Dentine Hypersensitivity Overview
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Questions and Answers

What is a key characteristic of the pain associated with dentine hypersensitivity?

  • Constant pain without any triggers
  • Dull, throbbing pain
  • Sharp pain that quickly resolves (correct)
  • Long lasting pain
  • Which of the following best explains the mechanism behind dentine hypersensitivity?

  • General wear and tear of the tooth structure
  • Increased enamel thickness leading to pain
  • Presence of stimulus combined with a susceptible tooth (correct)
  • Nerve damage due to dental treatments
  • Which of the following factors could potentially increase a tooth's susceptibility to dentine hypersensitivity?

  • Enhanced enamel strength
  • Gum recession exposing dentine (correct)
  • Consumption of dairy products
  • Regular use of fluoride toothpaste
  • What role does the dental therapist play in managing dentine hypersensitivity?

    <p>Provide preventative treatments and offer advice (B)</p> Signup and view all the answers

    Which symptom would most likely indicate dentine hypersensitivity?

    <p>Sensitivity to cold stimuli (D)</p> Signup and view all the answers

    Which symptom might indicate the presence of dentine hypersensitivity?

    <p>Pain that stops after removal of the stimulus (A)</p> Signup and view all the answers

    What should be the first step in diagnosing dentine hypersensitivity?

    <p>Conduct a thorough clinical examination (B)</p> Signup and view all the answers

    Which of the following is NOT a suggested method for patients to manage dentine hypersensitivity at home?

    <p>Apply ice directly to the tooth (C)</p> Signup and view all the answers

    Which component helps in occluding the dentinal tubules?

    <p>Calcium Phosphosilicate (A)</p> Signup and view all the answers

    What is the primary role of dental hygienists in managing dentine hypersensitivity?

    <p>Identify aetiological factors and educate the patient (D)</p> Signup and view all the answers

    Which agent is known for its ability to desensitize nerves in the context of dentine hypersensitivity?

    <p>Potassium Nitrate (A)</p> Signup and view all the answers

    Which of the following is an important factor to consider during history taking for dentine hypersensitivity evaluation?

    <p>Diet history and oral hygiene practices (C)</p> Signup and view all the answers

    When managing dentine hypersensitivity, what is the purpose of referring to a general dental practitioner (GDP)?

    <p>To provide additional preventative management and advice (A)</p> Signup and view all the answers

    What compounds are suitable for occluding dentinal tubules by forming precipitates in an acidic environment?

    <p>Bioactive glass (B)</p> Signup and view all the answers

    Which of the following statements is incorrect regarding the use of potassium nitrate in toothpaste?

    <p>It acts as a permanent solution for dentine hypersensitivity. (A)</p> Signup and view all the answers

    Which of these methods is recommended to enhance the long-term benefits of chemical agents applied to tooth surfaces?

    <p>Spit but do not rinse after use. (A)</p> Signup and view all the answers

    What is the role of fluoride in managing dentine hypersensitivity?

    <p>It creates calcium-phosphorous precipitates to block tubules. (B)</p> Signup and view all the answers

    What is a common agent used at home for immediate relief from dentine hypersensitivity?

    <p>Arginine (A)</p> Signup and view all the answers

    Which of the following treatments has been classified under professional treatment for dentine hypersensitivity?

    <p>Applying stannous fluoride varnishes. (B)</p> Signup and view all the answers

    What effect does the high concentration of extracellular potassium have on nerve fibers?

    <p>It results in inactivation of action potentials. (D)</p> Signup and view all the answers

    Which method is NOT mentioned for improving the efficacy of agents used for dentinal tubule occlusion?

    <p>Use with a high sugar diet. (B)</p> Signup and view all the answers

    Which theory suggests that nerves directly transmit pain through dentinal tubules?

    <p>Direct Innervation Theory (C)</p> Signup and view all the answers

    What percentage of the dentine volume is made up of water?

    <p>22% (B)</p> Signup and view all the answers

    Which of the following is not a stimulus that can cause pain from exposed dentine?

    <p>Radiation (C)</p> Signup and view all the answers

    What is one way dentine may become exposed due to natural morphology?

    <p>Localized gingival recession (C)</p> Signup and view all the answers

    Which of the following statements defines dentin hypersensitivity according to the Canadian Advisory Board?

    <p>Pain derived from exposed dentine in response to various stimuli (D)</p> Signup and view all the answers

    Which mechanism involves fluid movement from an area of high concentration to an area of low concentration?

    <p>Osmosis (C)</p> Signup and view all the answers

    What could be a potential cause of mechanical stimulation that contributes to exposing dentine?

    <p>Tooth brushing (D)</p> Signup and view all the answers

    Which of the following activities might lead to localized gingival recession?

    <p>Excessive nail biting (A)</p> Signup and view all the answers

    Flashcards

    Dentine Hypersensitivity

    A condition where stimulus causes sharp pain in exposed dentine.

    Typical Presentation

    Dentine hypersensitivity pain is short, sharp, and resolves quickly.

    Susceptible Tooth

    A tooth that is exposed or lacks protective enamel, making it sensitive.

    Pain Mechanism

    Stimulus on a susceptible tooth leads to quick pain sensation.

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    Management Role

    Involves providing preventative treatments and advice to patients with hypersensitivity.

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    Enamel

    The hard outer layer of a tooth that protects it.

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    Dentin

    The layer beneath enamel, softer than enamel and contains tubules.

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    Pulp

    The innermost part of a tooth containing nerves and blood vessels.

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    Hydrodynamic Theory

    Theory explaining tooth pain through fluid movement in dentinal tubules.

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    Osmosis

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

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    Stimuli for Sensitivity

    Factors like thermal, chemical, and mechanical that can cause dentin pain.

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    Causes of Exposed Dentin

    Factors such as gum recession, brushing, and tooth surface loss leading to sensitivity.

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    Dentinal Tubules Occlusion

    The process of blocking dentinal tubules to reduce sensitivity.

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    Temporary Agents

    Substances that provide short-term relief by occluding tubules.

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    Arginine in toothpaste

    A protein that helps chemical ions adhere to teeth surfaces.

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    Bioactive Glass

    A chemical that precipitates in acidic environments to occlude tubules.

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    Stannous Fluoride

    A fluoride compound that blocks dentinal tubules to alleviate sensitivity.

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    Potassium Nitrate

    A compound in toothpaste that raises potassium levels to depolarize nerves.

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    Fluoride's Role

    Fluoride helps in forming precipitates that obstruct dentinal tubules.

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    Spit vs Rinse

    Spitting allows chemicals to stay in contact with teeth for longer.

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    Clinical Examination

    Assessment performed to evaluate the source of dental pain, focusing on morphology and dentine exposure.

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    Verbal History Taking

    Gathering patient history through questions to identify sensitive areas and triggers for pain.

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    Dentine Exposure

    The exposure of dentine due to enamel loss, making it sensitive to external stimuli.

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    Prevent Tubule Exposure

    The action of protecting dentinal tubules from external stimuli to reduce sensitivity.

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    Home Care for Patients

    Strategies patients can implement at home to manage dentine hypersensitivity, including brushing techniques.

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    Mechanism of Action

    The processes by which dental products reduce sensitivity, including occlusion of tubules.

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    Desensitizing Agents

    Substances like calcium phosphosilicate and fluoride used to treat dentine hypersensitivity.

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    Study Notes

    Dentine Hypersensitivity

    • Dentine hypersensitivity is a condition characterized by pain in response to stimuli.
    • Pain is short-duration, rapid onset, sharp, and quickly resolves in the absence of other symptoms.
    • The pain is triggered by stimuli like hot, cold, acidic, tactile, and osmotic substances.
    • The aetiology of dentine hypersensitivity involves exposed dentine, caused by different factors.

    Causes of Exposed Dentine

    • Natural Morphology: In some cases, the natural arrangement of enamel and cementum results in exposed dentine.
      • 60%-65% of enamel might overlap cementum
      • 30% can be edge-to-edge
      • 5%-10% where enamel and cementum do not meet
    • Localised Gingival Recession: Factors such as tooth-brushing, nail-biting, using items, piercings, high frenum, periodontal disease, and lack of keratinized tissue lead to exposed dentine.
    • Generalised Gingival Recession: This can result from periodontal treatment.
    • Tooth Surface Loss: Erosion, abrasion, abfraction, and attrition.
    • Diagnosis of other issues: Issues like cavities, decay and other dental disorders

    Pain and Mechanisms

    • Stimulus + Susceptible Tooth = Dentine Hypersensitivity*
    • The pain is caused by a stimulus affecting exposed dentine (and reaching the pulp).
    • Hydro-Dynamic Theory: Fluid (water) movement through the dentinal tubules causes pain.
    • Direct Innervation Theory: Nerves in the dentine register the stimulus directly.
    • Odontal Blast Theory: Odontoblasts (cells that form dentin) sense the stimulus directly.

    How is the pain measured?

    • Short duration

    • Rapid onset

    • Sharp pain

    • Quickly resolves

    • In the absence of other symptoms

    How to diagnose?

    • History-Taking:
      • What: elicits the type of sensitivity
      • Where: the exact location
      • When: when the sensation is felt
      • How Long: the duration of the sensation
      • How often: how frequently is the sensation experienced
    • Examination: checking the tooth morphology and presence of exposed dentine (3 in 1 - to confirm symptoms and identify areas of interest)

    Treatment

    • Dental Hygiene and Therapists Role:
      • Identify the cause of pain
      • Identify the aetiological factors (e.g., diet history, oral hygiene)
      • Educate the patient about the problem
      • Provide preventative management and advice (e.g., brushing techniques, sensitivity-specific toothpaste)
      • Refer complex cases to a General Dentist (GDP)
    • Professional Treatment: Management of exposed dentin with agents.
    • Home Care:
      • Mechanisms of actions that can either remove the stimulus, occlude tubules, and desensitize nerves.
      • Use of toothpaste containing potassium nitrate.
      • Using sensitive-specific toothpaste.

    Agents Used at Home

    • Colgate: Sensitivity instant relief - Arginine
    • Sensodyne: Rapid - Contains stannous fluoride to occlude tubules; Repair and protect - Contains stannous fluoride to occlude tubules
    • Fluoride: Reduces dentin hypersensitivity.

    Summary

    • Dentine hypersensitivity is diagnosed by identifying the cause of the pain and the aetiological factors.

    • Treatment includes education, professional agents, or home care.

    • Solutions involve using agents that stick to the tooth surface or using high concentrations of fluoride.

    • Continuing daily use of these agents allows for longer-lived benefits.

    • Disclaimer: This information is for educational purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified dentist or other qualified healthcare providers with any questions you may have regarding medical conditions.

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    Description

    Explore the causes and characteristics of dentine hypersensitivity in this quiz. Understand how pain is triggered by various stimuli and the factors leading to exposed dentine. Test your knowledge on this dental condition and its implications.

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