scholarly journals An Update on Dentinal Hypersensitivity - Aetiology to Management – A Review

2021 ◽  
Vol 10 (37) ◽  
pp. 3289-3293
Author(s):  
Mrinalini Mrinalini ◽  
Urvashi B. Sodvadiya ◽  
Mithra N. Hegde ◽  
Gowrish S. Bhat
Keyword(s):  
Pain Relief ◽  
Hydrodynamic Theory ◽  
Dentin Hypersensitivity ◽  
Herbal Products ◽  
Dentinal Tubules ◽  
Tooth Structure ◽  
Dentin Sensitivity ◽  
Nerve Sprouting ◽  
Careful Clinical Examination ◽  
Dentinal Hypersensitivity

BACKGROUND Dentinal hypersensitivity is a common clinical disease that occurs as a result of dentin exposure. Though the term dentin hypersensitivity and dentin sensitivity is used interchangeably, dentin hypersensitivity is an exaggerated form of dentinal sensitivity which arises due to localized pulpal inflammation, pulpal nerve sprouting, and development of inflammatory sodium channels. It is characterised by short sharp pain emerging from exposed dentinal tubules in reaction to various stimuli. Such dentin exposure could be due to either enamel loss or cemental loss. This is followed by removal of smear layer by mechanical or chemical means. At present, the hydrodynamic theory, which describes fluid movement in response to stimuli within exposed dentinal tubules, is a commonly recognized explanation for dentin hypersensitivity. It is more common in premolars and canines, and it affects the facial surfaces of the teeth towards the cervical aspect. Studies suggested microscopic changes in the structure of sensitive dentin compared with normal dentin. The diagnosis of dentinal hypersensitivity requires careful clinical examination and eliciting the response using various stimuli. Dentinal hypersensitivity is usually managed by the use of physical or chemical agents. They work either by disturbing the neural response to pain stimulus or block fluid flow by occluding the tubule. The desirable features of a desensitising agent include the ability to give instant and longlasting pain relief, being simple to use, well accepted, not harmful to the pulp. It is recommended that the desensitizing agent is used for at least two weeks. Some of the newer agents used for management includes CPP-ACP, proarginine, nanomaterials, herbal products, propolis etc. In cases where there is tooth structure loss, appropriate restorative material is used to cover the exposed dentin. Root canal therapy is considered the last resort for pain relief after all other options have failed to provide relief. The present article outlines the etiopathogenesis, risk factors, diagnosis, prevention and treatment of dentinal hypersensitivity. KEY WORDS Dentinal Hypersensitivity; Dentin Sensitivity; Desensitizing Agents; Iontophoresis

Occlusal Considerations in the Hypersensitive Dentition

2015 ◽  
pp. 358-428 ◽  
Author(s):  
Nick Yiannios, DDS
Keyword(s):  
Pilot Study ◽  
Contact Force ◽  
Dentin Hypersensitivity ◽  
Analog Scale ◽  
Dentinal Tubules ◽  
Occlusal Contact ◽  
Occlusal Adjustment ◽  
Anterior Guidance ◽  
Dentinal Hypersensitivity ◽  
Guidance Development

In the literature, Dentinal Hypersensitivity (DH) is considered to arise from exposed dentin and patent dentinal tubules. However, clinical observation of recurrent DH sensitivity indicates it can occur in the presence or absence of exposed dentin. Quantified occlusal contact force and timing parameters have been ignored in studies assessing hypersensitive teeth. This chapter introduces a novel occlusal concept: Frictional Dental Hypersensitivity (FDH). Clinical evidence from combining computerized occlusal analysis and electromyography is presented linking opposing posterior tooth friction and muscular hyperactivity to Dentin Hypersensitivity. This chapter proffers how occlusion, muscular TMD symptoms, and frictional Dentin Hypersensitivity are all related. Lastly, a Pilot Study is presented that used a Visual Numerical Analog scale to quantify Dentin Hypersensitivity resolution observed in symptomatic patients who underwent the Immediate Complete Anterior Guidance Development (ICAGD) coronoplasty. This computer-guided occlusal adjustment eliminated pretreatment FDH symptomatology, further supporting that Dentinal Hypersensitivity has an occlusally-based, frictional etiology.

scholarly journals Mechanotransducers in Rat Pulpal Afferents

2008 ◽  
Vol 87 (9) ◽  
pp. 834-838 ◽  
Author(s):  
T.O. Hermanstyne ◽  
K. Markowitz ◽  
L. Fan ◽  
M.S. Gold
Keyword(s):  
Single Cell ◽  
Hydrodynamic Theory ◽  
Dentinal Tubules ◽  
Fluid Movement ◽  
Single Cell Pcr ◽  
Dentin Sensitivity ◽  
Novel Targets ◽  
Stimulation Of

The hydrodynamic theory suggests that pain associated with stimulation of a sensitive tooth ultimately involves mechanotransduction as a consequence of fluid movement within exposed dentinal tubules. To determine whether putative mechanotransducers could underlie mechanotransduction in pulpal afferents, we used a single-cell PCR approach to screen retrogradely labeled pulpal afferents. The presence of mRNA encoding BNC-1, ASIC3, TRPV4, TRPA1, the α, β, and γ subunits of ENaC, and the two pore K+ channels (TREK1, TREK2) and TRAAK were screened in pulpal neurons from rats with and without pulpal inflammation. ASIC3, TRPA1, TREK1, and TREK2 were present in ~67%, 64%, 14%, and 10% of pulpal neurons, respectively. There was no detectable influence of inflammation on the proportion of neurons expressing these mechanotransducers. Given that the majority of pulpal afferents express ASIC3 and TRPA1, our results raise the possibility that these channels may be novel targets for the treatment of dentin sensitivity.

scholarly journals Clinical Dentin Hypersensitivity: Understanding the Causes and Prescribing a Treatment

2001 ◽  
Vol 2 (1) ◽  
pp. 27-34 ◽  
Author(s):  
Peter L. Jacobsen ◽  
Gretchen Bruce
Keyword(s):  
Treatment Strategies ◽  
Gingival Recession ◽  
Potassium Nitrate ◽  
Nerve Tissue ◽  
Tooth Bleaching ◽  
Hydrodynamic Theory ◽  
Dentin Hypersensitivity ◽  
Dentinal Tubules ◽  
Dental Restorations ◽  
Sensitive Teeth

Abstract Dentin hypersensitivity is a common condition of transient tooth pain associated with a variety of exogenous stimuli. There is substantial variation in the response to such stimuli from one person to another. Except for sensitivity associated with tooth bleaching or other tooth pathology, the clinical cause of dentin hypersensitivity is exposed dentinal tubules as a result of gingival recession and subsequent loss of cementum on root surfaces. The most widely accepted theory of how the pain occurs is Brännström's hydrodynamic theory of dentin hypersensitivity. Dentinal hypersensitivity must be differentiated from other conditions that may cause sensitive teeth prior to treatment. Three principal treatment strategies are used. Dentinal tubules can be covered by gingival grafts or dental restorations. The tubules can be plugged using compounds that can precipitate together into a large enough mass to occlude the tubules. The third strategy is to desensitize the nerve tissue within the tubules using potassium nitrate. Several over-the-counter products are available to patients to treat this condition.

scholarly journals Effectiveness of Thymoquinone and Fluoridated Bioactive Glass/Nano-Oxide Contained Dentifrices on Abrasion and Dentine Tubules Occlusion: An Ex Vivo Study

2020 ◽  
Vol 14 (01) ◽  
pp. 045-054 ◽  
Author(s):  
Daud Anthoney ◽  
Shahreen Zahid ◽  
Hina Khalid ◽  
Zohaib Khurshid ◽  
Asma Tufail Shah ◽  
...  
Keyword(s):  
Bioactive Glass ◽  
Ex Vivo ◽  
Three Dimensional ◽  
International Standards ◽  
P Value ◽  
Dentin Hypersensitivity ◽  
Dentinal Tubules ◽  
Tooth Structure ◽  
Nano Zinc Oxide ◽  
Nano Zinc

Abstract Objectives Dentin hypersensitivity (DH) is mainly due to the loss and replenishment of minerals from tooth structure, where the lost minerals can be rehabilitated with a biomimetic approach. The objectives were to determine the relative dentin abrasivity (RDA) of experimental (EXT) dentifrices and to determine the efficacy to occlude dentinal tubules. Materials and Methods Experimental dentifrices contained nano-fluoridated bioactive glass (n-FBG: 1.5 wt.% [EXT-A], 2.5 wt.% [EXT-B], and 3.5 wt.% [EXT-C]), nano-zinc oxide (n-ZnO), and thymoquinone as active agents. Bovine dentin blocks were subjected to brushing treatments as per groups, that is, distilled water; commercial dentifrice (control, CT); EXT toothpastes; and EXT-D without active agents. Samples were tested for three-dimensional (3D) abrasion analysis according to ISO-11609:2010 (International Organization for Standardization [ISO]). The roughness average (Ra), RDA, surface topography, and elemental compositions were investigated. Statistical Analysis One-way analysis of variance (ANOVA) with post-hoc Tukey’s and Tamhane’s test was performed for characterizations using Statistical Package for the Social Sciences (SPSS) version 21. The result was considered significant with p-value ≤ 0.05. Results Comparisons of Ra differed significantly between all groups with p < 0.05 except CT and EXT-A. The RDA values of EXT-A, EXT-B, and EXT-C were calculated as 74.04, 84.26, and 116.24, respectively, which were well within the acceptable limit set by international standards. All n-FBG containing dentifrices demonstrated uniform occlusion of dentinal tubules; however, highly concentrated EXT dentifrices showed more occlusion. Conclusions Acceptable range of RDA and superior occlusion of tubules by novel dentifrices suggest that it may be recommended for treating DH.

scholarly journals Concept of experimental preparation for treating dentin hypersensitivity

Open Medicine ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. 387-393
Author(s):  
Marta Tanasiewicz ◽  
Mirosław Gibas ◽  
Małgorzata Skucha-Nowak ◽  
Henryk Twardawa ◽  
Agnieszka Machorowska-Pieniążek
Keyword(s):  
Dentin Hypersensitivity ◽  
Detailed Knowledge ◽  
Human Teeth ◽  
Tooth Structure ◽  
Comparable Performance ◽  
Therapeutic Problem ◽  
Dentinal Hypersensitivity ◽  
Tooth Tissue ◽  
Experimental Preparation

AbstractBackgroundDentinal hypersensitivity (DH) is a diagnostic and therapeutic problem that is now appearing more frequently in modern dentistry. The aim of this work was to elaborate formulation of a new, original desensitizing preparation with prolonged action based on the knowledge of similar commercializations and to compare their performance in vitro.MethodologyThe analyses were performed with the aid of NMR spectroscopy. The experimental and commercial preparations were examined in vitro after thermocycling on human teeth by optical microscopy. The presence of the material on tooth tissue, its ability to penetrate into the tooth structure and its layer thickness were subjected to statistical analysis.ResultsA detailed knowledge on composition of commercial material was achieved from spectroscopic measurements. A new adhesive monomer was synthesized and incorporated into an experimental desensitizing formulation. The new monomer appeared to have comparable performance to the commercial one when regarding the affinity to tooth tissue and resistance to thermocycling.ConclusionsThe experimental formulation comprising a new adhesive monomer seems to be promising and could be applied in dental practice providing that biocompatibility is satisfactory.

Occlusal Considerations in the Hypersensitive Dentition

2017 ◽  
pp. 398-469
Author(s):  
Nick Yiannios, DDS
Keyword(s):  
Pilot Study ◽  
Contact Force ◽  
Dentin Hypersensitivity ◽  
Analog Scale ◽  
Dentinal Tubules ◽  
Occlusal Contact ◽  
Occlusal Adjustment ◽  
Anterior Guidance ◽  
Dentinal Hypersensitivity ◽  
Guidance Development

In the literature, Dentinal Hypersensitivity (DH) is considered to arise from exposed dentin and patent dentinal tubules. However, clinical observation of recurrent DH sensitivity indicates it can occur in the presence or absence of exposed dentin. Quantified occlusal contact force and timing parameters have been ignored in studies assessing hypersensitive teeth. This chapter introduces a novel occlusal concept: Frictional Dental Hypersensitivity (FDH). Clinical evidence from combining computerized occlusal analysis and electromyography is presented linking opposing posterior tooth friction and muscular hyperactivity to Dentin Hypersensitivity. This chapter proffers how occlusion, muscular TMD symptoms, and frictional Dentin Hypersensitivity are all related. Lastly, a Pilot Study is presented that used a Visual Numerical Analog scale to quantify Dentin Hypersensitivity resolution observed in symptomatic patients who underwent the Immediate Complete Anterior Guidance Development (ICAGD) coronoplasty. This computer-guided occlusal adjustment eliminated pretreatment FDH symptomatology, further supporting that Dentinal Hypersensitivity has an occlusally-based, frictional etiology.

scholarly journals Dentin Hypersensitivity: A Review of its Etiology, Mechanism, Prevention Strategies and Recent Advancements in its Management

2013 ◽  
Vol 4 (3) ◽  
pp. 188-192 ◽  
Author(s):  
Imran Farooq ◽  
Saqib Ali
Keyword(s):  
Clinical Problem ◽  
Hydrodynamic Theory ◽  
Dentin Hypersensitivity ◽  
Prevention Strategies ◽  
Patient Number ◽  
Dental Clinics ◽  
Dentinal Hypersensitivity ◽  
Common Clinical Problem ◽  
Dental Professionals

ABSTRACT Dentinal hypersensitivity is one of the most common clinical problem for which patients seek treatment and visit dental clinics. Its incidence is on a rise probably because its etiology is not very well understood. Once initiated, it can either remain as sensitivity or it can trigger pain and creates severe discomfort for the patient. Number of theories have been put forward to explain the mechanism of hypersensitivity causing pain but hydrodynamic theory is most widely accepted nowadays. Treating dentinal hypersensitivity is a challenge for dental professionals. This article reviews the etiology, mechanism and prevention strategies of dentinal hypersensitivity and also discusses recent advancements in its management. How to cite this article Ali S, Farooq I. Dentin Hypersensitivity: A Review of its Etiology, Mechanism, Prevention Strategies and Recent Advancements in its Management. World J Dent 2013;4(3):188-192.

Dentinal Hypersensitivity: A Review

2005 ◽  
Vol 6 (2) ◽  
pp. 107-117 ◽  
Author(s):  
Patricia A. Walters
Keyword(s):  
Potassium Nitrate ◽  
Diagnostic Techniques ◽  
Hydrodynamic Theory ◽  
First Line ◽  
Dentinal Tubules ◽  
Non Invasive ◽  
Sharp Pain ◽  
Sensitive Teeth ◽  
Dental Professional ◽  
Dentinal Hypersensitivity

Abstract Dentinal hypersensitivity is generally reported by the patient after experiencing a sharp pain caused by one of several different stimuli. The pain response varies substantially from one person to another. The condition generally involves the facial surfaces of teeth near the cervical aspect and is very common in premolars and canines. The most widely accepted theory of how the pain occurs is Brannstrom's hydrodynamic theory, fluid movement within the dentinal tubules. The dental professional, using a variety of diagnostic techniques, will discern the condition from other conditions that may cause sensitive teeth. Treatment of the condition can be invasive or non-invasive in nature. The most inexpensive and efficacious first line of treatment for most patients is a dentifrice containing a desensitizing active ingredient such as potassium nitrate and/or stannous fluoride. This review will address the prevalence, diagnosis, and treatment of dentinal hypersensitivity. In addition the home care recommendations will focus on desensitizing dentifrices. Citation Walters PA. Dentinal Hypersensitivity: A Review. J Contemp Dent Pract 2005 May;(6)2:107-117.

Application of Fluorine Containing Bioactive Glass Nanoparticles in Dentin Hypersensitivity Treatment

2016 ◽  
Vol 696 ◽  
pp. 103-107 ◽  
Author(s):  
Carolina Emmanuelle Camargos Lins ◽  
Sandhra Maria de Carvalho ◽  
Agda Aline Rocha de Oliveira ◽  
Marivalda de Magalhães Pereira
Keyword(s):  
Heat Treatment ◽  
Bioactive Glass ◽  
Glass Structure ◽  
Spherical Shape ◽  
Dentin Hypersensitivity ◽  
Dentinal Tubules ◽  
Mineralized Tissues ◽  
The Matrix ◽  
New System

The effect of Bioactive Glass on remineralization of dentin is the focus of the present study due to its excellent regenerative properties in mineralized tissues. It is known that the effect of Bioactive Glass can be enhanced at the nanoscale. In addition, the incorporation of Fluorine in the glass structure makes possible the formation of Fluorapatite (FAP). The aim of this study was to synthesize and characterize a new system of Fluorine containing Bioactive Glass Nanoparticles (FBGNP), and evaluate the potential for in vitro dentin remineralization by occlusion of dentinal tubules. The FBGNPs produced were uniform, with spherical shape and nanoscale size. Agglomeration or partial sinterization of the particulate system probably occurred after heat treatment. The results suggest the formation of FAP crystals embedded within the matrix of the Bioactive Glass. The gel containing FBGNP produced was effective in obliterating the dentinal tubules in vitro, showing that FBGNP is a potential material to be used for treatment of dentin hypersensitivity.

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