Hyper sensitivity

Hypersensitivity is a common intermittent chronic sensation affecting, people when they eat, drink, touch their teeth, or when there is a cotd blast of air.The may cause psychological tension that can further reduce the tolerance threshhold.

Causes
Sensitivity is not encountered in teeth where the enamel and cementum are intact. When the underlying dentin is exposed by enamel loss or denudation of root surface, it can lead to dentin hyper sensitivity.

  1. Enamel loss (occlusal wear) - Dietary erosion
  2. Toothbrush abrasion:
    • Aging
    • Gingival recession
    • Incorrect tooth brushing habits
    • Tooth abnormally positioned in the arch.
    • Chronic periodontal disease
    • Periodontal surgery Root preparation.
    • Acidic Food-like citrus fruits,colas,soda
    • Hyperacidic saliva
  3. Treatment depends on:
    • Age
    • Oral hygiene
    • Diet (Frequency of ingestion of acidic foods and beverages(COLAS)
  4. Chemical
    • Antiinflaammatory e.g. silver nitrate, zinc chloride
    • Tubule occluding e.g: strontium chloride
    • Tubule sealants e.g. - Calcium hydroxide, potassium nitrate, fluorides, fluoride iontophoresis and potassium oxalate.

  5. Physical agents
    • Composite resins
    • Glass
    • Ionomers
    • Varnishes
    • Sealants
    • Soft tissue grafts
    • Laser sealing of the tubules
  6. Other approaches
    Once the cause of hypersensitivity is ascertained; explain the problem and its causes to the patient. Correct any preventable causes like, accumulation of plaque excessive tooth brushing with a hard tooth brush, and periodontal disease. if the patient has a high frequency of ingestion of acidic foods and beverages(COLAS), nutritional counselling should be part of the treatment. A tooth paste containing potassium nitrate should be advised for a 2 to 6 weeks trial. Most patients respond well to this initial treatment, which can be assessed in about four weeks. If the teeth remain sensitive after the initial treatment, use clinical treatment with potassium oxalate solution, sodium fluoride or calcium hydroxide.Avoid acid containing food and drinks.