Dentine Hypersensitivity Quiz
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Questions and Answers

What is the typical presentation of dentine hypersensitivity?

  • Pain only during hot beverages
  • Sharp pain with rapid onset (correct)
  • Long-lasting pain
  • Continuous dull ache

Which factor does NOT contribute to making a tooth susceptible to dentine hypersensitivity?

  • Exposure of the dentine
  • High fluoride content (correct)
  • Poor oral hygiene
  • Gum recession

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

  • Pain quickly resolves after the stimulus is removed (correct)
  • Pain is accompanied by swelling in the gums
  • Pain persists for several hours
  • Pain occurs without any stimuli

Which of the following is a key aspect of managing patients with dentine hypersensitivity?

<p>Providing preventative treatments and advice (D)</p> Signup and view all the answers

What is the mechanism that leads to dentine hypersensitivity?

<p>Open tubules in the dentine allowing stimuli to reach the nerve (B)</p> Signup and view all the answers

Which of the following dental team members plays a significant role in the treatment plan for dentine hypersensitivity?

<p>Dental Therapist (D)</p> Signup and view all the answers

What type of pain is typically experienced with dentine hypersensitivity?

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

Which of the following does NOT signify a change in a patient's oral health status related to dentine hypersensitivity?

<p>Dull pain that lingers (A)</p> Signup and view all the answers

What is the primary purpose of the cemento-enamel junction?

<p>To prevent dentine exposure (C)</p> Signup and view all the answers

Which of the following is NOT a cause of gingival recession?

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

If tooth surface loss (TSL) is identified, what is the next step in management?

<p>Manage as per TSL lecture with prevention and active treatment (C)</p> Signup and view all the answers

What is a key component of verbal history taking during a dental examination?

<p>Identifying the duration of symptoms (C)</p> Signup and view all the answers

Which factor is assessed during the clinical examination to determine sensitivity?

<p>Tooth morphology and exposed dentine (D)</p> Signup and view all the answers

What does sensitivity or pain mainly indicate during an examination?

<p>Possibility of dental hypersensitivity (B)</p> Signup and view all the answers

Which of the following could be a trigger for dental hypersensitivity?

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

When assessing pain, how can it be categorized?

<p>Localized or generalized (D)</p> Signup and view all the answers

What should NOT be the focus when managing dentine hypersensitivity?

<p>Finding a lasting cure (B)</p> Signup and view all the answers

Which habit is a potential contributing factor to localized gingival recession?

<p>Nail biting (B)</p> Signup and view all the answers

What is the primary purpose of dentinal tubules in teeth?

<p>To transmit pain signals through nerves (D)</p> Signup and view all the answers

Which theory suggests that odontoblast processes register stimuli directly through dentinal tubules?

<p>Odontoblast Receptor Theory (D)</p> Signup and view all the answers

What effect does thermal stimulation have on dentin sensitivity?

<p>It creates fluid movement that activates nerves (A)</p> Signup and view all the answers

How does osmosis relate to dentinal sensitivity?

<p>It facilitates movement of irritants into the tubules (B)</p> Signup and view all the answers

What percentage of dentin volume is water?

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

Which of the following best defines dentin hypersensitivity?

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

What causes dentin to become exposed?

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

Which type of stimuli can activate dentin sensitivity?

<p>Chemical, thermal, tactile or osmotic stimuli (C)</p> Signup and view all the answers

Which statement accurately describes the hydrodynamic theory?

<p>It explains fluid movement as a cause of dentin hypersensitivity (C)</p> Signup and view all the answers

What can trigger chemical stimulation of dentin?

<p>Acids that remove the smear layer (D)</p> Signup and view all the answers

What is the primary role of dental hygiene and therapists when dealing with a patient’s pain?

<p>Identify the cause of the patient's pain (A)</p> Signup and view all the answers

Which dietary consideration is important for preventing tooth erosion?

<p>Limiting acidic drinks (A)</p> Signup and view all the answers

What should patients use to address tooth sensitivity at home?

<p>Sensitive toothpaste (B)</p> Signup and view all the answers

Which of the following describes a method for preventing exposure of dentinal tubules?

<p>Application of fluoride varnish (D)</p> Signup and view all the answers

What is the effect of over brushing on dental health?

<p>Causes tooth surface loss (D)</p> Signup and view all the answers

What is a significant factor that dental professionals consider when assessing a patient's oral health?

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

What is one way to desensitize tooth nerves?

<p>Application of sensitive toothpaste (C)</p> Signup and view all the answers

What should be done if a patient's condition requires additional treatment after initial assessment?

<p>Refer to a general dental practitioner as needed (B)</p> Signup and view all the answers

Which of the following is a correct brushing technique for patients with sensitivity?

<p>Using a circular motion gently (A)</p> Signup and view all the answers

Which of the following mechanisms prevents exposure of dentinal tubules?

<p>Occluding tubules (B)</p> Signup and view all the answers

What is the primary action of agents like Calcium Phosphosilicate and Bioactive Glass in dental care?

<p>They work by blocking dentine tubules. (A)</p> Signup and view all the answers

Which agent is recommended for at-home use to help occlude dentine tubules?

<p>Arginine-based toothpaste (B)</p> Signup and view all the answers

How do chemical precipitates form in relation to the use of fluoride in dental care?

<p>In acidic environments. (A)</p> Signup and view all the answers

What is the effect of potassium ions in treating dentine hypersensitivity?

<p>They reduce action potential in the nerves. (C)</p> Signup and view all the answers

Why are the occluding effects of agents like Fluoride and Arginine considered temporary?

<p>They are washed away quickly in saliva. (D)</p> Signup and view all the answers

Which of the following solutions is suggested to maintain the benefits of dentine hypersensitivity treatments?

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

What compound in Sensodyne's Repair and Protect toothpaste aids in occluding dentine tubules?

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

Flashcards

Dentine Hypersensitivity

A condition characterized by short, sharp, and quickly resolving pain in response to stimulus affecting the dentin surface of the tooth.

Dentin Hypersensitivity Pain

Brief, sharp pain triggered by stimuli on the dentin surface of a tooth.

Dentin Surface

The inner layer of a tooth, composed of dentin; exposed dentin is sensitive.

Stimulus-Susceptible Tooth

A tooth more likely to experience pain due to hypersensitivity when stimulated.

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Susceptible Tooth Factor

Characteristic of a tooth that makes it vulnerable to dentin hypersensitivity.

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Hypersensitivity Presentation

The way hypersensitivity manifests itself, including symptoms like short pain episodes.

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Diagnosis of Dentin Hypersensitivity

Identifying sensitivity of specific areas of the tooth surface to stimuli.

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Dentin hypersensitivity Mechanism

The process by which a stimulus triggers pain in exposed dentin.

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Dentin Tubules

Tiny channels running through dentin, connecting the tooth surface to the pulp.

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Hydrodynamic Theory

Fluid movement through dentin tubules causing pain.

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Osmosis

Fluid movement from high to low concentration through a semi-permeable membrane.

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Exposed Dentin

Dentin at the surface of the tooth, lacking enamel or cementum protection.

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Thermal Stimuli

Temperature changes (hot or cold) that can trigger dentin hypersensitivity.

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Chemical Stimuli

Acids (e.g., from some foods) or other chemicals that irritate exposed dentin.

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Mechanical Stimuli

Actions that physically disturb exposed dentin (e.g., tooth brushing or chewing).

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Pulp

Innermost part of the tooth containing nerves and blood vessels.

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Enamel

Hard outer layer of the tooth. Protects dentin from damage.

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Cemento-enamel junction

The point where the enamel of the crown and the cementum of the root meet. Ideally, it overlaps to prevent dentin exposure.

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Dentin exposure

When the dentin layer of a tooth is exposed due to recession or enamel loss.

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Causes of gingival recession

Various factors can contribute to the gum receding, exposing dentin. Common causes include toothbrushing, nail biting, piercings, and periodontal disease.

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High fraenum

A tight band of tissue attaching the lip or tongue to the gum, which can pull the gum away and expose dentin.

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Orthodontics

A practice that can cause recession by applying pressure to the teeth and gums.

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What causes dentin hypersensitivity?

The pain usually occurs when the dentin is exposed due to recession or enamel loss, making it vulnerable to stimuli.

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How to elicit pain in dentin hypersensitivity

Use cold air, cold drinks, or a probe to stimulate the exposed dentin and identify the source of the pain.

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Managing dentin hypersensitivity

Depending on the severity, treatment options may include desensitizing toothpaste, fluoride varnish, or professional procedures like bonding or laser treatment.

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Refer to a GDP

A general dental practitioner who can provide comprehensive care and determine if further treatment or specialized care is needed.

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Acidic Diet & Tooth Loss

A diet high in acidic foods and drinks can contribute to tooth surface loss, leading to sensitivity.

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Overbrushing

Brushing too hard or with a hard-bristled brush can wear away tooth enamel, exposing sensitive dentin.

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Desensitizing Agents

Ingredients in toothpaste or gels that block the tubules in dentin, reducing sensitivity.

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Tubule Occlusion

The process of blocking or sealing off tiny tubules in dentin, preventing stimuli from reaching nerve endings.

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Stimulus Removal

Avoiding foods and drinks that trigger pain, such as acidic foods, hot drinks, or sweets.

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Preventive Management

Strategies to prevent further tooth surface loss and hypersensitivity, such as proper brushing technique and a balanced diet.

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Sensitive Toothpaste

Toothpaste containing desensitizing agents, such as potassium nitrate, to reduce pain.

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Correct Brushing Technique

A gentle and effective method of brushing that removes plaque without damaging enamel.

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Dentine Hypersensitivity Solutions

Strategies to address sensitivity by blocking dentin tubules and preventing pain.

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Occluding Dentin Tubules: Challenge

The difficulty in permanently blocking dentin tubules because chemical agents can be dissolved, removed mechanically, or need to form a precipitate to be effective.

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Occluding Dentin Tubules: Solutions

Strategies to overcome the challenge of temporary solutions by using proteins, chemicals that precipitate in acidic environments, higher fluoride concentrations, and consistent daily use.

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Arginine for Dentine Hypersensitivity

A protein that sticks to the tooth surface, allowing chemical agents to occlude dentin tubules effectively.

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Bioactive Glass for Dentine Hypersensitivity

A chemical agent that precipitates in an acidic environment, forming a barrier to occlude dentin tubules.

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Fluoride for Dentine Hypersensitivity

A chemical agent that blocks dentin tubules by forming calcium-phosphorous precipitates, calcium fluoride, and fluoroapatite.

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Potassium Nitrate for Dentine Hypersensitivity

A chemical agent that reduces action potential within nerves by diffusing potassium ions through dentin tubules and into the pulp surrounding the nerve.

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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.
  • Review of dentine hypersensitivity terminology, epidemiology, mechanisms, aetiology, and management.
  • Guidelines for General Dental Practice regarding dentine hypersensitivity.

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Dentine Hypersensitivity PDF

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.

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