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Dentin hypersensitivity is a problem that affects approximately 15% of the population. Pain, sometimes of considerable intensity, occurs as a result of thermal stimuli, e.g. cold or hot food, mechanical stimuli when brushing teeth, or chemical stimuli, e.g. sweet or sour food.
What is dentin hypersensitivity?
Dentin hypersensitivity is short-term and self-limiting pain caused by stimuli such as cold, heat or mechanical irritation with a brush. Hypersensitivity occurs when dentinal tubules are exposed as a result of factors in the mouth and the loss of root cement (e.g. due to erosions or other factors). Dentin hypersensitivity is a condition that can affect a single tooth or an entire group of teeth. Pain usually occurs in the cervical area of the teeth, on excessively worn tooth surfaces, in places where there are clasps or prosthetic attachments, and in places where food remains. Periodontal diseases with recession of the gingival margin or periodontal surgery are favorable factors. The formation of dentin hypersensitivity can be explained by the hydrodynamic theory, which states that the degree of pain perception is largely influenced by the number and condition of the tubules (dentin hypersensitivity does not occur when it is covered with enamel or cement).
Some role in dentin hypersensitivity is also assigned salivathat naturally soothes hypersensitivity or completely eliminates it. There is a large amount of phosphates and calcium in saliva, which, by closing the open zebin tubules, thus block a number of situations responsible for registering pain stimuli. Therefore, people whose saliva is secreted in smaller amounts are at greater risk of caries, dentin hypersensitivity and tooth decalcification.
What is dentine?
Dentin is a much less dense tissue under the enamel and cement layer. In the dentin, there are dental tubules through which fluids (cold, warm, acidic, sweet) stimulate nerve cells in the pulp, which is perceived as dentine hypersensitivity. This kind of stimulation does not cause permanent damage to the pulp tissue.
Causes of dentin hypersensitivity
The most common mechanisms causing dentin hypersensitivity are:
1.mechanical damage – they may appear as a result of improper brushing of teeth (e.g. brushing too hard) or by using toothbrushes that are too hard. Such situations lead to abrasion of the enamel and exposure of the dentin. In people whose dentin hypersensitivity was caused by a poorly selected toothbrush, it is recommended to use those with medium hardness bristles and soak in water before use;
2. improper nutrition – consuming a lot of carbonated drinks, citrus juices and sweetened drinks significantly lowers the pH in the oral cavity; sugar and corn syrup is rich in a large amount of fructose used to sweeten beverages. It is a substrate for bacteria that like acid and stimulate the demineralisation process of hard tooth tissues. For such people it is recommended to dilute citrus juices with water. Note: Do not brush your teeth immediately after eating acidic foods!
3. stress – many people in stressful situations grind their teeth unconsciously or bite their pen. Such action causes the surface layer of the tooth to undergo the destruction process;
4. exposure of the root dentine – occurs in periodontal diseases and can also cause hypersensitivity.
If you suffer from dentin hypersensitivity, you can try Sylveco’s natural fluoride-free toothpaste that does not irritate the gums. We also recommend Perlax gel toothpaste for sensitive teeth, available at a promotional price on Medonet Market.
Treatment of dentin hypersensitivity
Treatment of dentin hypersensitivity is two-way:
- acting on receptors, which reduces the conductivity of impulses and stabilizes the membranes of nerve cells (potassium ions are used, which change the excitability of the pulp endings of nerve fibers);
- closing and blocking the flow of fluid in the dentinal tubules that conducts pain-causing impulses (e.g. precipitation of insoluble silver, calcium or strontium salts) and mechanical closure of the tubules’ mouths with glass ionomers.
Home treatment
The patient is responsible for the treatment of dentin hypersensitivity, who implements appropriate procedures after receiving appropriate instructions from the doctor. In the first place, patients are recommended to change their diet (eliminate acidic foods, fruit and sweetened juices); changing a hard toothbrush to a soft one and improving improper eating habits. In addition, the use of special gels, pastes and rinses that eliminate hypersensitivity brings good action. Gels and rinses with fluoride (mainly amine fluorides) and potassium nitrate should be rubbed 2-3 times a day for a month or used once a week. Mouthwashes that complement the effect of the toothpaste should be used daily.
Types of toothpastes that close the mouths of the tubules:
- containing hydroxyapatite (inhibition of fluid flow in the tubules);
- containing fluorine (precipitation of calcium fluoride);
- containing potassium chloride (keeping nerve endings depolarized by direct interaction with them).
Treatment at the dentist’s office
A visit to the dentist’s office is necessary when home remedies do not bring any results. The doctor recommends patients to use preparations containing a high concentration of fluoride (in the form of a rubbing liquid) or varnish and ionopheresis. Teeth varnishing every few days significantly reduces dentine hypersensitivity. Ionopheresis is used much less frequently. Its properties lead to the precipitation of calcium fluoride and stimulation of tertiary dentin growth and conduction of nerve impulses.
For patients in whom dentine hypersensitivity has led to a large loss of tooth hard substance, reconstruction with composite or glass ionomer materials is considered. Before it is used laser (fibril depolarization or melting of the superficial dentine layer), the possible risk of complications should be considered and the lack of information on long-term effects of this method should be taken into account. In extreme cases, when all methods (at home and in the dentist’s office) have failed – the root canal treatment of the tooth which causes hypersensitivity is finally performed.
Read also: How to care for sensitive teeth?