dentin hypersensitivity Flashcards
What is dentin hypersensitivity?
Transient tooth pain, short and sharp, from exposed dentin in response to stimuli not due to other defects or pathology.
According to the Hydrodynamic Theory, what triggers the nerve response?
Fluid movement within dentinal tubules altering pressure and exciting nerve receptors.
What does the Direct Innervation Theory propose?
Nerve endings extend to dentino-enamel junction and are directly stimulated.
What does the Odontoblast Receptor Theory suggest?
Odontoblasts act as receptors and transmit signals to nerve terminals.
What are the 5 common stimuli that can cause dentinal hypersensitivity pain?
Thermal, Mechanical (Tactile), Osmotic, Evaporation, Chemical.
What are examples of thermal stimuli?
Hot and cold drinks and foods.
What is an example of an evaporation stimulus?
Air blast from a dental instrument.
What are examples of mechanical (tactile) stimuli?
Toothbrushing, dental probe, periodontal scaling, root planing.
What is an example of an osmotic stimulus?
Hypertonic solutions such as sugars.
What are examples of chemical stimuli?
Acids from diet, gastric sources, and acid etch during dental treatment.
What does diagnosis of dentinal hypersensitivity begin with?
Thorough clinical history and examination.
Why is accurate diagnosis important before managing dentinal hypersensitivity?
Because it can resemble other conditions like caries, fractured tooth syndrome, and pulpitis.
Why should clinical tests for dentinal hypersensitivity be performed gently?
Because they can be very painful for the patient.
What does pain upon tapping teeth suggest?
Pulpitis or periodontal involvement.
What does pain when biting on a stick suggest?
Fractured tooth.
What is a simple clinical method to test for dentinal hypersensitivity?
Jet of air or exploratory probe on exposed dentin.
Are bacteria involved in erosion?
No.
What causes tooth erosion?
Highly acidic foods and medical conditions like acid reflux, anorexia, or bulimia.
Where does most mineral loss from erosion occur?
At the surface of the tooth.
How does fluoride inhibit bacteria?
It interferes with essential enzyme activity.
Is fluoride alone effective in managing dental caries?
No, it’s more effective when combined with antibacterial rinses.
What is an example of an antibacterial rinse used with fluoride?
Chlorhexidine gluconate.
What is the earliest clinically detectable sign of demineralization?
White spot lesion.
What causes demineralization?
Fermentable carbohydrates → organic acid from cariogenic bacteria → calcium and phosphorus loss.
Do demineralized areas take up more or less fluoride than sound enamel?
More.
What is the critical pH for root surface demineralization?
6.7.
Name four products used in remineralization.
Fluorides, amorphous calcium phosphate (ACP), calcium sodium phosphosilicate, resin infiltration.
What are the two main mechanisms of desensitization?
Prevent nerve repolarization and occlusion of dentin tubules.
How does preventing nerve repolarization work?
Interrupts neural transmission in the pulp.
What are common forms of desensitizing agents?
Gels, toothpastes, mouthwashes, resin composite, glass ionomer cement, dentin adhesives, laser application.
How does occlusion of dentin tubules reduce sensitivity?
Prevents fluid movement in and out of the tubules.
What agents are used to prevent nerve repolarization?
Potassium salts (potassium chloride, potassium nitrate, potassium citrate, potassium oxalate).
What is required for potassium salts to be effective?
Consistent use; relief typically in 2 weeks.
How do calcium phosphates help in desensitization?
Release calcium and phosphate ions to mineralize and seal tubule openings via hydroxyapatite deposition.
What do oxalate salts do to reduce sensitivity?
Form calcium oxalate crystals that block dentin tubules.
What is acute fluoride toxicity?
Rapid intake of excess fluoride in a short time.
What are symptoms of acute fluoride toxicity?
Nausea, vomiting, increased salivation, thirst, abdominal pain.
What are severe symptoms of acute fluoride toxicity?
Muscular weakness, spasms due to hypocalcemia (fluoride binding with calcium).
What is chronic fluoride toxicity called?
Skeletal fluorosis.
What causes skeletal fluorosis?
Long-term use (20+ years) of water with 10–25 ppm fluoride.
What is the treatment for mild-to-moderate sensitivity?
At-home desensitizing therapy.
What is the treatment for extreme dentinal hypersensitivity?
Endodontic therapy.
What is the treatment for severe dentinal hypersensitivity?
In-office treatment.
