Dentin hypersensitivity, tooth sensitivity, is one of the most frequent complaints patients have when they come for dental appointments.
Sensitivity is characterized by a sharp pain arising from exposed dentin (tooth structure under the enamel composed of tubules which extends to the pulp) in response to thermal, chemical or tactile stimuli.
It is important to rule out active pathology such as caries or inflamed pulp, before providing treatment for tooth sensitivity. To be hypersensitive, three conditions must be met:
- The dentin must be exposed
- The ends of the exposed dentin tubules must be open.
- The dentin tubule must be open along its entire path from the oral cavity to the pulp.
The personal perception of sensitivity varies, and tolerance level can also be different among individuals. Therefore, the severity of the sensitivity may not be proportional to the level of dentin exposure and/or strength of the stimuli for a particular patient.
Frequently encountered conditions associated with tooth sensitivity.
- Tooth: Dental caries; erosion, wear and abrasion; Chipped or broken tooth; pulp inflammation and trauma.
- Restorations: Broken and/or failing restorations; marginal leakage; shrinkage of restorative materials.
- Periodontal tissues: Gum recession; chronic periodontal/gum disease.
- Dental procedures: Teeth whitening; restoration replacement; scaling and root planning or periodontal surgery.
The most commonly used technology for occluding open dental tubules include calcium and phosphate precipitating agents, bonding agents and even surgical grafting of gum tissues. Pastes and varnishes of high fluoride concentration are also recommended (For example, Colgate PreviDent 5000 prescription toothpaste and Colgate PreviDent 5% fluoride varnish) This products have been found to be effective in promoting mineral deposition and thus tubule occlusion leading to symptom relief.
Reference: September 2013 Colgate publication on Dentin Hypersensitivity, Current Concepts in Management.
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