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PHONE:  206-248-3330
      FAX:  206-431-1158
                  6715 Fort Dent Way
        Tukwila, WA 98188-2540

Kwan Google 36
Steven C. Kwan, D.D.S., M.S.D.
Diplomate of the American Board of Endodontics

6715 Fort Dent Way
Tukwila, WA 98188-2540


Autumn 2021 - (Volume 10, Number 4)

I hope you all had a great Thanksgiving and are looking forward to more fun times this Holiday season! In this issue, we have a very interesting randomized control trial that showed that valacyclovir, an anti-herpes viral medication, can reduce endodontic pain. This new use for an old medication that can be prescribed over the phone could have great utility in helping to manage endodontic pain.

Sabeti M, Zhong J, Hildebrandt K, Slots J. Valacyclovir in Pain Management of Acute Apical Abscesses: A Randomized Placebo-Controlled Double-Blind Pilot Study. J Endod 2021;47:1724-1728.
This randomized control trial evaluated the efficacy of valacyclovir in reducing pain in patients that present with an acute apical abscess. Twenty patients were randomly assigned to either an amoxicillin + valacyclovir group or an amoxicillin + placebo group. The valacyclovir was given as 2 g immediately, followed by 500 mg bid for a total of three days. Patients were followed for a week to determine post operative pain and analgesic use. The valacyclovir group reported significantly less pain and pain medication use than the placebo group, starting immediately on the first day after baseline and continuing to be significant through the duration of the study. Although the study size was small, this is a very interesting and potentially impactful study, as traditionally root canal infections were viewed as a purely bacterial infection. However, these authors have recently shown that herpes family viruses are involved in periapical disease which provides a plausible mechanism for valacyclovir to work. Additionally, the rapid and significant improvement in pain could make antivirals, which can be called in to a pharmacy by phone, a very useful tool in managing emergent endodontic pain. SUMMARY: In a randomized controlled trial, valacyclovir was shown to significantly and rapidly decrease endodontic pain.

Endodontic Spotlight is published quarterly by Steven C. Kwan, D.D.S., M.S.D.
is located at 6715 Fort Dent Way, Tukwila WA 98188
206-248-3330; 206-431-1158 (fax);
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