DENTAL HYPERSENSITIVITY
-Dr. Divya Talla
Pain is the most common reason for people toend up in a dentist’s office. However, pain can be due to different reasonslike caries, trauma, and dental hypersensitivity. Dental hypersensitivity isthe most commonly observed in our day-to-day life. It is characterized byshort, sharp pain in response to thermal(cooldrinks), chemical(carbonated orcitrus drinks), and tactile(air or by chewing) stimulus.
Prevalence:
Most commonly observed in the younger agegroup of around 20-50 yrs of age. Hence it is widely prevalent and concerning.Aggressive tooth brushing habits, lifestyle, taking 2 or more carbonated drinksper day, taking citrus juices throughout the day and lack of knowledge on oralhygiene are the main reasons for the development of younger people.
Mostcommon regions:
Neck of teeth
Facial regions of permanent teeth
Causes:
The most common reason for the development ofdental hypersensitivity is the loss of the ENAMEL layer on the tooth surface.Enamel is the hardest and outermost layer of the tooth which protects it fromocclusal/biting forces and chemicals. Once this layer is lost, underlyingsensitive layers of teeth are exposed leading to pain or hypersensitivity whena tooth is exposed to a stimulus like cold or citrus agent.
Another reason is gum recession. When the gumsrecede, a most sensitive part called cementum is exposed to the oral cavity,which might lead to hypersensitivity. This is usually observed in patientsundergoing periodontal/gum therapy.
There are different reasons for the loss ofenamel and cementum from the tooth surface. They are:
Enamel loss:
● Occlusal wear
● Toothbrush abrasion
● Dietary/chemical erosion- acidreflux disease
● Abfraction- loss of toothstructure at neck due to improper occlusal forces
● Parafunctional habits- like bruxism
Cemental loss:
● Gum recession
● Periodontal disease
● Root planing
● Periodontal surgery
Sometimes the treatment procedures likebleaching and orthodontic treatment may also lead to dental hypersensitivity.Consult your dentist for further knowledge before starting these procedures.
Prevention:
As it is rightly said, “prevention is betterthan cure”, hence it is better to visit a dentist at least once a year to getyour teeth checked and take proper oral care advice. For patients who aresuffering from mild dentinal hypersensitivity, dentists can provide valuableadvice to prevent and reduce the clinical symptoms. This includes the followingmeasures,
● Diet counseling regardingconsumption of acidic fruits and beverages- Rinse the mouth thoroughly withwater after consuming acidic foods and drinks
● Correct brushing technique toprevent abrasion of teeth- keep the brush at 45-degree angulation to tooth andbrush towards the occlusal surface
● Restorations must be checkedperiodically for any marginal leaks and care should be taken by dentists toavoid damage to the tooth while filling.
● Care should be taken duringperiodontal procedures like scaling and root planing
Managementof severe dentinal hypersensitivity:
In patients with severe sensitivity, treatmentcan be done by:
● Prescribing desensitizingtoothpaste containing potassium nitrate
● Use of dental varnish
● Topical calcium hydroxide paste
● Tooth mousse- CPP-ACP
● Severe sensitivity due to exposureto underlying dentin can be treated with the help of LASER.
Oral health is the reflection ofphysiological, social, and psychological factors that are essential to ourquality of life. So consult your dentist today to keep your pearly whiteshealthy :)
