Dental Hypersensitivity Exam 3

Question 1

What is Dentin ?

Answer 1

• composed of dentinal tubules filled with dental fluid- this portals transmit stimuli
• odontoblasts extends only in a short distance

Question 2

What is the relationship between cementum to enamel?

Answer 2

Cementum overlap enamel – 14%
Cementum and enamel met without overlap – 76%
Cementum and enamel do not meet – 10%

Question 3

What are the different sensory nerve fibers?

Answer 3

• A- delta - localized, sharp painl fastest, associated with dental hypersensitivity
• A beta- localized sharp pain- response to electrical stimuli
• C- fibers- dull, poorly localized aching pain; pulp

Question 4

What does the hydrodynamic theory transmit?

Answer 4

Outside stimuli causes
fluid movement within dentinal
tubules

Question 5

Recipe for Hypersensitivity

Answer 5

• Open dentinal tubule
• Outside stimuli
• Transmission through fluid
• A-delta nerve stimulation of a vital pulp
• Perception of pain

Question 6

What are the different types of stimuli?

Answer 6

• Tactile or mechanical
• Thermal
• Evaporative
• Osmotic
• Chemical

Question 7

Why is there pain ?

Answer 7

• nerve depolarization

Question 8

What is the eitiology for dental hypersensitivity ?

Answer 8

• Recession
• Tooth development
• Loss of tooth structure
• Instrumentation
• Scaling and root planing
• Frequent or improper stain removal techniques
• Root Caries

Onset: Sudden or Gradual, Acute or Chronic

Question 9

What are the Contributing Factors to Gingival Recession?

Answer 9

• Thinner labial plate of bone
• Frenum attachment
• Trauma
• Periodontal surgery
• Restorative procedures
• Aging process
• Poor oral hygiene
• Scaling and root planing
• Occlusal trauma
• Fenestrations
• Dehiscence

Question 10

What is secondary dentin

Answer 10

• Formed slower than primary dentin
• Less mineralized than primary dentin
• Deposited after teeth fully developed

Question 11

What is tertiary dentin?

Answer 11

• Formed as a result of injury (caries)
• Thicker, highly mineralized layer of peritubular dentin

Question 12

What is the smear layer?

Answer 12

• Organic and inorganic shavings
• has both postive and negative effect

Question 13

What else acts like a natural plug?

Answer 13

Calculus

Question 14

Dental hypersensitivity affects patients who are?

Answer 14

• Periodontally involved
• 20 to 40 years old
• More prevalence in females
• Oral hygiene habits

Question 15

Dental Hypersensitivity affects the teeth how?

Answer 15

• Gingival recession present
• Cervical 1/3 buccal
• Especially Premolars and canines
  BUT ANY TOOTH CAN EXHIBIT
  SYMPTOMS!

Question 16

What would be a differential diagnosis?

Answer 16

• Etiology of pain: Systemic, pulpal, periapical, restorative, degenerative, neoplastic

Question 17

What questions would you ask your patient?

Answer 17

• Where is the pain?
• When does the pain occur?
• Does it go away when removing the cause?
• How long…
• Describe the pain

Question 18

What are some diagnostic test?

Answer 18

• Nasal/ sinus problems
• Clinical exam
• Occlusal exam
• Percussion
• Bite stick
• Mobility
• Transillumination
• Radiographic exam
• Pulp Test

Question 19

How to treat and manage hypersensitivity ?

Answer 19

• Pain relief/ modification
• Eliminate contributing factors
• Most conservative / least invasive à more aggressive
• Pain Resolution
• Reassessment

Question 20

What are the selfcare treatment interventions?

Answer 20

• Dietary
• Biofilm
• Burnishing
• Toothbrush type