to assesss and compare the efficacy of willow bark extract with ibuprofen for patients with acute pulpal pain -a randomized placebo controlled double blinded clinical trial

Odontogenic pain refers to pain initiating from the teeth or their supporting structures, the mucosa, gingivae, maxilla, mandible or periodontal membrane. The overall pooled prevalence of toothache in children and adolescents was 36.2% and   patients with dental caries have 3.49 times more chance of reporting toothache according to literature. Evidence gathered from studies and the work of others appears to support the presence of two distinct nerve pain pathways in the dental pulp, represented by fast conducting A-delta and slow conducting C-fibers. Each of these types of fibers has different pain characteristics: A-delta fibers evoke a rapid, sharp, lancinating pain reaction, and C-fibers cause a slow, dull, crawling pain. Usually for management of odontogenic pain, Non Steroidal Anti-inflammatory drugs (NSAIDS) are prescribed which   decrease the production of prostaglandins thereby decreasing the intensity of pain. Most commonly prescribed are ibuprofen (400 mg ) , naproxen (500 mg),Aspirin (600 mg) .Although NSAIDs are safe if used for a short period of time, they may cause heartburn, nausea, vomiting, diarrhea, and in some cases potentially serious adverse effects such as gastric ulcer gastric perforation , and  cardiovascular risks. Hence ,there is a need for alternative medicinal therapy. One such safer method is Phytotherapy (Herbal medicine).So, these emerging trends can meet the changing demands of the patients. Herbal medicines are safe , since they are found in nature, such remedies are assumed to be safer than NSAIDs. Furthermore, the value of many of the herbs has been celebrated throughout ages, without any mention of detrimental side effects. One of the modern advances in herbal therapy is the use of willow bark (Salix Alba). The chemical oxidation of salicin, a known constituent of the bark of the willow tree (Latin name: Salix), resulted in a new substance termed ‘salicylic acid’, and the acetylated derivative of this substance eventually turned into one of the most successful drugs in history, Aspirin. According to the literature 240 mg salicin/day will produce no more than115mg of salicylic acid and would therefore not be expected to produce analgesic or anti-inflammatory action of salicylic acid. However, Willow bark extract has been used in required amount because of its anti-inflammatory, antianalgesic, and antipyretic action in few earlier studies .