Dentine Hypersensitivity and Histology

A short, sharp pain in response to a stimulus from the teeth.

Brief, sudden, sharp pain that quickly subsides.

A triggered stimulus touching a tooth surface.

A tooth that's easily triggered to cause dentine hypersensitivity.

Anything that triggers the pain, like temperature or pressure changes.

Pinpointing the area of the tooth is helpful in the diagnosis of dentin hypersensitivity

Pain lasting for a short time, then subsiding

Rapid onset of pain when the trigger occurs

Management of patients with dentine hypersensitivity, encompassing prevention and advice

The factors that cause dentine hypersensitivity.

About 22% of dentin's volume is water.

Dentin that is no longer covered by enamel or cementum.

Tiny tubes running through dentin, containing nerves and fluid.

Movement of fluid from high to low concentration through a membrane.

Thermal (hot/cold), chemical (acids), and mechanical factors (brushing).

Gum tissue pulling back from teeth, exposing dentin.

Exposure due to gum recession, usually localized, possibly due to various oral habits.

Gum disease that can cause gum recession.

Erosion, abrasion, abfraction, or attrition affecting tooth structures.

Asking questions about the patient's dental pain (location, triggers, frequency, duration).

Visual assessment of tooth structures for any visible defects or dentin exposure.

Identifying causes of the pain, educating patients about the issue, providing preventative advice, and referring to a dentist when needed.

Substances used to reduce sensitivity, like fluoride, calcium, strontium solutions etc.

Temporarily stopping a tooth sensitivity trigger, like heat, cold or pressure, to stop pain.

Methods of treating dentin hypersensitivity that aim to prevent dentin tubules from being exposed.

Closing the dentin tubules with desensitizing agents to prevent pain from stimuli.

The process of blocking open dentinal tubules, which are microscopic channels in the dentin that lead to the pulp of the tooth. This blockage helps to prevent sensitivity by reducing the flow of fluids and stimuli to the nerve endings.

Chemical ions can easily dissolve, be mechanically removed, or form precipitates within dentinal tubules, leading to temporary relief from sensitivity. However, these effects are often short-lived.

To achieve long-lasting relief from dentin sensitivity, strategies involve using proteins to bind chemical ions to tooth surfaces, using chemicals that precipitate in acidic environments, and using higher concentrations of fluoride.

Potassium nitrate is a common active ingredient in toothpaste for sensitive teeth. It works by increasing the potassium concentration around the nerve endings in the dentin, reducing the sensitivity to stimuli.

Potassium nitrate increases the potassium concentration around the nerve endings, initially causing a sharp pain due to depolarization. However, the sustained high potassium concentration then deactivates the nerve, leading to a reduction in sensitivity over time.

Professionals can treat dentin hypersensitivity using various techniques that range from straightforward procedures like applying a desensitizing agent to more complex treatments for severe cases.

Fluoride helps to occlude dentinal tubules by forming calcium-phosphorous precipitates, calcium fluoride, and fluoroapatite, contributing to the reduction of sensitivity.

Arginine, a protein, is used in some toothpaste formulations for sensitive teeth. It helps bind chemical ions to the tooth surface, effectively reducing sensitivity by limiting fluid flow through the tubules.

After using sensitivity toothpaste, it's recommended to spit out the excess paste and avoid rinsing. This allows the active ingredients to stay in contact with the tooth surface for a longer duration, increasing their effectiveness.