prevention dentinal hypersensitivity

hydrodynamic theory

• proposes that stimuli are transmitted to pulp surface via movement of fluid or semifluid materials found within the dentinal tubule

• an open dentinal tubule channel must traverse from exposed dentin surface to vital pulp

• exposed dentin necessary for each hypersensitivity is most commonly result of gingival recession or enamel loss along with other causes

causes of gingival recession

• age

• tooth type

• bacterial plaque biofilm

• trauma from traumatic toothbrushing

• occlusal trauma

factors that contribute to dentinal hypersensitivity

• gingival recession

• loss of enamel

• toothbrush abrasion

• erosion

• abfraction

• acidic foods

• periodontal surgery

• occlusal hyperfunction

• cusp grinding

• instrumentation (root planing, scaling, extrinsic stain removal)

• cosmetic tooth whitening

mechanisms of action for desensitizing agents

• physical occlusion of dentinal tubules

• chemical occlusion of dentinal tubules

• nerve desensitization to block pulp tissue transmission

• photobiomodulation using laser therapy

self-applied desensitizing agents

• 5% potassium nitrate

• 0.4% stannous fluoride

• 8% arginine, calcium carbonate

• strontium acetate or strontium chloride

• casein derivatives, including CPP-ACP

• oxalates

professionally applied desensitizing agents

• varnishes and precipitants

• primers containing hydroxyethyl methacrylate

• polymerizing agents (glass ionomer cements or adhesive resin primers)

• iontophoresis

• lasers

• restorations

• periodontal plastic surgery

varnishes and precipitants

• arginine and calcium carbonate paste that is burnished into the tooth surface with a rubber cup

• one of the ONLY systems where a dentifrice can function as a professional in office treatment

iontophoresis

• delivery of sodium fluoride by passing an electrical current through the cervical dentinl

lasers

• dentin treated with _ is harder than untreated dentin

restorations

• cover exposed dentin and restore tooth anatomy

periodontal plastic surgery

• connective tissue graft

HEMA (GLUMA)

• protein coagulation/ seal

• immediate relief

• professional application only

arginine and calcium carbonate

• tubule plug

• immediate relief

• can be applied chairside and at home

strontium

• tubule occlusion

• moderate speed of action

• for home care use

potassium nitrate

• nerve desensitization

• slow speed

• for home use