Anagelisics
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Includes Credits
CE Hours: 1.0
Description: Up until recently the only drugs available to manage acute dental l pain were acetaminophen, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids. NSAIDs cannot be taken by a variety of patients due to poor renal function, a history of GI ulcers, drug allergy or sensitivity and for the possibility of adverse drug interactions with anticoagulants and lithium. Opioids are wrought with acute side effects including dizziness, drowsiness, nausea, vomiting and constipation. Their potential to cause substance misuse, physical dependence and addiction are also well described. On January 30, 2025 suzetrigine, a novel voltage gated sodium channel 1.8 (Nav 1.8) blocking agent was granted FDA approval for the management of moderate to severe pain. By selectively blocking the Nav 1.8 it is hoped that side effects will be less numerous and severe compared to drugs that indiscriminately block other Nav subtypes such as anticonvulsants and local anesthetics.. Unlike opioids, suzetrigine also appears to be devoid of addiction potential. In two Phase 3 post-surgical pain trials on research patients who underwent bunionectomy or abdominoplasty, suzetrigine was significantly more effective than placebo, but its analgesic effects were only equivalent to acetaminophen 325 mg plus hydrocodone 5 mg (APAP 325 mg/HYDRO 5 mg) respectively. These results are somewhat disappointing with regards to postsurgical dental pain where 440 mg naproxen sodium or APAP 500 mg plus ibuprofen 400 mg (APAP 500 mg/IBU 400 mg) have been demonstrated to provide superior analgesic effects when compared to APAP 650 mg/HYDRO 10 mg or APAP 300 mg/HYDRO 5 mg respectively. This presentation will discuss the genesis of dental postsurgical pain, the nomenclature and anatomical locations of various Nav channel subtypes and suzetrigine's possible utility and limitations in treating orofacial pain. Suzetrigine represents only the first step to optimize the selective blockade of Nav channels to treat various patient maladies.
Learning Objectives:
- Discuss the mechanism of action of suzetrigine
- Discuss the advantages and limitations of employing suzetrigine in the treatment of acute dental pain
- Identify which patients should not receive analgesic regimens that contain ibuprofen or naproxen sodium
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Includes Credits
CE Hours: 1.0
Description: This presentation will focus on two areas. 1) Serious adverse drug interactions that may occur in the Endodontic Patient because of drugs that he/she prescribes or administers and 2) Serious adverse drug interactions that may occur in the endodontist himself/herself because of drugs that they are taking for various medical conditions. The three serious drug interactions that may adversely affect the dental patient include; 1) the ability of the antimicrobials metronidazole and fluconazole to inhibit the metabolism of warfarin by blocking cytochrome P-450 2C9 (CYP-2C9), the major metabolic pathway of warfarin, resulting in dramatic increases in patients' international normalized ratios (INRs) and potentially fatal bleeding. 2) The ability of ibuprofen or naproxen sodium to inhibit the renal excretion of the major bipolar disorder drug lithium resulting in tremors, seizures and renal toxicity. 3) The ability of propranolol and other nonselective beta-adrenergic blocking agents to inhibit the vasodilatory effect of epinephrine in dental local anesthetic solutions, leading to severe hypertensive reactions and a concomitant reflex bradycardia. Interactions relevant to the health of dentists themselves include the ability of grapefruit juice/grapefruit to elevate blood levels of statin cholesterol lowering drugs, increasing the risk of myalgia, rhabdomyolysis and acute renal failure. It is important for clinicians to understand the theoretical basis behind these often-predictable interactions, and comprehend the evidenced-based-science that supports their existence.
Learning Objectives:
- Discuss the pharmacological mechanism behind the potentially lethal metronidazole or fluconazole/warfarin interaction.
- Discuss the rationale of why recommending ibuprofen (Advil®) and naproxen sodium (Aleve®) for pain control is a bad idea in a bipolar disorder patient taking lithium (Eskalith®).
- Identify which class of anti-hypertensive drugs where high doses but therapeutic doses of local anesthetic plus epinephrine is most likely to cause a a pressor response with a reflex bradycardia.
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Includes Credits
CE Hours: 1.25
Description: This course is an unbiased and evidence-based presentation of marijuana and its role in dentistry. I will present an introduction to the history of marijuana and trends pertaining to its use. Next, I will provide a basic science review regarding the Cannabis plant, the drug marijuana, and the Endocannabinoid System. I will review how marijuana use affects oral and general health. Finally, I will address areas of possible dental research related to cannabinoids.
Learning Objectives:
- Describe the Endocannabinoid System, what cannabinoids are, and how marijuana is connected.
- Define how marijuana affects oral and general health - specifically detailing oral pathology, dental caries, and periodontal disease
- Describe how to communicate with patients regularly using marijuana
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Includes Credits
CE Hours: 1.0
Description: Cannabidiol (CBD) is a primary cannabinoid that has shown great promise as an analgesic alternative. This talk will present the most up-to-date data on the use of cannabidiol (CBD) for managing dental pain.
Learning Objectives:
- Evaluate the current preclinical and clinical evidence on CBD for dental and orofacial pain, including efficacy, dosing considerations, safety profile, and limitations of existing studies.
- Describe biological mechanisms by which cannabidiol (CBD) modulates dental pain, with emphasis on peripheral and central nociceptive pathways.
- Discuss the potential clinical implications of CBD as a non-opioid adjunct for dental pain management, highlighting opportunities, challenges, regulatory considerations, and future directions for endodontic and dental practice.
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Includes Credits
CE Hours: 1.0
Description: Dental pain can be incapacitating, and non-opioid alternatives to current regimens are warranted. This session will discuss Cannabidiol (CBD), a primary cannabinoid, as a dental analgesic. We will present data from the first randomized clinical trial on the effectiveness and safety of CBD for patients presenting with emergency dental pain. We will further elaborate on potential mechanisms of action based on our preclinical models.
Learning Objectives:
- Recognize the opioid crisis and the need for more non-opioid analgesics for dental pain.
- Discuss the advantages of using CBD as a drug for dental pain and utilize it in a clinical setting.
- Identify possible mechanisms of action for the CBD analgesic effect.
Vanessa Chrepa, DDS, MS, PhD
Dr. Vanessa Chrepa was born and raised in Athens, Greece. She received her DDS from the University of Athens School of Dentistry. She completed her residency and Master’s in Endodontics at UT Health San Antonio with a full scholarship from the Onassis Foundation. Later, she received a PhD in Translational Science from UTSA. She is currently an Associate Professor and Director of Clinical and Translational Research in the Endodontics and Oral Biology departments at Rutgers School of Dental Medicine. Dr. Chrepa is a Diplomate of the American Board of Endodontics and a full-time educator for 10 years. In 2017, she received the AAE Educator Fellowship Award for her academic accomplishments. Her research interests include regenerative endodontics, stem cell biology, endodontic outcomes, and cannabinoids for dental pain. She is a member and past chair of the AAE Regenerative Endodontics Committee. She is an Editorial Review member for the Journal of Endodontics and International Endodontic Journal, among others. Alongside her teaching and research, Dr. Chrepa maintains a private practice limited to Endodontics.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 2.0
Description: Narcotics can provide substantial pain relief, and when used judiciously on a case-by-case basis, can be a valuable tool. You will first learn about the inflammatory, neurological and psychological processes that contribute to the great range of pain responses you encounter. This foundational knowledge will feed a discussion of preoperative, perioperative and postoperative approaches for more effective pain management, which when used together can prevent a need for narcotics in most cases. But there are times when you will use narcotics. Dr. Young will explain how narcotics work and how they compare to each other and to other forms of pain control, in addition to dosing, how dependence and addiction occur and how that differs by age and by psychological make-up. He will also cover the controlled-substances prescribing laws, and how to recognize and address addiction and drug-seeking behavior.
Learning Objectives:
- Develop practices for pain management in dentistry.
- Describe the regulatory requirements for prescribers and dispensers.
- Develop dental office procedures for managing vulnerable or substance use disorder patients.
Andrew Young, D.D.S., M.S.D.
Andrew Young earned his DDS from UCSF, his GPR certificate from the VA Northern California Healthcare System, and his MSD in Orofacial Pain from UMDNJ (now Rutgers School of Dental Medicine). He is Board-Certified with the American Board of Orofacial Pain, and a Fellow of the American Academy of Orofacial Pain.
He is an Associate Professor with Tenure in the Department of Diagnostic Sciences at the Arthur A. Dugoni School of Dentistry, University of the Pacific. There he is in charge of the teaching, research, and patient-care of patients with temporomandibular disorders, neuropathic pain, and headaches. Before joining UOP full-time, he worked part-time at a community clinic for 9 years. His other role at UOP is heading the evidence-based dentistry curriculum, which teaches students to acquire, appraise, and apply research when making clinical decisions.Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.75
Description: When a patient has persistent pain after root canal treatment it can be disruptive to a practitioner’s schedule and psyche. The first part of this two-part session will give practitioners a review of practice-based research outcomes on persistent pain, differential diagnosis for persistent pain following root canal treatment, pharmacologic management of persistent pain on the neurobiology of pain. The second part of the session will present cases of patients with persistent post-treatment pain, diagnostic and treatment considerations, and pharmacologic management, with opportunities for audience questions.
Learning Objectives:
- Discuss treatment options for managing persistent pain following endodontic treatment.
- Discuss pharmacologic management of persistent pain.
- Discuss how endodontists can work with facial pain practitioners to manage patients with persistent pain.
Alan S. Law, DDS, PhD
Dr. Alan Law received his Doctor of Dental Surgery and Certificate in Endodontics from the University of Iowa College of Dentistry, Iowa City, Iowa. He also completed his PhD, “Mechanisms and Modulation of Orofacial Pain”, with the Department of Pharmacology at the University of Iowa. Dr. Law has published over 40 articles in scientific and clinical journals, and has co-authored chapters on The Non-Odontogenic Toothache and Regenerative Endodontics in Pathways of the Pulp, and has lectured at over 300 local, national and international meetings. Dr. Law is a member the American Dental Association, American Association of Endodontics, and Omicron Kappa Upsilon Dental Honor Society, and a Fellow of the American College of Dentists and the International College of Dentists. He is a Past President of the American Association of Endodontists, Past President of the Minnesota Association of Endodontists, and Past President of the American Board of Endodontics. He is in full –time practice in the Twin Cities, and President of The Dental Specialists, a multi-specialty dental practice with over 35 specialists. He is also a Research Professor in the Division of Endodontics at the University of Minnesota.
Speaker Disclosure
In accordance with this policy, I declare I have a past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith, as indicated: National Dental Practice-Based Research Network and the American Dental Association.
Karen Baker, BSRPh, MS
Professor Karen Baker has been on the Dental College faculty at the University of Iowa for over 40 years and occupies a unique role in dental practice and education. She is a clinical pharmacist with a Master’s degree in clinical pharmacology and therapeutics and is focused on patient-specific dental drug therapy. She has given well over 1000 invited programs nationally and internationally and holds memberships in many dental and clinical pharmacology and therapeutics organizations. Her dental education-based pharmacy and drug therapy consultation center is the only one in the United States. She has authored many articles and abstracts and lectures extensively in pre-doctoral and graduate courses at the University of Iowa.
Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
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Includes Credits
CE Hours: 1.25
Description: When a patient has persistent pain after root canal treatment it can be disruptive to a practitioner’s schedule and psyche. The first part of this two-part session will give practitioners a review of practice-based research outcomes on persistent pain, differential diagnosis for persistent pain following root canal treatment, pharmacologic management of persistent pain on the neurobiology of pain. The second part of the session will present cases of patients with persistent post-treatment pain, diagnostic and treatment considerations, and pharmacologic management, with opportunities for audience questions.
Learning Objectives:
- Discuss the frequency of persistent pain following root canal treatment based upon results of recent practice-based research.
- Discuss potential predictors of persistent pain following root canal treatment based upon results of recent practice-based research.
- Discuss a differential diagnosis for persistent pain following root canal treatment
Alan S. Law, DDS, PhD
Dr. Alan Law received his Doctor of Dental Surgery and Certificate in Endodontics from the University of Iowa College of Dentistry, Iowa City, Iowa. He also completed his PhD, “Mechanisms and Modulation of Orofacial Pain”, with the Department of Pharmacology at the University of Iowa. Dr. Law has published over 40 articles in scientific and clinical journals, and has co-authored chapters on The Non-Odontogenic Toothache and Regenerative Endodontics in Pathways of the Pulp, and has lectured at over 300 local, national and international meetings. Dr. Law is a member the American Dental Association, American Association of Endodontics, and Omicron Kappa Upsilon Dental Honor Society, and a Fellow of the American College of Dentists and the International College of Dentists. He is a Past President of the American Association of Endodontists, Past President of the Minnesota Association of Endodontists, and Past President of the American Board of Endodontics. He is in full –time practice in the Twin Cities, and President of The Dental Specialists, a multi-specialty dental practice with over 35 specialists. He is also a Research Professor in the Division of Endodontics at the University of Minnesota.
Speaker Disclosure
In accordance with this policy, I declare I have a past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith, as indicated: National Dental Practice-Based Research Network and the American Dental Association.
Karen Baker, BSRPh, MS
Professor Karen Baker has been on the Dental College faculty at the University of Iowa for over 40 years and occupies a unique role in dental practice and education. She is a clinical pharmacist with a Master’s degree in clinical pharmacology and therapeutics and is focused on patient-specific dental drug therapy. She has given well over 1000 invited programs nationally and internationally and holds memberships in many dental and clinical pharmacology and therapeutics organizations. Her dental education-based pharmacy and drug therapy consultation center is the only one in the United States. She has authored many articles and abstracts and lectures extensively in pre-doctoral and graduate courses at the University of Iowa.
Speaker Disclosure
I declare that I have no proprietary, financial, or other personal interest of any nature or kind in any product, service, course, and/or company, or in any firm beneficially associated therewith, that will be discussed or considered during the proposed presentation.
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Includes Credits
CE Hours: 1.75
Description: This presentation will first identify the potential problem in prescribing opioids for dental postsurgical pain and other painful dental conditions. The biochemical and physiological mechanisms behind post-surgical dental pain will be reviewed and a discussion of various double-blind randomized controlled trials on the efficacy of various analgesic agents following the surgical removal of impacted third molar teeth will take place. A discussion of the “drug seeking patient” and the prescription opioid abuse problem will be highlighted. The final portion of this discussion will focus on meta-analysis data for various analgesics in both dental pain and other post-surgical pain models. In other words, “Which analgesics consistently lead the pack and which are consistently dogs.” An updated flexible analgesic schedule which was published in JADA will finalize the program.
Learning Objectives:
- Explain the potential consequences of even short-term exposure to opioids.
- Compare the analgesic efficacy of NSAIDs to single entity oral opioids and acetaminophen/opioid combination drugs in randomized placebo controlled double-blind oral surgery pain studies.
- Summarize meta-analysis data of NSAIDs and opioid combination drugs on the numbers needed treat (NNT) to obtain one additional patient with at least 50% maximum pain relief.
Elliot V. Hersh, D.MD, M.S., Ph.D
Dr. Elliot V. Hersh is currently a professor of pharmacology/oral surgery at the University of Pennsylvania School of Dental Medicine. He received his D.M.D. degree from New Jersey Dental School UMDNJ in 1981 and his M.S. and Ph.D. degrees from UMDNJ Graduate School of Biomedical Sciences in 1983 and 1988 respectively. Since arriving at the University of Pennsylvania in 1988, Dr. Hersh has won the Dental School's Excellence in the Teaching of Basic Science Award 24 different times and was also presented with a University Lindback Award in 1993, the highest teaching honor in the entire university. He has published more than 200 scientific articles, abstracts and book chapters in the areas of dental pharmacology, drug interactions, analgesics and local anesthetics. His scholarly and research contributions in the areas of local anesthesia and pain control were recognized by the International Association of Dental Research in 2007 when he was presented with the Distinguished Scientist Award in Pharmacology, Therapeutics and Toxicology. He is currently collaborating with Dr Katherine Theken at PENN in trying to identify presurgical biomarkers that may predict the analgesic response to NSAIDs. "While the research accolades are nice, the most important thing I do is sharing this knowledge with my students and other dental professionals."
Disclosure(s): NIH/NIDCR: Grant/Research Support (Ongoing)
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Includes Credits
CE Hours: 1.5
Description: The goal of outpatient regimens for anxious dental patients is often described as 'sedation', a non-specific decrease in consciousness and patient responsiveness which is often accompanied by respiratory depression. The patient perspective suggests that reduction in anxiety and minimal pain during the procedure are more specific outcomes that can be accomplished with drugs that produce negligible CNS depression: benzodiazepines, effective local anesthesia and nitrous oxide. This presentation will describe the scientific evidence to support safe pharmacologic strategies for outpatient procedures without the risks of parenteral drug administration or additive drug combinations that incrementally reduce safety with little benefit to the patient.
Learning Objectives:
- Identify the major variable that contributes to therapeutic efficacy and sedation for outpatient sedation procedures in dental offices
- Identify the drugs, doses and routes of administration that optimize the balance between safety and therapeutic success
- Identify the benefits of having an appropriately trained clinician to monitor the patient, administer the anxiolytic agents and manage adverse events independent of the clinician performing the dental procedure
Raymond Dionne, D.D.S., M.S. Ph.D.
Dr. Dionne received a DDS from Georgetown University and a PhD from the Medical College of Virginia. He conducted clinical and translational pain research at the National Institute of Dental and Craniofacial Research for 34 years, as well as practiced dentistry part-time in the District of Columbia. He is currently a restless retiree living in Missouri.
Speaker Disclosure
In accordance with this policy, I declare I have a past or present proprietary or relevant financial relationship or receive gifts in kind (including soft intangible remuneration), consulting position or affiliation, or other personal interest of any nature or kind in any product, service, course and/or company, or in any firm beneficially associated therewith, as indicated: AIM Targeted Therapeutics: Consultant on preclinical development of an investigational analgesic formulation (Ongoing); Rilento Pharma: consultant for pre-clinical development of investigational analgesic formulation (Ongoing)