Consideration of steroids for endodontic pain

Up to 80% of endodontic patients who report with preoperative pain continue to experience some level of pain following the endodontic procedure. Since endodontic pain is often associated with chronic inflammation, the presence of bacterial by-products, influx of primed immune cells and activation of the cytokine network and other inflammatory mediators, pain may be reduced by administration of glucocorticoid steroids. This review will include the pharmacology, pharmacodynamics and purported mechanisms of actions of steroids as well as their indications for endodontics, contraindications, dosages and side-effects.