Transient pain arising from exposed dentin typically in response to a variety of stimuli that cannot be explained as arising from any other form of dental defect or pathology and that subsides quickly when stimulus is removed
What is dentin hypersensitivity?
Mechanical stimuli
This type of sensitivity arises from contact with a toothbrush, eating utensils, or dental instruments
Thermal stimuli
This type of sensitivity arises from temperature changes (ie hot or cold foods that touch the tooth)
Evaporative stimuli
This type of sensitivity arises from dehydration of oral fluids (example: applying air to the tooth)
Chemical stimuli
This type of sensitivity arises from acids in foods or drinks (certain fruits, carbonated beverages etc..)
Use of a medium or hard toothbrush, aggressiveness, ortho movement, short frenum
These factors contribute to gingival recession and subsequent root exposure?
recession, abrasion/attrition, erosion, abfraction, crown preps, instrumentation, root surface caries
Loss of enamel and cementum are mechanisms for dentin exposure, what are some ways this can manifest?
Hydrodynamic theory
This is a currently accepted theory that fluid movement creates a pressure on nerve endings within the dentinal tubule.
Neural activity
This is pain registered by the depolarization/neural discharge mechanism that characterizes all nerve activity
Sclerosis of dentin(deposits of minerals,) secondary dentin (deposited over time after teeth develop, Smear layer(like a natural bandage,) Calculus formation (provides a coating
What causes natural desensitization?
smear layer
This acts as a natural bandage
calculus
This provides a soothing coating to the tooth to make it less sensitive
pain
Approximately 1/3 of patient report having this?
pain perception
The process by which stimuli effects fluid flow within the tubules and activates the receptors of nerve endings.
can be either acute or chronic
What is the impact of pain?
Differential
This type of diagnosis would describe the pain of dentin hypersensitivity as sensitive to hot or cold, throbbing pain, or the pain goes away when the stimulus is removed
by interview: ask open ended questions, establish where and when pain occurs
What is the best way to collect data when accessing dentin hypersensitivity?
visual palpation, occlusal exams, x-rays mobility test, pain from biting, transillumination & pulp tests
Diagnostic techniques and tests for dentin hypersensitivity include ___?
ASSESS (eval hyg measures, frequency of irritating food/drinks, parafunctional habits, stress levels) EDUCATE, TX HIERACRCHY (1st pain relief) REASSESS: (evaluate in a couple of weeks)
What is the process for managing patients with sensitive teeth?
Put to use mechanisms of desensitization, behavioral changes, self applied measures, dental professional measures, additional considerations
What are some ways that we as hygienists can intervene in the care of tx of dentin hypersensitivity for our patients?
Iontophoresis
This is a means applying medications with the assistance of a small electric current to impregnate with ions of soluble salts: used in dentistry to transfer flouride ions into the tooth
Neural depolarization mechanism
Reduction of the rest potential or nerve membrane so that a nerve impulse is fired.
Patent
Open, unobstructed
Intratubular or peritubular dentin
This is increased deposition of minerals into tubules that become more mineralized with increasing age, resulting in thicker, sclerotic dentin
Intratubular dentin
Dentin that is located between the dentin tubules is known as ___?
grinding debris" from instrumentation or other devices that are applied to the tooth: consists of microcrystalline particles of cementum, dentin tissue and cellular debris: it serves to plug tubule orifices
What is another name for the smear layer?
smear layer
This serves to plug tububle orifices