What are the 6 types of sensitivity?
1. Tactile
2. Thermal
3. Evaporative
4. Osmotic
5. Chemical
6. Hydrodynamic Theory
What is tactile sensitivity?
Contact from a toothbrush, eating utensil or dental instrument.
What is thermal sensitivity?
Dehydration of oral fluids (high volume evacuation or applying air to the teeth)
What is osmotic sensitivity?
Altercation of osmotic pressure in dental tubules due to isotonic solutions (equal amount) of sugar and salt
What is chemical sensitivity?
Acids in foods such as citric foods, spices, carbonation, gastric regurgitation and condiments etc.
What is hydrodynamic theory sensitivity?
When the fluids within the dentinal tubules absent of a smear layer are subjected to thermal, chemical, tactile or evaporative stimuli, the movement stimulates a nerve receptor sensitive to pressure, which leads to the transmission of the stimuli and ulti
What are the characteristics of sensitive teeth?
-Sharp, short, transient
-Chronic with acute episodes
-Cessation from pain upon stimulus removal
-Pain response to non-noxious stimulus
What are the 3 reasons why teeth are sensitive when Dentin is exposed?
1. Stimuli transmitted through fluid-filled dentinal tubules
2. Normally dentin is covered with cementum and/or gingiva, and NOT exposed to oral stimuli
3. Nerves intertwined with odontoblasts in tubules
What are the effects of oral health care habits that can cause sensitivity?
Hard TB, aggressive brushing, anatomy, surgery, hygiene procedures, ortho, restorative procedures, aging, tooth whitening procedures
Loss of ____ and ____ of the tooth can also contribute to sensitivity.
Enamel and Cementum
What are some other factors that contribute to sensitivity?
Thin cementum, enamel & cementum do NOT meet, attrition, erosion, abfraction, instrumentation, root caries, frequent/improper stain removal technique etc.
Wedge or "V" shaped cervical lesions created by the stresses of lateral tooth movements during occlusal function bruxing resulting in enamel micro fractures.
Abfraction
The mechanical wearing away of tooth substance by forces other than mastication.
Abrasion
The loss of tooth substance by a chemical process that does NOT involve a known bacterial action.
Chemical Erosion
What are the 2 chemical erosions that may occur?
Vomiting
Extrinsic Stains
What occurs by mineral deposition within tubules as a result of stimuli such as attrition and dental caries. This results in smaller dentin tubules.
Dentin can become sclerotic
What is created by odontoblasts, this is deposited gradually on the floor and root of the pulp chamber after the teeth are fully developed. This "walling off" effect between the tubules and the pulp; insulates the pulp from fluid disturbances such as cari
Secondary Dentin Formation
What is formed along the pulpal wall or root canal as a protective mechanism in response to trauma or irritation such as caries or traumatic cavity prep.
Tertiary/Reparative Dentin Formation
Consists of microcrystalline particles of cementum, dentin, tissue and cellular debris, which serve to plug tubule orifices. Debris from instrumentation applied to teeth.
Smear Layer
At what % of adult population experiences sensitivity ?
8-30%
Is that percent larger in perio patients?
Yes it is!
At what age is sensitivity usually the greatest?
20-40 years of age
Do men or women report more sensitivity?
Women report more.
What teeth does sensitivity most often occur on?
Recession, premolars and canines.