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

CE Hours: 0.75

Description: Endodontics has achieved significant progress in both diagnostic procedures and therapeutic approaches. However, the pharmacological management of acute endodontic pain still relies heavily on conventional strategies, predominantly based on systemic monotherapy. Although many of these approaches are clinically effective, their inappropriate or excessive use has contributed to relevant public health issues, particularly due to the misuse and overprescription of certain drugs. In this context, an important question arises: where should the future of acute endodontic pain management be directed? While the development of new analgesic drugs remains a long and expensive process, more accessible short-term alternatives may be considered. These include the combination of existing pharmacological agents to achieve synergistic effects, as well as the design of advanced drug delivery systems aimed at modulating peripheral mechanisms of pain transmission.Multimodal analgesia, through the use of synergistic combinations, allows for a shift in prescription habits-offering enhanced analgesic efficacy, reduced side effects, and shorter treatment durations. Furthermore, the incorporation of hydrogels, nanomaterials, and polymeric scaffolds as carriers for localized, controlled drug release presents a promising alternative that may significantly reduce the need for systemic drug exposure. This lecture explores currently available multimodal analgesic strategies in endodontics and discusses emerging peripheral alternatives that target pain control directly at its source. Such innovations may represent a paradigm shift in how dental professionals approach pharmacological pain management, promoting more precise, efficient, and safer therapeutic protocols.

Learning Objectives:  

• Recognize the peripheral and central mechanisms involved in the development of endodontic dental pain.
• Identify the principles to propose effective pharmacological combinations by analyzing multimodal strategies based on analgesic synergism.
• Identify emerging drug delivery systems as a strategy for the peripheral control of endodontic pain.

CE Hours: 1.5

Description: Post-treatment pain remains one of the most significant concerns for both patients and providers following root canal treatment. This session will explore the latest evidence and clinical strategies for recognizing, preventing, and managing pain after endodontic therapy. Experts will review the differential diagnosis and management of acute posttreatment pain, highlight advances in understanding the mechanisms and risk factors for persistent pain, and discuss findings from practice-based research that reflect real-world outcomes across diverse practice settings.

Learning Objectives:  

• Diagnose and manage acute posttreatment pain using evidence-based strategies for pharmacologic and non-pharmacologic interventions.
• Recognize the risk factors, mechanisms, and clinical presentation of persistent pain following root canal treatment and apply current management approaches.
• Interpret findings from practice-based research on posttreatment pain and integrate these insights into everyday clinical practice.

CE Hours: 1.25

Description: This lecture will provide an overview of common orofacial pain  clinical presentations and diagnoses to help the endodontist differentiate between odontogenic and non-odontogenic etiology and provide a roadmap of evidence-based treatment strategies. The lecture will include relevant head and neck anatomy, neurologic pathways, treatments and a practical approach to clinical diagnosis and management of patients who present with atypical clinical symptoms.

Learning Objectives:  

• Describe the pathophysiology of common non-odontogenic causes of orofacial pain mimicking dental symptoms
• Identify clinical exam and diagnostic testing strategies to identify the true source of pain
• Describe evidence-based management of non-odontogenic symtpoms

CE Hours: 1.0

Description: Central sensitization is a critical mechanism underlying persistent pain following root canal therapy. It occurs when the central nervous system enters a prolonged state of hyperexcitability, leading to the amplification of pain. This phenomenon contributes to the development of neuropathic pain, which may affect approximately 1-12% of patients after endodontic procedures. One proposed mechanism is deafferentation, where the removal or injury of pulp afferent neurons disrupts normal sensory input. This disruption can trigger maladaptive neuroplastic changes, including activation of glial cells, which perpetuate a hyperexcitable state and reinforce chronic pain pathways. Preventing neuropathic pain begins during endodontic therapy. Minimizing neural trauma, recognizing early signs of sensitization, and applying evidence-based pain management strategies are essential to improving patient outcomes. This lecture aims to clarify central sensitization in endodontic therapy, its relationship with neuropathic pain, and the implications of these occurrences in endodontic treatment.

Learning Objectives:  

• Identify signs of central sensitization in endodontic patients
• Define the neurobiological mechanisms linking endodontic procedures to neuropathic pain
• Implement preventive  strategies to reduce the risk of persistent post-treatment pain

CE Hours: 1.5

Description: Orofacial pain presents a complex diagnostic landscape that often overlaps with endodontic pathology, making accurate diagnosis and effective treatment a significant clinical challenge. The collaboration between orofacial pain specialists and endodontists is emerging as a pivotal strategy in improving patient outcomes, especially in cases where conventional endodontic diagnosis fails to fully explain a patient's symptoms. This interdisciplinary approach enables a more comprehensive evaluation of pain mechanisms, distinguishing odontogenic from non-odontogenic sources, neuropathic conditions, and referred pain patterns.Recent therapeutic advances have enhanced the ability to identify and manage atypical presentations of endodontic pain, such as persistent idiopathic facial pain and neuropathic components of post-root canal treatment.   

Learning Objectives:  

• Differentiate among odontogenic, musculoskeletal, neuropathic, and referred pain mechanisms.
• Use structured approaches to evaluate cases that do not follow conventional endodontic patterns.
• Integrate recent evidence and therapeutic advances in the management of acute non-odontogenic pain in their practice.

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 

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.

CE Hours: 1.0

Description: This presentation will explore current evidence-based strategies for pain management before, during, and after endodontic procedures. We will review the neurobiological mechanisms underlying acute and persistent pain, providing a foundation for understanding the core principles of effective pain control. Emphasis will be placed on integrating these principles into clinical decision-making to optimize patient outcomes. Additionally, the session will include case-based scenarios that highlight pain management challenges, such as performing endodontic treatments on patients with pre-existing chronic pain conditions. These cases will illustrate practical evidence-based strategies that tailor pain management strategies to individual patient needs. The knowledge gained will enhance attendees clinical practice by optimizing patient comfort during and after surgical and non-surgical procedures.

Learning Objectives:  

• Describe the neuro-biological mechanisms that drive acute and persistent pain after endodontic treatments.
• Identify risk factors for worse or non-resolving pain after endodontic procedures in your patients.
• Identify the current evidence for newer pharmacologic and non-pharmacologic approaches to pain control.

CE Hours: 1.0

Description: Acute apical abscesses are known for rapid-onset pain and swelling from pulp necrosis. While typically associated with polymicrobial infections, recent research suggests that active herpesvirus infections may also contribute. This randomized, doubleblind, placebo-controlled trial aimed to evaluate if valacyclovir, when combined with amoxicillin, can consistently manage pain and how individual patients respond within a larger population.

At the conclusion of this article, the reader will be able to: 

• Explain the proposed role of herpesviruses, particularly HCMV and EBV, in the pathogenesis and severity of acute apical abscesses. 
  
• Describe the rationale for using adjunctive valacyclovir with systemic antibiotics in patients with acute apical abscesses and moderate-to-severe persistent pain. 
• Evaluate the study design, eligibility criteria, and primary clinical outcomes used to assess whether adjunctive valacyclovir accelerates pain reduction and decreases analgesic use.