Dentine hypersensitivity.


Dentine hypersensitivity is sensation felt when the nerves inside the dentin of the teeth are exposed to the environment. Dentin is the tissue that makes up the core of each of the teeth. It has a bunch of little tunnels in it which lead right down to a nerve center within. The enamel serves as a protective barrier for the dentin and its nerves. The nerves of the dentin are exposed when the nerves wears away. When taking hot, cold or acidic foods break through the enamel, they make their way down to the tunnels in the dentin into the nerve endings resulting in sharp pain.

Although exposed dentin has no cure, patients find relief by using toothpaste formulated for sensitive teeth. These products contain a desensitizing agent known as potassium nitrate which is found in products such as sensodyne or crest sensitive as a remedy and is approved as a monographed drug. An ideal desensitizing agent should not irritate or endanger the integrity of the pulp, it should be relatively painless on application or afterwards. It should be easy to apply it, should work rapidly, should have a permanent effect and finally it should not discolor the tooth structure. Others include; amorphous calcium and phosphate, strontium chloride, fluoride therapy or calcium sodium phosphosilicate. With continual use of such products, it travels down the tunnels formed in the dentin forming a protective barrier around the nerve endings. Once this barrier is established, the nerve endings are significantly less responsive to any triggers.

The enamel might be damaged due to brushing to hard, gum disease, chipped or cracked teeth and grinding teeth. Long time consumption of citrus or carbonated drinks and also bulimia can cause damage to the enamel.

This condition may be treated by the application of dental sealants, having fillings put over the exposed root that causes sensitivity. Another possible treatment includes the use of fluorides. Nowadays, dentine hypersensitivity treatments use adhesives, which include varnishes, bonding agents and restorative materials because they offer improved desensitization.

The ultimate goal in treatment of dentine hypersensitivity is the immediate and permanent relief from pain. Once a definitive diagnosis has been made, a careful assessment of aetiological factors must be considered which in turn if identified and correctly managed may enhance the outcome of the currently used desensitizing agents and ensure the most successful management.

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