Dentine Hypersensitivity

Question 1

What is dentine hypersensitivity?

Answer 1

Short sharp pain arising from exposed dentine in response to stimuli (thermal, osmotic and tactile) which cannot be due to any other form of dental defect or pathology

Usually due to hot/cold, spicy food, sweet food and from contact e.g. toothbrushing (thermal, osmotic and tactile stimuli)

Question 2

What causes dentine hypersensitivity?

Answer 2

Tooth wear and gingival recession
e.g. perio patients and overenthusiastic brushers, bruxists, acidic diets, acid reflux/bulimia, xerostomia, tobacco diet

Dentine exposure due to gingival recession or tooth wear
Pain proking stimuli comes into contact with exposed dentine
Open tubules in exposed dentine makes it hypersensitive
Stimuli causes fluid shift in dentine tubules, exciting pulpal nerves and causing pain

Question 3

What indicates dentine hypersensitivity in a pt’s history?

Answer 3

Short, sharp pain
Pain triggered by thermal, osmotic, tactile
Excessive brushing, poor OH
Excessive dietary acids - fruit, wine, fruit juices, pickles
Look for signs of gastric reflux or excessive vomiting

Question 4

How to manage dentine hypersensitivity?

Answer 4

Preventative advice

• Reduce risk factors
• Brushing advice: avoid overly frequent or aggressive tooth brushing, recommend use of a soft bristled brush

Tx to use at home:
- Desensitising toothpaste:
Stannous fluoride builds a layer over and within dentine tubules
NovaMin technology reduces hydroxyapatite layer to occlude dentine tubules
Potassium ions depolarise the nerve and prevent it from firing impulses