Dentinal Hypersensitivity (DH) or Dental Sensitivity is defined as intense and transitory pain that is caused by the exposure of the dentin, the internal part of teeth, to the oral environment and which occurs when contact is made with an external stimulus: food or drink that is cold, hot, acidic, sweet; tactile pressure, etc.
It is the most frequent cause of dental pain, and shows a high prevalence, affecting approximately 1 out of 7 adults and can trigger the onset of oral diseases including caries, gingivitis or periodontitis, if it is not properly treated.
It normally occurs between the ages of 18 and 40, and over recent years it has been observed to increase among young patients because of an excess consumption of acidogenic beverages and the indiscriminate and unsupervised use of tooth whitening products.
Tooth sensitivity is produced with the dentin - which is protected by gums, root cementum and tooth enamel - loses its natural protection and is exposed.
The dentin contains thousands of microscopic tubes, called dentinal tubules, which connect the external part of the tooth to the nerve endings. When a tooth loses its protection from gum recession and/or tooth enamel wear, these tubules are exposed to the outside, allowing external stimuli to reach the nerve endings and cause pain.
A variety of situations cause dentinal tubules to become exposed, potentially triggering Tooth Sensitivity. These tend to be related to patients’ lifestyle and daily oral hygiene habits:
- Inadequate brushing strength and/or frequency and very abrasive toothpaste may cause abrasion to the enamel and/or cementum, exposing the dentin.
- Acidic food and drinks (citric juices, carbonated soft drinks, etc.) cause tooth decalcification or erosion, particularly at the neck level.
- Excessive chewing force (occlusal trauma, bruxism) or poor habits can cause wear (attrition and/or abfraction) and dentinal exposure.
- Periodontal treatment, especially surgery, can remove some of the gum, leading to gingival recession.
- General maladies or certain situations that cause an acidic oral environment, such as stomach disorders (ulcers, hiatal hernias, etc.), psychological disorders (bulimia, anorexia nerviosa) or job-related (wine tasters, bakers, etc).
- It can also occur as a consequence of gingival recession caused by dental treatments, including professional cleaning, basic periodontal treatment or orthodontics. Although it can also be caused by a mere anatomical abnormality causing dentin to become exposed.
Pain from dental sensitivity is easily identifiable, since it always occurs with various, but clearly recognisable, stimuli: very cold or very hot foods or beverages, sweet or acidic foods, toothbrushing, breathing cold air, etc. The pain that occurs is intense, of short duration and localised in just one tooth or number of teeth; it is only felt while the causal stimulus is working.
If the pain that is produced cannot be related to a certain stimulus and/or it persists after this is gone or it is not well localised, the cause is probably not dental sensitivity, but rather potentially some underlying condition, such as dental caries, for example.
Therefore, it is important to visit your dentist for a thorough examination and an accurate diagnosis.
Adequate treatment of dental sensitivity requires establishing preventive measures and applying the proper treatment measures (in office and/or at home treatment).
The preventive measures that are recommended are the following:
- Follow certain dietary habits: avoid acidic food and drink.
- Correct poor habits: avoid the use of wooden picks, bruxism, etc.
- Follow proper oral hygiene instructions: adequate brushing technique and use of non-abrasive toothpaste.
On top of these measures, it is also important to use desensitising agents to treat dental sensitivity.
The great majority of products for at-home treatment of dental sensitivity contain potassium salts, which are desensitising agents that penetrate the pulp through exposed dentinal tubules and work by inhibiting the nerve transmission that causes pain. They sometimes also contain fluorides, which can partially block dentinal tubules.
The use of hydroxyapatite nanoparticles contained in an innovative technology: DENTAID nanorepair® technology, is a Revolution in the treatment of dental sensitivity, because it seals dentinal tubules completely. The size and concentration of the hydroxyapatite nanoparticles are adequate, allowing them to deposit on the enamel surface, sealing dentinal tubules that have been exposed and preventing the transmission of external stimuli that cause pain. They also form a wash-resistant layer, from the first application.
If tooth sensitivity is treated daily with the right products, the pain it causes can be avoided, restoring normalcy to teeth and gums.
- Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J. Can. Dent. Assoc., 69(4):221-6, 2003.
- Närhi MVO. Dentin sensitivity: a review. J Biol Buccale 1985; 13: 75-80.
- Addy M. Causas y efectos clínicos de la hipersensibilidad dentinaria. Dent Clin N Am 1990; 34 (3): 465-476.
- Brämmström M. The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and dentinal cracks syndrome. J Endod 1986; 12 (10): 453-457.
- Gil Loscos, F. J., Iborra, Martí y Alpiste. Estudio in vitro para evaluar la capacidad de sellado tubular de un nuevo producto con nanopartículas de hidroxiapatita para el tratamiento de la Sensibilidad Dental. Universidad de Valencia 2011. Póster presentado en el congreso de la Sociedad Española de Periodoncia 2012.
THE SOLUTION DENTAID
- Eficacia de un colutorio de nitrato potasico y fluoruro sodico