Dentinel Sensitivity Flashcards
what are the components in dentin
- organic components
- inorganic components
- dentinal tubules
describe dentinal tubules
- run from pulp to the outer dentinal surface
- contain Tomes fibers
- three types of nerve fibers
dentinal tubules can be ____ or _____
open; plugged
where are the tomes fibers
extend into the dentinal tubules from the odontooblasts
- communicate with the pulp
what are the types of nerve fibers
- A delta
- A beta
- C
what causes hypersensitive dentin
- tubules open to cavity
- large number of tubules
describe the smear layer
- deposit of salivary proteins
- debris from toothpaste and other matter
what is brannstrom’s hydrodynamic theory
- stimuli are transmitted to the pulp surface due to the movement of fluid or semi fluid within open dentinal tubules
what is the etiology of dentinal hypersensitivity
- gingival recession
- mulitple factors
- enamel loss
what is dentinal sensitivity
short, sharp pain when stimulus reaches exposed dentin
what are the factors that affect dentin sensitivity
- thermal
-chemical - tactile
- evaporative
what is the most common factor causing dentinal hypersensitivity
thermal
what causes gingical recession
- anatomy of labial plate
- periodontal disease
- frenum involvement
- toothrbush abrasion
- poor oral hygiene
- inadequate attached gingiva
- periodontal surgery
- iatrogenic loss
- aggressive scaling/root planing
- acute or chronic trauma
- occlusal trauma
- excessive oral hygiene
what are the common factors of erosion
- acid reflux disease
- bulimia
- frequency of acidic food/drink
what is the prevalence of enamel loss
- all age ranges but higher incidence in 20-40 year old age group
- females more prone
what is the common site of occurence of enamel loss
buccal and labial surfaces
- canine/premolar
- incisors
- 2nd premolars and molars
what diagnoses do you need to exclude in sensitivity
- dental caries
- fractured teeth
- fractured restorations
what causes exposed dentin
- enamel loss
- gingival recession
how can you limit hypersensitivity
modify patient behaviors
- dietary modifications
- teeth whitening
what can cause enamel loss
- abrasion
- erosion
- abfraction
what are the treatment options in office for dentinal hypersensitivity
-varnishes/precipitates
- primers
- placement of restorations
- composite resin based
- restorations with glass ionomer
is erosion irreversible
no
what are the treatment options for at home dentinal hypersensitivity and mode of action
- dentrifics, gels, rinses
- mode of action: depolarizes nerve endings, tubule occlusion
what are the products we use in office
- gluteraldehyde/HEMA based agents
- 5% sodium fluoride varnish
what does gluteraldehyde/HEMA based agents do
- reduce hypersensitivity immediately after treatment
- reduced dentin permeability
what does 5% sodium fluoride varnish do
- forms a barrier over exposed dentin
- relief provided by calcium fluoride deposits
what is the product used as an in office treatment/at home treatment and what is mechanism of action and how is it used
- MI paste
- recaldent (CCP-ACP)
- casein phosphopeptide- amrophous calcium phosphate
- mechanism of action: replaces calcium and phosphate ions
- use: apply with prophy cup or if at home after brushing
diagnosis of hypersensitivity is one of:
exclusion
how do at home treatments work
- interference with neural transmission
- tubule occlusion
how do at home treatments interfere with neural transmission
- dentrifices containing 5% potassium nitrate
- works by penetrating the length of the tubule to depolarize the nerve endings
- frequent and regular applications are needed
what ingredients in at home treatments cause tubule occlusion
- main active ingredient is fluoride
- stannous fluride- most commonyl used
- arginine and calcium cabronate
- hydroxyapatite
- prescription strength fluoride toothpaste
what is the strength of prescription strength fluoride toothpaste
-5,000 ppm
- 1.1% sodium fluoride
- prevident
