Recession and Dentine Hypersensitivity Flashcards
Demographics of root surface and dentinal hypersensitivity
- 8-30% of population
- Women more tham men
- Younger age, prevalence decreases with age
- Higher in groups with perio
What is the Brannstrom theory of hydrodynamics
When stimuli are applied to the dentine, it is transmitted to nerve int he pulp via fluid movement in the dentine tubules
Root surface sensitivity Differential Diagnosis
- Cracked tooth syndrome
- Fractured restorations
- Dental caries
- Post op sens
- Palatal gingival groove
- ypoplastic enamel
- Congenital open CEJ
- Teeth acute hyperfunction
- Vital bleaching
Clinical symptoms of root surface sensitivity:
- Pain of rapid onset
- Sharpness
- Short duration
Stimuli for root surface sensitivity
- Tactile - toothbrush, digital probing, scaling
- Hot, cold
- Acid, sweet
Diagnostic and Treatment pathway for dentineal hypersensitivity
- Eliminate predisposing factors and use desensitizing toothpaste
PAIN PERSISTS
- Topical agent + desensitivising toothpaste
PAIN PERSISTS
- Adhesive material or surgery + prevention
What aetiological factors for dentine hypersensitivity can be addressed?
- Tooth brushing technique
- Reduce acidic foods/drinks
What are the two ways of desensitizing exposed root surfaces
- Desensitize the nerves
- Close the dentine tubule by coagulation, mineralisation or coating
What ingredient desensitizes nerves in Sensodyne? What other agent in it helps?
Potassium salts turn down the nerve whilst fluoride occludes the tubules
What ingredient occlused the dentine tubules in Colgate sensitive pro relief
Strontium Oxalates (Pro-Argin)
Are there nerves in cementum?
No
IN addition to turning down signalling and occluding the tubules, how else do topical agents help with reducing dentine hypersensitivity?
Irritation and stimulation from external agents promotes build up of secondary dentine
How does plaque control contribute to reducing hypersensitivity?
Regular removal results in smooth harder surface with blocked tubules
Two key topical desensitizing agents used in sensitive toothpastes?
- Potassium salts
- Strontium Oxalates
- Fluoride
How do potassium salts desensitize nerves?
They buffer membrane potentials, so their action is focussed toward symptomatic relief. They require minimum 2 weeks of twice daily use. Usually 4-8 weeks for full pain relief.
Which is said to be more effective for desensitization?
a) Potassium salts
b) Strontium Chloride
a)
How does fluoride reduce sensitivity?
Formation of fluoride hydroxyapatie which decreases tubule diameter
In unresolving cases of severe sensitivity, what might be a surgical option?
PEriodontal plastuc surgery (pedicle flap)
Potential side effects of periodontal tx:
- Gingival recession
- Longer looking teeth
- Increasing gaps between teeth
- Increases sensitivity and soreness
- Food packing
Why should excessive and aggressive debridement of the root surface be avoided
Can lead to prolonged sensitivity
