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What to avoid, what treatments can be performed to deal with tooth sensitivity?
A very common problem concerning teeth, or actually dentin, is pain sensation under the influence of multiple stimuli. Under normal, physiological conditions, the dentin tissue in the area of the tooth crown is covered with enamel and in the root part with cement. As a result, it is resistant to external factors. Only the exposure of dentin reveals its sensory function, which is a natural defense reaction to its irritation. Exposed dentin reacts with pain which is transmitted through the dentinal tubules to the pulp of the tooth. Open mouths of dentinal tubules, pressure changes, rapid flow of fluids, irritation of protoplasmic protoplasmic dentin-forming cells’ extensions are some of the theories of pain transmission through dentin.
The sensitivity and pain of dentin, appearing during the action of irritating stimuli, is short-lived, but strong, sharp and very troublesome. It disappears when the stimulus that causes it is removed.
Most often it is sensitivity to:
– thermal stimuli – too cold, too hot food or liquids.
– mechanical stimuli – touch, while cleaning with a toothbrush, drawing air.
– chemical stimuli – eating sour and sweet foods and liquids, using spicy spices.
To prevent hypersensitivity, you should: reduce the frequency and amount of drinking fruit juices, avoid very cold or hot drinks, do not use too hard brushes, avoid toothpastes with strong abrasives and whitening toothpastes.
Using the correct technique for brushing your teeth: circular and sweeping movements, vertical and pulling the gums up, can help prevent recurrent sensitivity.
Dental procedures performed in the office are also the cause of pain. A patient with dentin sensitivity suffers as a result of contact of the drill with dentin tissue or by drying it with a tampon or a stream of air.
That is why we are constantly striving to achieve painless treatment of teeth in the dental office, using a variety of anesthesia. The physician most often uses topical agents: fluoride gels, varnishes, pastes and solutions by rubbing or applying calcium-magnesium preparations, resins and agents to impregnate the dentin and block the dentinal tubules on the bare and hypersensitive surface.
The places particularly exposed to pain from the exposed dentin are: abrasions in the cervical sections, gingival recession places, leakage of fillings, places of cracks and fractures of the tooth crown, without the exposure of the pulp, excessively worn enamel surfaces of the teeth, shallow cavities in the front teeth, erosions and wedge cavities , places where clasps of dentures and orthodontic appliances adhere, exposed surfaces of tooth roots.
Treatment of hypersensitivity is carried out in parallel; doctor at the dentist’s office and the patient at home. Home treatment is limited to pastes and gels that minimize pain effects. You may find it helpful to combine toothpastes with mouthwashes suitable for sensitive teeth. This allows you to achieve maximum results on the part of dentin in pain therapy.
The dentine hypersensitivity to mechanical, thermal and chemical stimuli is definitely greater in adults and the elderly than in children. In young patients, the places of exposure and dentine symptoms include: abrasion of the deciduous teeth, the cervical area of the teeth, shallow cavities of the anterior teeth, deep cavities in the vicinity of the dental pulp. The enamel-dentin border is also more weaker. The action of painkillers and sedatives can reduce some of the pain. However, it is inevitable to visit the dentist’s office, where the doctor will administer topical medications to the child, using Xylocainum spray or Lidocainum gel if necessary.
Home treatment of hypersensitivity mainly applies to children over 6 years of age. Then you can use special gels for brushing or topical application once a week. The ideal solution is to use toothpaste that is adapted to hypersensitive teeth, which effectively removes dentin hypersensitivity, in combination with a mouthwash applied once a day. In the case of acute dentine hypersensitivity, it is recommended to use the rinse twice a day.
Text: lek. Agnieszka Kłusek, a dentist, med – Kękuś AKKDent Kraków