The most common cause of pulp/periapical pathosis is caries. In this chapter host–microbial interaction and the pulp’s dynamic response to the inflammatory process is described. The process occurs within a unique low-compliance environment due to the hard unyielding walls of dentin surrounding the pulp. The result of this anatomy is an inability of the pulp to swell as it becomes progressively more inflamed. Understanding canal anatomy is an essential part of recognizing endodontic symptoms and providing emergency pain relief and subsequent therapy.
Recognizing factors that predispose a patient to pain is an important part of implementing pain-preventive strategies. While iatrogenic errors (inaccurate measurement control, over-instrumentation) often play a role in postoperative pain, there are other, less obvious, factors including genetics, gender, and anxiety that may predispose a patient to pain. The significance of these factors in relation to patient’s pain is described. Strategies to reduce patient’s anxiety are also discussed.
Postoperative pain may occur following instrumentation or obturation. Pain-preventive, evidence-based strategies, including occlusal reduction, are described.
