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Questions and Answers
What is the typical presentation of dentine hypersensitivity?
What is the typical presentation of dentine hypersensitivity?
Which factor does NOT contribute to making a tooth susceptible to dentine hypersensitivity?
Which factor does NOT contribute to making a tooth susceptible to dentine hypersensitivity?
What is a primary characteristic of the pain associated with dentine hypersensitivity?
What is a primary characteristic of the pain associated with dentine hypersensitivity?
Which of the following is a key aspect of managing patients with dentine hypersensitivity?
Which of the following is a key aspect of managing patients with dentine hypersensitivity?
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What is the mechanism that leads to dentine hypersensitivity?
What is the mechanism that leads to dentine hypersensitivity?
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Which of the following dental team members plays a significant role in the treatment plan for dentine hypersensitivity?
Which of the following dental team members plays a significant role in the treatment plan for dentine hypersensitivity?
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What type of pain is typically experienced with dentine hypersensitivity?
What type of pain is typically experienced with dentine hypersensitivity?
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Which of the following does NOT signify a change in a patient's oral health status related to dentine hypersensitivity?
Which of the following does NOT signify a change in a patient's oral health status related to dentine hypersensitivity?
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What is the primary purpose of the cemento-enamel junction?
What is the primary purpose of the cemento-enamel junction?
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Which of the following is NOT a cause of gingival recession?
Which of the following is NOT a cause of gingival recession?
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If tooth surface loss (TSL) is identified, what is the next step in management?
If tooth surface loss (TSL) is identified, what is the next step in management?
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What is a key component of verbal history taking during a dental examination?
What is a key component of verbal history taking during a dental examination?
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Which factor is assessed during the clinical examination to determine sensitivity?
Which factor is assessed during the clinical examination to determine sensitivity?
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What does sensitivity or pain mainly indicate during an examination?
What does sensitivity or pain mainly indicate during an examination?
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Which of the following could be a trigger for dental hypersensitivity?
Which of the following could be a trigger for dental hypersensitivity?
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When assessing pain, how can it be categorized?
When assessing pain, how can it be categorized?
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What should NOT be the focus when managing dentine hypersensitivity?
What should NOT be the focus when managing dentine hypersensitivity?
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Which habit is a potential contributing factor to localized gingival recession?
Which habit is a potential contributing factor to localized gingival recession?
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What is the primary purpose of dentinal tubules in teeth?
What is the primary purpose of dentinal tubules in teeth?
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Which theory suggests that odontoblast processes register stimuli directly through dentinal tubules?
Which theory suggests that odontoblast processes register stimuli directly through dentinal tubules?
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What effect does thermal stimulation have on dentin sensitivity?
What effect does thermal stimulation have on dentin sensitivity?
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How does osmosis relate to dentinal sensitivity?
How does osmosis relate to dentinal sensitivity?
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What percentage of dentin volume is water?
What percentage of dentin volume is water?
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Which of the following best defines dentin hypersensitivity?
Which of the following best defines dentin hypersensitivity?
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What causes dentin to become exposed?
What causes dentin to become exposed?
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Which type of stimuli can activate dentin sensitivity?
Which type of stimuli can activate dentin sensitivity?
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Which statement accurately describes the hydrodynamic theory?
Which statement accurately describes the hydrodynamic theory?
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What can trigger chemical stimulation of dentin?
What can trigger chemical stimulation of dentin?
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What is the primary role of dental hygiene and therapists when dealing with a patient’s pain?
What is the primary role of dental hygiene and therapists when dealing with a patient’s pain?
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Which dietary consideration is important for preventing tooth erosion?
Which dietary consideration is important for preventing tooth erosion?
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What should patients use to address tooth sensitivity at home?
What should patients use to address tooth sensitivity at home?
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Which of the following describes a method for preventing exposure of dentinal tubules?
Which of the following describes a method for preventing exposure of dentinal tubules?
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What is the effect of over brushing on dental health?
What is the effect of over brushing on dental health?
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What is a significant factor that dental professionals consider when assessing a patient's oral health?
What is a significant factor that dental professionals consider when assessing a patient's oral health?
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What is one way to desensitize tooth nerves?
What is one way to desensitize tooth nerves?
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What should be done if a patient's condition requires additional treatment after initial assessment?
What should be done if a patient's condition requires additional treatment after initial assessment?
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Which of the following is a correct brushing technique for patients with sensitivity?
Which of the following is a correct brushing technique for patients with sensitivity?
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Which of the following mechanisms prevents exposure of dentinal tubules?
Which of the following mechanisms prevents exposure of dentinal tubules?
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What is the primary action of agents like Calcium Phosphosilicate and Bioactive Glass in dental care?
What is the primary action of agents like Calcium Phosphosilicate and Bioactive Glass in dental care?
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Which agent is recommended for at-home use to help occlude dentine tubules?
Which agent is recommended for at-home use to help occlude dentine tubules?
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How do chemical precipitates form in relation to the use of fluoride in dental care?
How do chemical precipitates form in relation to the use of fluoride in dental care?
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What is the effect of potassium ions in treating dentine hypersensitivity?
What is the effect of potassium ions in treating dentine hypersensitivity?
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Why are the occluding effects of agents like Fluoride and Arginine considered temporary?
Why are the occluding effects of agents like Fluoride and Arginine considered temporary?
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Which of the following solutions is suggested to maintain the benefits of dentine hypersensitivity treatments?
Which of the following solutions is suggested to maintain the benefits of dentine hypersensitivity treatments?
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What compound in Sensodyne's Repair and Protect toothpaste aids in occluding dentine tubules?
What compound in Sensodyne's Repair and Protect toothpaste aids in occluding dentine tubules?
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Study Notes
Dentine Hypersensitivity
- Dentine hypersensitivity is pain from exposed dentine, triggered by chemical, thermal, tactile, or osmotic stimuli
- Pain is short-duration, rapid onset, sharp, and quickly resolves (absent of other symptoms)
- This presentation aids in diagnosis.
Histology of Enamel and Dentine
- Slides are provided for pre-reading prep from the histological lectures.
Learning Objectives
- Define dentine hypersensitivity using its characteristic presentation
- Explain the mechanism of dentine hypersensitivity
- Identify and recognize aetiological factors causing dentine hypersensitivity
- Outline the role of the dental professional in managing patients with dentine hypersensitivity, including preventive treatments and patient advice.
What is Dentine Hypersensitivity?
- Dentine hypersensitivity only affects a specific tooth surface, aiding later diagnosis.
- Patients may experience an excessive reaction to certain stimuli, allowing early recognition of minor alterations.
- Pain is presented as a significant indicator.
How Does This Pain Present?
- Short duration (quick pain onset).
- Rapid onset (instant pain).
- Sharp pain (intensity of pain).
- Pain quickly resolves (disappears quickly).
Why Does This Pain Occur?
- This presentation discusses how pain is registered through various theories.
- A stimulus (e.g., hot or cold) plus a susceptible tooth equals dentine hypersensitivity.
What Makes a Tooth Susceptible?
- Loss of protective enamel, exposing dentine.
- Gingival recession, resulting in exposed dentine and cementum.
Dentinal Tubules
- Extend from the tooth surface to the pulp.
- Contain nerve endings, responsible for pain response.
- Holes are present which are dentinal tubules.
Theories on How Pain is Registered
- Direct innervation theory: nerves directly transmit pain to the central nervous system through dentinal tubules.
- Odontoblastic receptor theory: Specialized cells (odontoblasts) extend into tubules and directly register stimuli.
- Hydrodynamic theory: movement of fluids within tubules initiates pain signals. The explanation of the hydrodynamic theory is due to be examined.
Hydrodynamic Theory
- Fluid movement, as a mechanism of pain registration.
Osmosis, Fluid Movement
- Fluid moves from high to low concentration through a semi-permeable membrane
Stimuli
- Thermal (hot/cold).
- Chemical (e.g., acid, whitening gels).
- Mechanical (brushings, eating, breathing).
Aetiology Definition
- Pain originating from exposed dentine, in response to stimuli (chemical, thermal, or osmotic), not attributable to any other dental problem.
How Does Dentine Become Exposed?
- Natural morphology: Variation in enamel and cementum overlap.
- 60-65% of enamel overlap cementum
- 30% edge to edge of overlap
- 5-10% no overlap.
- Localized gingival recession: from toothbrushing, nail biting, opening items, piercings, high frenum, periodontal disease.
- Generalized gingival recession: from periodontal treatments.
- Tooth surface loss (erosion, abrasion, abfraction, attrition).
Diagnosis
- History Taking (What, Where, When, How Long, How Often, Action): Crucial for accurate diagnosis.
- Clinical Examination: Tooth morphology and areas of exposure assessment, pain elicitation.
Dental Hygiene and Therapist Role
- Assess patient pain.
- Identify aetiological factors (diet, oral hygiene).
- Educate patient on the problem.
- Provide preventative management and advice.
- Refer to a GDP if required.
Patient Home Care
- Correct brushing technique.
- Sensitive toothpaste (e.g. Sensodyne and Colgate).
- Limit acidic drinks.
- Correct amount of sensitive toothpaste.
- Remove stimuli.
Mechanisms of Action
- Remove stimuli
- Desensitize nerves.
- Occlude tubules (block surface).
- Prevent further exposure.
How do these agents work?
- Agents mentioned in the presentation (e.g., calcium phosphosilicate, calcium triphosphate, bioactive glass, strontium chloride/acetate, fluoride, arginine), block the dentinal tubules, preventing dentine hypersensitivity.
Occluding Dentinal Tubules
- Topical agents block dentinal tubules.
Agents for Home Use
- Colgate sensitive toothpaste
- Sensodyne (contains stannous fluoride)
- Fluoride toothpaste
Potassium Nitrate in Toothpaste
- Potassium nitrate reduces pain by reducing nerve action potential, effectively decreasing response via diffusion into the pulp.
- K+ concentration in the area affects nerve depolarization and action potential.
Professional Treatment
- Fluoride varnish application.
- Resin-based products.
- Gingival grafts.
- Root canal treatment.
- Recession coverage (cover exposed areas)
Summary
- Identify if sensitivity is the problem.
- Identify aetiology (causes).
- Educate the patient on the problem.
- Refer to a GDP for complex care.
- Professionally apply agents for appropriate treatment.
- Provide advice for self-care treatment.
Recommended Reading
- Review of dentine hypersensitivity terminology, epidemiology, mechanisms, aetiology, and management.
- Guidelines for General Dental Practice regarding dentine hypersensitivity.
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Description
Test your knowledge on dentine hypersensitivity with this quiz. You'll explore typical presentations, contributing factors, pain characteristics, and management strategies related to this dental condition. Perfect for dental students and professionals looking to enhance their understanding.
