Pain Management
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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: 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.
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Includes Credits
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.
Mike Sabeti, DDS, MA
Dr. Sabeti's impressive dental career began with a DDS degree from the University of Texas Dental Branch at Houston in 1993. He then pursued further specialization, completing programs in Periodontics at Tufts School of Dental Medicine and Endodontics at the Herman Ostrow School of Dentistry of USC .
Following his postgraduate training, Dr. Sabeti served at the University of Texas Dental Branch from 1995 to 2000 in postgraduate periodontology. He has since distinguished himself through leadership roles at the University of California, San Francisco (UCSF). Currently, he directs their postgraduate endodontics program and chairs the PECC. He also holds the prestigious position of president for the Northern California Academy of Endodontics. He is also a site visitor for The Commission on Dental Accreditation and a delegate with the American Dental Education Association.
Dr. Sabeti is a board-certified endodontist renowned for his contributions to the field. He has actively shared his expertise through numerous invited presentations, publications in textbooks and chapters, and his dedication has been recognized with several awards. These include the Certificate in Recognition of Outstanding Services at USC, a Certificate of Appreciation from the University of Texas, and the Excellence in Teaching Award from UCSF's Haile T. Debas Academy of Medical Educators.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.
Kyle Kitasoe, DDS
- Explain the proposed role of herpesviruses, particularly HCMV and EBV, in the pathogenesis and severity of acute apical abscesses.
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Includes Credits
CE Hours: 1.0
Description: Postoperative pain remains a critical concern in endodontic treatment, influenced by multiple factors, including the choice of root canal sealer. Calcium silicate–based sealers like NeoSealerFlo offer biocompatibility and bioactivity, while resin-based sealers such as AH Plus are widely regarded as the gold standard in endodontics. This study aimed to compare postoperative pain and sealer extrusion between these two materials in a large-scale clinical setting.
At the conclusion of this article, the reader will be able to:
- Describe the differences in postoperative pain between Calcium Silicate-Based and Resin-Based root canal sealers over time.
- Examine differences in postoperative pain related to pulpal diagnosis.
- Discuss the factors that may contribute to postoperative pain and pain resolution.
Pablo Ensinas, DDS, MSc
José Aranguren, D.D.S., M.S.
José Aranguren Cangas Dr. José Aranguren received his Doctor Of Dental Surgery Degree in 2000, from the Universidad Europea de Madrid(UEM), in Madrid, Spain. He has practicing exclusively Endodontics since 2000. Dr. Aranguren received his Specialty Certificated in Endodontics from the Southern Mississippi University (USM), Madrid. He has been involved in academics since 2003, and practicing exclusively Endodontics in Madrid, Spain. His major area of scientific research interest include the performance of nickel-titanium endodontic instruments, and Metalurgia. Dr. Aranguren is an internationally recognized lecturer; he is the author of numerous scientific papers published in peer-reviewed journals as well as dental magazines. And also coautor of the book “Microdentistry a practical guide”. (2014). Dr. Aranguren is Associate Professor of Endodontics at the University Rey Juan Carlos of Madrid and Professor of the Director of thr Postgraduate program in Advanced Endodontics at the Rey Juan Carlos University. Now he is also a Faculty member at the International Dental Institute (IDI) and International Endodontic Institute (IEI) in Fort Lauderdale and Palm Beach Gardens, Florida. He is the secretary of the Spanish Society of Endodontics, Member of the American Association of Endodontics and Member of the Carl Zeiss Dental Academy.
Vincenzo Tosco, DDS, PhD
Kenneth Pineda, DDS, MSc, PhD
Giulia Malvicini, DDS
Alejandro R. Perez, DDS, MSc, PhD
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Includes Credits
CE Hours: 1.0
Description: This session will focus on the key aspects of painful TMDs and other orofacial pain conditions, including neuropathic, neurovascular, and nociplastic types, which can mimic or overlap with endodontic pain. The multifactorial etiology and contributing factors—such as occlusion, trauma, and psychosocial influences—of common non-odontogenic orofacial pain conditions will be outlined. We will explore important symptoms, medical history, and personal factors that may affect the pain experience and indicate a non-endodontic origin of pain in endodontic patients. Additionally, a brief TMD pain screening questionnaire tailored for a busy endodontic practice will be reviewed. A validated TMD examination protocol, alongside internationally recognized diagnostic criteria and differential diagnostic measures for neurovascular, neuropathic, and nociplastic pain, will also be presented.
Learning Objectives:
- Identify nonodontogenic orofacial pain diagnoses with a potential to masquerade as endodontic pain. Categorize toothaches originating from nondental sources into one of four main groups of nonodontogenic pain conditions.
- Demonstrate understanding of multifactorial etiology and contributing factors to the most common nonodontogenic orofacial pain conditions.
- Reference and utilize relevant screening tools, diagnositc criteria, and differential diagnostic measures for various orofacial pain conditions mimicking endodontic pain.
Iryna H. Daline, D.M.D., M.S.
Dr. Iryna Daline is both an Endodontist and a board-certified Orofacial Pain specialist. She completed her orofacial pain residency at the University of Minnesota and endodontic residency at the University of North Carolina at Chapel Hill. Her clinical and research interests include differential diagnosis, comorbidity, and treatment of endodontic pain and other orofacial pain conditions. She has received grants from the American Association of Endodontists, American Board of Orofacial Pain, International Association for Dental Research, and Dental Foundation of North Carolina to support her research bridging endodontics and orofacial pain. She has published articles in the Journal of Endodontics, Journal of Oral Rehabilitation, and Cephalalgia. Dr. Daline is a co-author of chapters on non-odontogenic pain in the 3rd edition of Seltzer and Bender's Dental Pulp and the 7th edition of Principles and Practice of Endodontics. She has been repeatedly invited to speak and share her expertise with both dental and endodontic professionals.
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. -
Includes Credits
CE Hours: 0.75
Description: Endodontists necessarily focus on the procedural aspects of root canal treatment, from diagnosis to technique and recall. However, we must also understand the patient’s perspective, and we must know ourselves. Endodontic outcomes, from the presenter’s published systematic reviews, amongst other studies, will be discussed from patients’ and doctors’ points of view. This presentation will explore data on patient’s perceptions. What do patients know about root canal treatment, and why does this matter? What level of anxiety can be expected, and how can it be reduced? Pain, what should be expected, the intensity, the duration, and management? How does root canal treatment impact quality of life? How much does tooth retention and a smile matter? Differences between institutional outcome studies and real-world community endodontics will be explained. The positive economic impact of root canal treatment on the patient will be enumerated. Data on the critical impact of root canal treatment to the elderly and the vulnerable will be summarized. Ways to identify and understand vulnerable young adults will be explained. We dentists may assume that we are completely objective dispassionate scientific professionals implementing evidence-based practice, but the reality is that we also carry all the complex attributes of humanity. Just like patients, our cognitions, knowledge, attitudes, and behaviors are shaped by all of our interactions with the wider world. These will be elucidated, and key differences between endodontists and generalists will be documented. This presentation is both a looking glass, and a celebration, of the conduct and impact root canal treatment.
Learning Objectives:
- Describe endodontic outcomes as measured by data from clinical success and survival instruments, patient-centered instruments, and dentists’ perceptions.
- List the outcome metrics that have the highest impact on patients, and comprehensively evaluate a variety of outcome metrics.
- Discuss the impact of dentists’ cognitions, attitudes and behaviors on treatment outcomes.
Shane N. White, B.Dent.Sc., M.S., M.A., Ph.D.
Shane White is a Professor at the UCLA School of Dentistry. He received his dental training from Trinity College Dublin, spent several years in general practice and part-time teaching in Dublin, received a master's degree in Oral Biology and Certificates in Prosthodontics and Endodontics from UCLA, and a PhD in Craniofacial Biology from USC.
He enjoys teaching in D.D.S. and endodontic residency programs and mentoring student researchers. His research interests include dental biological materials, as well as in patient-centered endodontics and dental outcomes – focusing on the human side. He has won several major research awards, held a handful of National Institutes of Health grants and authored over 130 research papers He has been serially listed in the Stanford University Study as being among the top 2% of scientists worldwide. He has given approximately 400 invited scholarly lectures around the world.
He served as Chair, University of California Academic Senate, and as Faculty Representative to the University of California Board of Regents, being one of the 3 principal leaders of the University of California in 2016-18. He has a notable record of Senate and departmental service at UCLA, where he served as Chair of the UCLA Division of the Academic Senate in 2020-21, being in office throughout the COVID-19 Pandemic from 2019-23. Within the School of Dentistry, he has chaired the Section of Endodontics, the school’s Curriculum Committee and both of its faculty advancement committees. As a professor, and in all of his servant-leadership positions, he has striven to promote access, diversity, equity, inclusion, transparency, and accountability.
He surfs whenever he can.
Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 0.75
Description: Studies have shown that neuropathic pain occurs in 1 to 12% of the patients after root canal treatment. Due to the difficulties of diagnosis, this kind of pain is undertreated, and the patients have a history of repeated unsuccessful therapies. This presentation aims to discuss the mechanisms of its occurrence, how this pain differs from odontogenic pain, the recommended management, and how to prevent this kind of pain during root canal therapy. Among the theories of neuropathic pain, deafferentation is one of the most studied. Afferent neurons from the pulp, after their excision, can lead to chronic pain due to deafferentation. This occurrence involves central sensitization, leading to hyperexcitability of nociceptor neurons in the trigeminal system and persistent pain. In addition, this phenomenon includes glial cell activation. The clinician needs to identify this pain in their practice. The treatment is multidisciplinary and focused on the neurochemistry of this addicted neural circuit. Usually, the prevention of it can be done during endodontic therapy.
Learning Objectives:
- Distinguish neuropathic pain from odontogenic pain.
- Discuss effective treatment options.
- Prevent neuropathic pain during endodontic therapy.
Helena F. Filippini, D.D.S., M.S, Ph.D
Dr. Filippini is an assistant professor of Endodontics at Virginia Commonwealth University. She received a D.D.S. from the Lutheran University of Brazil in 1998. In 2002, she got her Master of Science degree in Endodontics from the same university. Dr. Filippini completed her residencies in Endodontics (2001) and TMJ and orofacial pain (2010) at the Brazilian Association of Dentistry in Brazil. After that, she got a grant from the Brazilian Government that allowed her to do part of her Ph.D studies in Canada at Dr. Barry Sessle's Lab at the University of Toronto.
During her Ph.D., her research was focused on the mechanisms of dental pain and central sensitization, specifically exploring the roles of glial cells and toll-like receptors. She continued to expand her expertise through postdoctoral fellowships in Neuroscience at Dr. Avivi-Arber's lab at the School of Dentistry and at Dr. Bonin's Lab at the School of Pharmacy, both at the University of Toronto. Her studies aimed to understand nociceptive behaviors in mice, particularly the neuropharmacology of hanging behavior that is decreased under inflammatory and neuropathic pain.
In addition, Dr. Filippini worked as an adjunct professor at the Lutheran University of Brazil for over 16 years. Her teaching experience focused on Endodontics, Comprehensive care clinics, Physiology, and Microbiology. She also had her private practice in Brazil for over 20 years, focusing on Endodontics and Orofacial pain therapies. Her research interests are dental pain, glial cells, rodent behavior, and pain modulation.Disclosure(s): No financial relationships to disclose
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Includes Credits
CE Hours: 1.0
Description: Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth.
At the conclusion of this article, the reader will be able to:
- Describe the effectiveness of cold and electric pulp tests (EPT) in assessing the success of inferior alveolar nerve blocks (IANB) in patients with symptomatic irreversible pulpitis.
- Evaluate the sensitivity, specificity, and predictive values of the cold test and EPT in diagnosing pulpal anesthesia failure.
- Discuss the clinical implications of combining cold and electric pulp tests for improving diagnostic accuracy in determining pulpal anesthesia success.
Farzaneh Afkhami, DDS, MSc
Dr. Farzaneh Afkhami is a board-certified endodontist and an associate professor at the Department of Endodontics, Tehran University of Medical Sciences, Iran, and holds an academic affiliation with the School of Dentistry, The University of Queensland, Australia. She has authored over 50 research papers related to endodontics in prestigious peer-reviewed journals. Her work has garnered over 1.3 K citations and an h-index of 19 on Google Scholar. Dr. Afkhami has shared her findings at international scientific conferences and has supervised both
undergraduate and postgraduate students. Additionally, she holds a patent on a nanomaterial product as a root canal medicament, further advancing the field of endodontics.
Sholeh Ghabraei, DDS, MSc
Dr Sholeh Ghabraei is board-certified specialist in endodontics. She currently serves as associate professor in endodontics department, Dental school, Tehran university of medical sciences. Her research focuses on various aspects of endodontics including randomized controlled trials of anesthesia and pain control. She published 44 peer reviewed manuscripts.
Nasim Hashemi, DDS, MSc
Dr. Nasim Hashemi is a board-certified specialist in Endodontics. She achieved 2nd rank in the Iranian Endodontic Board Examination in 2025. Her research focuses on various aspects of endodontics including randomized controlled trials of anesthesia and pain control and broken instrument removal.
She has published nine peer-reviewed manuscripts, contributing to advancements in endodontic science.
Ove A. Peters, D.M.D., Ph.D., M.Sc.
Dr. Ove A. Peters is a clinician-scientist at the UQ School of Dentistry; his expertise is in endodontics, including root canal treatment and vital pulp therapy, combining lab research with clinical studies and >35 years of experience as a dentist. Dr. Peters joined The University of Queensland in 2020 after faculty positions in Heidelberg, Germany and Zurich, Switzerland, as well as at the University of California, San Francisco. He now serves as the Deputy Head of School and professor of Endodontics at UQ. Earlier Dr. Peters was the founding director of the postgraduate endodontic program at the Arthur A. Dugoni School of Dentistry in San Francisco, a professor with tenure and the Chair of the Department of Endodontics at that school; he is board certified by the ABE and currently registered as specialist endodontist in Australia and New Zealand. He has published more 300 manuscripts and 3 books; his works have been cited more than 24,000 times (see here https://scholar.google.com.au/citations?user=BX9jJ_UAAAAJ). He serves as associate editor for the International Endodontic Journal. Dr. Peters has received the Louis I Grossman Award by the AAE, the Hans Genet Award by the ESE and more recently the Distinguished Scientist Award in Pulp Biology by the IADR.Disclosure(s): Dentsply Sirona: Grant/Research Support (Ongoing), Honorarium (Ongoing)
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Includes Credits
CE Hours: 1.25
Description: Pain is fraught in the dental world. It is often the driver of emergency dental visits, yet it also keeps many fearful patients out of the dental chair. Thankfully, we live in a world with effective pharmaceuticals to manage pain of endodontic origin pre-operatively, effective anesthesia to eliminate painful delivery of care, and strategies to minimize postoperative discomfort. In this lecture, we’ll present an organized and evidence-based algorithm for both diagnosing and managing pain of endodontic origin, including before, during and following the delivery of definitive care.
Learning Objectives:
- Explain the origins of orofacial pain
- Discuss appropriate management strategies for pain of endodontic origin
- Review management strategies for postoperative and persistent pain conditions
Brooke Blicher, DMD, Certificate in Endodontics
Dr. Brooke Blicher received her BA in Chemistry from Colgate University, where she graduated Magna Cum Laude and Phi Beta Kappa, her DMD from the Harvard School of Dental Medicine where she graduated with honors in research, and her certificate in Endodontics from Tufts University School of Dental Medicine.
Dr. Blicher is a Diplomate of the American Board of Endodontics, and a Fellow in both the American College of Dentistry and the International College of Dentistry. She continues to be involved with teaching, research and mentorship, holding faculty appointments at both Harvard and Tufts Schools of Dental Medicine. Dr. Blicher has been involved in organized dentistry as a member of several committees for the American Association of Endodontists, and her local and state dental societies.
While providing state of the art specialty care in her private practice in White River Junction, Vermont, Dr. Blicher continues to pursue her academic interests. She authored the chapter “Diagnosis and Treatment Planning” in the 6th edition of Endodontics: Principles and Practice, as well as the textbooks Endodontics: A Review, now in its second edition, and the newly published Clinical Endodontics, available in March. She has published extensively, including in the Journal of Dental Research, General Dentistry, Inside Dentistry, and Compendium. Dr. Blicher has lectured both locally and internationally on endodontic diagnosis, non-odontogenic pain, fractures, trauma, resorption, treatment of immature teeth, and CBCTs in endodontics as well as on ideal restorative care following endodontic treatment.
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: Quintessence Publishing (Individual(s) Involved: Self): other financial or materials support.