cosmetic dentistry - beauty & science

22 I I research _ hypersensitivity cosmeticdentistry 2_2012 _All dental practices have patients with dentine hypersensitivity. Many patients avoid dental treat- ment because of their hypersensitivity. Surprisingly, most practices do not have a systematic approach for diagnosing and treating this condition. This is simply becauseitseemstoocomplicated.Thereisamultitude of products. What works? Why does it work? Many practitioners have had poor success in the past with sensitivity treatments and are reluctant to try again. Today’s products are effective and easy to use. The following discussion will attempt to bring simplicity and clarity to the subject of diagnosis and treatment ofdentinehypersensitivity. _Definition Dentinehypersensitivityisdefinedasashortsharp painarisingfromexposeddentineinresponseto: _thermalchange, _evaporationofair, _tactilestimulus, _osmoticpressureor _chemicalstimulus andcannotbeascribedtoanydefectorpathology.1 The three essential components of dentine hyper- sensitivityare(Fig.1)2 : 1.exposeddentinesurfaces; 2.open tubule orifices on the exposed dentine sur- faces; 3.patenttubulesleadingtovitalpulp. Dentine hypersensitivity has been reported to af- fectupto57%ofthegeneralpopulation.3–10 Itoccurs most frequently in patients of 30 to 40 years of age.11 All teeth are susceptible but canines and premolars arethemostaffected.12,13 A 2002 international survey of 11,000 adults re- vealed that only half of the affected individuals had talked to their dentist about their sensitivity and only half of this group actually received treatment recom- mendations.14 Many patients do not wish to burden the dentist with this problem, or they may feel that it maynotbetakenseriously. _Mechanism of action The most widely accepted theory for the mech- anism that causes dentine hypersensitivity is the hydrodynamic theory first proposed by Brännström in 1963.15 When dentinal tubules in vital teeth are exposed and open, the fluid in the tubules flows in an inward or outward direction, depending on pres- Fig. 1 Dentinehypersensitivity: Simplified Author_Dr Fay Goldstep, Canada Fig. 1_The essential components of dentine hypersensitivity are exposed dentine surfaces with open patent tubules leading to a vital pulp. (Image courtesy of GSK)