pain during Tx how to eliminate it?

[suha maddah]

Dear doctors
I am am a 5th year dental student and you know this is the first time we do endo Tx
Last week I start with molar I first remove the caries
and then open the access cavity
but bcz there is no time I put a cotton pellet then temporary restoration
without insering any file to the pulp the next week I open again there was no bleeding I clean the canal irrigate
and dry the canals and close again the pt was feeling sever pain I told her to take profen after eating
Pt still feels sever pain what can I prescribe for her to relief the pain and what is the cause?

[minori]

ibuprofen 600mg

[niranjan_vatkar]

According to the method which you have followed, first of all if you open a tooth with vital pulp inside and if you do not negotiate and remove the pulp, the pulp remaining gets inflammed. Subsequently when you do the filing in next appointment it is very difficult to achieve anaesthesia at that moment. And patient keeps yeeling until all the pain is relieved. This terrific and horrifying experience prolongs even after the cleaning and shaping is over for 2-3 days for which we then need to prescribe medications. Also if you have not done the occlusal reduction the pain then worsens tremendously. Another thing, if you place calcium hydroxide which even slightly goes beyond apex, the patient is going to wake you from your sleep.
Therefore just follow few simple but absolutely important steps which I have mentioned below -
1.First, remove all the caries.
2. Do the occlusal reduction
3.Do the pre-endodontic restoration (preferably composite)
4.Finish the cleaning & shaping in the same appointment of you root canal opening. Dont postponed it till your next appointment.
5.Place calcium hydroxide only inside the canal. Take care it does not go beyond apex.