.


Attendees will learn:

  1. To better understand the scope and nature of iatrogenic chronic pain as a risk in endodontic and related dental practice.

  2. To develop a current understanding of the complexity of pain, its modulation, and its central mechanisms.

  3. Current scientific theories for how acute pain can fail to resolve and eventually become chronic.

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