Acupuncture for Management of Endodontic Emergencies: a Review

Abstract

Root canal treatment (RCT) employed for painful endodontic conditions like apical periodontitis and irreversible pulpitis is associated with a high incidence of postoperative pain. Pharmacological management for this purpose is effective, but not entirely free from side effects and in some cases may fail to provide adequate relief. Furthermore, concerns have been raised regarding the transmission of coronavirus disease-2019 (COVID-19) as a result of the aerosols generated and prolonged chair side time required for RCT. Acupuncture is a traditional Chinese therapy commonly employed as an alternative for the treatment of pain. And what's more, the use of acupuncture has been recently reported as treatment for the management of endodontic pain as well as on the anesthetic success in patients with irreversible pulpitis. This review aims to evaluate the current evidence for acupuncture in endodontics and its potential role in emergency pain relief and management for patients. To combat this, a thorough search for literature within the field was performed in five electronic databases. Retrieved studies were screened according to the pre-defined eligibility criteria. After both an electronic and manual search, five studies were selected for review. These studies reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis and in controlling both intraoperative and postoperative pain following RCT. In addition, it was also reported to reduce anxiety surrounding the dental procedure and minimized the intake of analgesics after the endodontic procedure, which can result in some unwanted side effects. However, more in depth clinical research is required before any recommendation regarding the application of acupuncture in endodontic patients can be made.

Acupuncture: New Uses for an Ancient Treatment or a Waste of Time? Part II

“…In that review, the authors evaluated the current evidence for the addition of acupuncture in endodontics and its potential role in emergency pain relief. 11 Five studies met the established criteria and reported the beneficial effects of acupuncture in reducing the failure of nerve block in patients with irreversible pulpitis, and in controlling both intraoperative and postoperative pain after root canal treatment.…”

Comprehensive Strategies in Endodontic Pain Management: An Integrative Narrative Review

“…A few studies have explored its adjunctive role with local anesthesia and reported that it can improve the efficacy of local anesthesia when administered as a nerve block. It also helped calm the patients, reducing their apprehension and minimizing the need for oral analgesics, which can lead to other side effects [ 55 ]. Despite the promising results of acupuncture in managing endodontic pain, there are notable challenges and limitations to its wider adoption in dental practice.…”

“…Furthermore, a systematic review of randomized controlled clinical trials has concluded that the effectiveness of phototherapy in reducing PEP after RCT remains debatable. To better understand the true potential for success, more randomized controlled trials involving laser interventions need to be conducted following established guidelines and parameters [ 54 - 55 ]. There is a glimmer of hope in research that suggests lasers have been therapeutically used for various applications, including direct irradiation of root canals, adjunctive use with irrigants in combination with photosensitizers for antimicrobial photodynamic therapy, and pain management through photobiomodulation [ 57 ].…”