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Periodontology > Dentine Hypersensitivity: The Clinical Problem > Flashcards

Dentine Hypersensitivity: The Clinical Problem Flashcards

1
Q

What does the hydrodynamic theory suggest about treating hypersensitive dentine

A
  • Occludent patent (open) tubules and so reduce any stimulus-evoked fluid movements
  • Reduce intradental nerve excitability, so that the nerves do not respond to the stimulus-evoked fluid movements
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2
Q

Describe the development of dentine hypersensitivity

A
  1. Dentine must be exposed and the dentine tubules must be opened
  2. Dentine hypersensitivity is most common in cervical dentine, where gingival recession is thought to be a more important factor in lesion localisation than loss of cervical enamel
  3. Lesion initiation involves removal of both the cementum and dentine smear layers
    N.B. this is mainly caused by erosive agents but can be potentiated by abrasion (brushing trauma)
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3
Q

What are some of the aetiological and predisposing factors that can lead to dentine hypersensitivity

A
  • Loss enamel
  • Gingival recession
  • Attrition/ abrasion/ abfraction/ erosion
  • Tooth malposition
  • Periodontal disease and its treatment
  • Patient habits
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4
Q

What are some potential differential diagnoses of pain besides dentine hypersensitivity

A
  • Cracked tooth syndrome
  • Fractured restorations
  • Fractured teeth
  • Dental caries
  • Post-op sensitivity
  • Acute hyper function of teeth
  • Hypoplastic enamel
  • Congenitally open CEJ
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5
Q

Describe the character and timing of the pain with tooth hypersensitivity

A

Sharp
Stabbing
Stimulation provoked

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6
Q

Describe the character and timing of the pain with Reversible pulpitis

A

Sharp

Stimulation evoked

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7
Q

Describe the character and timing of the pain with Irreversible pulpitis

A

Sharp
Throbbing
Intermittent/continuous

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8
Q

Describe the character and timing of the pain with Cracked Tooth Syndrome

A

Sharp

Intermittent

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9
Q

Describe the character and timing of the pain with Periapical periodontitis

A

Deep
Continuous
Boring

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10
Q

Describe the character and timing of the pain with a lateral periodontal abscess

A

Deep

Continuous aching

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11
Q

Describe the character and timing of the pain with pericoronitis

A

Continuous

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12
Q

Describe the character and timing of the pain with Dry Socket (acute alveolar osteitis)

A

Continuous

4-5 days post extraction

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13
Q

What is the pain intensity for tooth hypersensitivity

A

Mild to moderate

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14
Q

What is the pain intensity for reversible pulpitis

A

Mild to moderate

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15
Q

What is the pain intensity for irreversible pulpitis

A

Severe

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16
Q

What is the pain intensity for Cracked Tooth Syndrome

A

Moderate to severe

17
Q

What is the pain intensity for periapical periodontitis

A

Moderate to severe

18
Q

What is the pain intensity for a lateral periodontal abscess

A

Moderate to severe

19
Q

What is the pain intensity for pericoronitis

A

Moderate to severe

20
Q

What is the pain intensity for dry socket (acute alveolar osteitis)

A

Moderate to severe

21
Q

What are the provoking factors for tooth hypersensitivity

A
  • Thermal
  • Tactile
  • Chemical
  • Osmotic
22
Q

What are the provoking factors for reversible pulpitis

A
  • Hot
  • Cold
  • Sweet
23
Q

What are the provoking factors for irreversible pulpitis

A
  • Hot
  • Chewing
  • Lying flat
24
Q

What are the provoking factors for cracked tooth syndrome

A

biting

“rebound pain”

25
Q

What are the provoking factors for periapical periodontitis

A

Biting

26
Q

What are the provoking factors for a lateral periodontal abscess

A

Biting

27
Q

What are the provoking factors pericoronitis

A

Biting

28
Q

What are the reliving factors for dry socket

A

Irrigation

29
Q

What are the stages of management of dentine hypersensitivity

A
  1. Diagnosis
  2. Eliminate predisposing factors + desensitising dentrifice or mouthwash
    - If pain persists
  3. Topical agent + prevention ± densensiting dentrifice, mouthwash
    - If pain persists
  4. Adhesive material or surgery + prevention

Periodontology (12 decks)

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