Hypersensitivity

Question 1

What stimuli causes short, sharp pain when it reaches exposed dentin?

Answer 1

• Thermal
• Tactile
• Chemical
• Evaporative

Question 2

What are the components of dentin?

Answer 2

• Organic Components
• Inorganic Components
• Dentinal Tubules (where sensitivity occurs)

Question 3

What is brannstrom’s hydrodynamic theory?

Answer 3

Stimuli are transmitted to the pulp surface due to the movement of fluid or semi-fluid within open dentinal tubules

Question 4

What is the etiology of dentinal hypersensitivity?

Answer 4

• gingival recession
• enamel loss

Question 5

What can cause gingival recession?

Answer 5

• anatomy of labial plate
• periodontal surgery
• periodontal disease
• iatrogenic loss
• frenum involvement
• agressive scaling/root planing
• toothbrush abrasion
• acute/chronic trauma
• poor oral hygiene
• occlusal trauma
• inadequate attached gingiva
• excessive oral hygiene

Question 6

What can cause enamel loss?

Answer 6

• abrasion
• attrition
• abfraction
• erosion

Question 7

What can cause erosion?

Answer 7

• acid reflux disease
• bulimia
• frequency of acidic drinks/foods

Question 8

What is the prevalence of gingival recession (hypersensitivity)?

Answer 8

• all age ranges (higher incidence in 20-40 yr old age group)
• females more prone

Question 9

Where are the more common sites of occurrence of gingival recession (hypersensitivity)?

Answer 9

• Common site of occurrence are buccal and labial surfaces

Question 10

What are the main areas effected by hypersensitivity?

Answer 10

• Canine/premolar
• Incisors
• 2nd pre-molars and molars

Question 11

How do you diagnose hypersensitivity?

Answer 11

one of exclusion

• if it is not caries, fractured teeth, or fractured restorations then it is hypersensitivity

Question 12

What is a way to treat hypersensitivity through behavior?

Answer 12

modify patient behaviors

Question 13

What are the ways to modify patient behaviors to treat hypersensitivity?

Answer 13

• dietary modifications
• stop/altering teeth whitening

Question 14

What are the treatment options for hypersensitivity in office?

Answer 14

• Varnishes/Precipitates
• Primers
• Placement of restorations (Composite resin-based and Restorations with glass ionomer)

Question 15

What are the treatment options for hypersensitivity at home?

Answer 15

Dentifrices, Gels, Rinses

• Mode of action:
  – Depolarizes nerve endings
  –Tubule Occlusion

Question 16

When part of the dentin are you focused on with hypersensitivity?

Answer 16

dentin tubules

Question 17

What is the mode of action of dentrifices, gels, and rinses in treating hypersensitivity?

Answer 17

• Depolarizes nerve endings
• Tubule Occlusion

Question 18

What are examples of in-office treatments for hypersensitivity?

Answer 18

• Glutaraldehyde/HEMA based agents (Gluma)
• 5% Sodium Fluoride Varnish

Question 19

What are examples of at home treatments for hypersensitivity?

Answer 19

• MI Paste (can also be in-office)
• Interference with neural transmission (dentifrices with 5% potassium nitrate)
• Tubule Occlusion (Fluoride products)

Question 20

How does 5% sodium fluoride varnish help with hypersensitivity?

Answer 20

• Forms a barrier over exposed dentin
• Relief provided by calcium fluoride deposits

Question 21

How does Glutaraldehyde/HEMA based agents (Gluma) help with hypersensitivity?

Answer 21

• Significantly reduce hypersensitivity immediately after treatment
• Reduces dentin permeability

Question 22

What is the mechanism of action of MI Paste?

Answer 22

• replaces calcium and phosphate ions
• Casein phosphopeptide = amorphous calcium phosphate

Question 23

What is the mode of action of dentifrices containing 5% potassium nitrate?

Answer 23

Works by penetrating the length of the tubule to depolarize the nerve endings

*interference with neural transmission

Question 24

With MI Paste what allergy do you need to be aware of?

Answer 24

Milk allergy

Question 25

What are examples of dentifrices containing 5% potassium nitrate?

Answer 25

- sensodyne (gold standard) - arm and hammer sensitive teeth and gums - colgate sensitive - crest sensitive

Question 26

What is the most commonly used in toothpaste for tubule occlusion?

Answer 26

stannous fluoride - arginine, calcium carbonate, hydroxyapatite are also options

Question 27

What is the strength of Prevident?

Answer 27

5,000 ppm (1.1% NaF)