28Flare-up …interappointment emergencies (IAE) such as pain or swelling which require nonscheduled office visits and palliative treatment…Torabinejad et.al.
29Factors associated with increased incidence of flare-ups Factors associated with increased incidence of flare-ups Torabinejad et al.Age between 40 and 59FemaleMandibular bicuspidsHistory of allergiesPreoperative complaintsNo or small periapical lesionsRetreatment casesLevel of Evidence 4
30Factors associated with decreased incidence of flare-ups Factors associated with decreased incidence of flare-ups Torabinejad et al.Presence of a sinus tractTaking medications postoperativelyLevel of Evidence 4
31Flare-up Etiologic Factors Seltzer & Naidorf Alteration of the local adaptation syndromeChanges in periapical tissue pressureMicrobial factorsEffects of chemical mediatorsChanges in cyclic nucleotidesImmunological phenomenaVarious psychological factorsLevel of Evidence 5
32Mor C, Rotstein I, Freidman S Mor C, Rotstein I, Freidman S. Incidence of interappointment emergency associated with endodontic treatment. JOE 19924.2% incidence in 334 patients treated by undergraduate studentsSignificantly higher in nonvital teethLevel of Evidence 4
33Problem Solving in Endodontics Gutman J, Lovdahl P. 5th ed.
34Problem Solving in Endodontics Gutman J, Lovdahl P. 5th ed Problem Solving in Endodontics Gutman J, Lovdahl P. 5th ed. Chapter 15 – Problem solving in the management of painful tooth emergencies
41FLARE-UPS "The danger of periapical inflammation cannot be eliminated by any plan of treatment.” Dr. G.V. Black
42Mikes’ Guidance for Prevention of Emergency Visits a. k. a Mikes’ Guidance for Prevention of Emergency Visits a.k.a. “Rules of Disengagement”Talk about expectationsConsider creating artificial drainageReassure patients of your availabilityProvide appropriate prescriptionsSchedule follow-up visitsKnow when to cut your lossesLevel of Evidence 5