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Teeth Sensitivity

What Is teeth sensitivity / dentin sensitivity?

Teeth sensitivity

Teeth sensitivity is characterized by short, sharp pain arising from exposed dentin in response to stimuli typically thermal, evaporative, tactile, osmotic, or chemical that cannot be attributed to any other dental defect or pathology.
Dentin get exposed due to wearing off of overlying enamel of the tooth by mechanical and chemical means. Common examples are vigorous tooth brushing, frequent consumption of acidic beverages.

dentin sensitivity mechanism

What are the special features of tooth sensitivity?

                                               

• A short duration pain 
• sharp pain
• pain arising from exposed dentin in response to 
• Thermal (while taking hot or cold drinks) 
• Evaporative
• Tactile (while brushing) 
• Osmotic stimuli (while eating sweets)
• There is no evidence of caries

• wearing off of the enamel may not always visible.

What causes tooth sensitivity?

• Abnormal thickness or structure of enamel- most of the time may be present from birth. Ex. Amelogenesis imperfecta, enamel hypoplasia.
• Vigorous tooth brushing and other brushing related causes leading to enamel wear-off.
• Frequent consumption of acidic and carbonated drinks.
• Gastric acid regurgitation (frequent vomiting)
• Dentin exposure by enamel cracks or fractures.
• Aging
• Root exposure due to periodontal diseases.
• After tooth bleaching.

What are the preventive methods of tooth sensitivity?

reasons for tooth sensitivity

1. Use of Proper tooth brushing technique
1. Use a tooth brush with soft bristles.
2. Do not brush soon after meals. wait for about at least one hour.
3. Do not apply excessive pressure on the brush while brushing
4. Pregnant mothers should not brush there teeth soon after vomiting 
2. Do not drink acidic or carbonated drinks, fruit juices frequently
3. Protect your gums from periodontal diseases which lead to root exposure

What are the Treatment available for sensitive teeth?

Treatment Strategies

• Plug the dentinal tubules preventing fluid flow
• Desensitize the nerve making it less responsive to stimulation

Plug the dentinal tubules preventing fluid flow

• Composite or GIC restoration 
• Crown placement 
• Periodontal surgery to cover the exposed roots

 plug the inside of the dentinal tubules

Ions or salts: stannous fluoride, sodium fluoride, potassium oxalate, etc
Precipitates: glutaraldehyde 

Resin: dentin sealers

• Potassium nitrate containing product/toothpaste  should be used 2×day for at least 2 week

Desensitize the nerve making it less responsive to stimulation

Potassium Nitrate is the only one approved by FDA and ADA. 

KNO3 penetrates through the dentinal tubules to the nerve; K+ may depolarize the nerve and prevent it from repolarizing; Thereby, Preventing it from sending pain signals to the brain.

What could be done to eliminate Post bleaching sensitivity?

Active methods

Use of either fluoride,potassium nitrate, or both in combination. Traditionally,fluoride has been used
as a method of reducing sensitivity. The primary mechanism for action is to occlude dentinal tubules or
increase the hardness of enamel, which impedes the flow of materials to the pulp.

Passive approach

The passive approach for treating sensitivity was first used. This involved a reduction in wear

time, or in frequency of application.Cessation of treatment results in no lingering sensitivity.