Hypersensitivity Flashcards
What stimuli causes short, sharp pain when it reaches exposed dentin?
- Thermal
- Tactile
- Chemical
- Evaporative
What are the components of dentin?
- Organic Components
- Inorganic Components
- Dentinal Tubules (where sensitivity occurs)
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
- enamel loss
What can cause gingival recession?
- anatomy of labial plate
- periodontal surgery
- periodontal disease
- iatrogenic loss
- frenum involvement
- agressive scaling/root planing
- toothbrush abrasion
- acute/chronic trauma
- poor oral hygiene
- occlusal trauma
- inadequate attached gingiva
- excessive oral hygiene
What can cause enamel loss?
- abrasion
- attrition
- abfraction
- erosion
What can cause erosion?
- acid reflux disease
- bulimia
- frequency of acidic drinks/foods
What is the prevalence of gingival recession (hypersensitivity)?
- all age ranges (higher incidence in 20-40 yr old age group)
- females more prone
Where are the more common sites of occurrence of gingival recession (hypersensitivity)?
- Common site of occurrence are buccal and labial surfaces
What are the main areas effected by hypersensitivity?
- Canine/premolar
- Incisors
- 2nd pre-molars and molars
How do you diagnose hypersensitivity?
one of exclusion
- if it is not caries, fractured teeth, or fractured restorations then it is hypersensitivity
What is a way to treat hypersensitivity through behavior?
modify patient behaviors
What are the ways to modify patient behaviors to treat hypersensitivity?
- dietary modifications
- stop/altering teeth whitening
What are the treatment options for hypersensitivity in office?
- Varnishes/Precipitates
- Primers
- Placement of restorations (Composite resin-based and Restorations with glass ionomer)
What are the treatment options for hypersensitivity at home?
Dentifrices, Gels, Rinses
- Mode of action:
– Depolarizes nerve endings
–Tubule Occlusion
When part of the dentin are you focused on with hypersensitivity?
dentin tubules
What is the mode of action of dentrifices, gels, and rinses in treating hypersensitivity?
- Depolarizes nerve endings
- Tubule Occlusion
What are examples of in-office treatments for hypersensitivity?
- Glutaraldehyde/HEMA based agents (Gluma)
- 5% Sodium Fluoride Varnish
What are examples of at home treatments for hypersensitivity?
- MI Paste (can also be in-office)
- Interference with neural transmission (dentifrices with 5% potassium nitrate)
- Tubule Occlusion (Fluoride products)
How does 5% sodium fluoride varnish help with hypersensitivity?
- Forms a barrier over exposed dentin
- Relief provided by calcium fluoride deposits
How does Glutaraldehyde/HEMA based agents (Gluma) help with hypersensitivity?
- Significantly reduce hypersensitivity immediately after treatment
- Reduces dentin permeability
What is the mechanism of action of MI Paste?
- replaces calcium and phosphate ions
- Casein phosphopeptide = amorphous calcium phosphate
What is the mode of action of dentifrices containing 5% potassium nitrate?
Works by penetrating the length of the tubule to depolarize the nerve endings
*interference with neural transmission
With MI Paste what allergy do you need to be aware of?
Milk allergy
What are examples of dentifrices containing 5% potassium nitrate?
- sensodyne (gold standard)
- arm and hammer sensitive teeth and gums
- colgate sensitive
- crest sensitive
What is the most commonly used in toothpaste for tubule occlusion?
stannous fluoride
- arginine, calcium carbonate, hydroxyapatite are also options
What is the strength of Prevident?
5,000 ppm (1.1% NaF)
