Desensitization

Question 1

what is dentinal hypersensitivity

Answer 1

• abnormal condition occurring when vital dentin is exposed to oral environment
• pain stimuli reach the pulp

Question 2

where are the most common places to feel hypersensitivity

Answer 2

• labial and lingual surfaces of mx and mn anterior teeth
• buccal surfaces of posterior teeth
• areas of abrasion

Question 3

what is the ethology (cause) of dentinal hypersensitivity

Answer 3

1. removal of coronal enamel (attrition, abfraction)

2. root exposure: removal of cementum and exposure of dentinal tubules

Question 4

CEJ and enamel

Answer 4

• 10% of cementum fails to meet enamel at the CEJ
• 60% of population cementum overlaps enamel at CEJ
• 30% cementum meets enamel at CEJ

Question 5

what are some causes of root exposure

Answer 5

1. gingival margin inflammation
2. aging
3. chronic periodontal disease
4. tooth positions
5. periodontal surgery
6. incorrect tooth brushing habits
7. grinding/clenching
8. root planing/scaling

Question 6

what are 3 ways to produce a stimuli producing sensitivity

Answer 6

• mechanical
• chemical
• thermal
• all stimuli is perceived as pain

Question 7

how can we assess hypersensitivity

Answer 7

• explore along areas of exposed dentin

- cold solution of cold air - be careful not to use cold water or direct compressed air

Question 8

what are some characteristics of desensitizing agents

Answer 8

• easy to use and apply
• non irritating to the pulp
• require few dental appointments to apply
• relatively painless upon application
• will not discolour teeth
• minimum application/action time/expense
• long lasting or permanent effects
• consistently effective

Question 9

what are some home self care procedures to help care for/avoid dentin hypersensitivity

Answer 9

• plaque control (patient education regarding brushing, flossing and tp)
• dentifrices
• self applied fluoride rinses/gels: fluoride blocks the dentinal tubules and remineralizes
• diet control: watch for acidic foods, sugary or spicy

Question 10

what should patients be on the lookout for in a desensitizing dentifrice

Answer 10

• low in abrasively
• anti caries
• approved desensitizer
• strontium chloride: (SrCl) Sensodyne regular, formation of crystals (strontium phosphate crystals), occlude dentinal tubules
• potassium nitrate: Sensodyne F, penetrates tubules and decreases nerve response to stimuli, most effective at home product