Managing pain can be one of the most challenging aspects of the clinical practice of endodontics, and one by which the skill of the clinician is often judged. Achieving successful pain control in a predictable, efficient manner requires a working knowledge of the underlying biology of the body pain system and mechanism by which drugs and therapies provide relief. Management of pain for endodontic therapy encompasses three aspects: Pre-operative, intra operative and post-operative pain management. First and the most important in managing any kind of pain is the correct diagnosis, as correct treatment begins with correct diagnosis. Before going to the definitive treatment pre-medication should be considered as primitive therapy as it not only inhibits the attenuation of the nociceptive signal (pre-operative pain) but also prevents the progression to chronic, recalcitrant neurogenic pain. Pain control by means of local anaesthesia is an intrinsic part of clinical practice in dentistry. The importance of inter-appointment intracanal medicament should be considered to eliminate and prevent re-colonization of bacteria. Drug therapy including analgesic, anti-inflammatory and antibiotics.
