hygiene - the international C.E. magazine of dental hygiene

I 27hygiene 1_2012 trends_ patient education I is an important factor with regard to dentinal hy- persensitivity. A thorough questionnaire or dietary analysis will flush out the potential for sensitivity caused by acid erosion and the overconsumption of acid-containing beverages. Aciderosioncanalsobecausedbymedicalcondi- tions such as gastroesophogeal reflux disease, also knownasGERD.However,thisconditionwouldcause erosion on the lingual surfaces of the teeth due to thelowpHofgastricjuicesregurgitatedintotheoral cavity and not the erosion that would be consistent with soda, which is equally distributed throughout the oral cavity. A bulimic patient would also show erosion on the lingual surfaces of the teeth for the same reason as seen with GERD. Another assessment strategy is the visual clinical exam. The patient should be evaluated for all types of sensitivity, including localized, generalized, peri- odontal, tooth decay, fractures, abscesses, coronal and dentinal sensitivity. By providing a typical clini- calassessment,thedentalclinicianshouldbeableto identify which type of sensitivity the patient might be suffering from. What strategies can be implemented to reduce aciderosionandhelptoneutralizesodaacid? There are many strategies to help neutralize the acidinthepatient’smouthduetoacidfromthesoda they drink. Once we have educated the patient on the acid content of soda and the destruction it can cause the enamel and dentin of all tooth surfaces, at-home strategies followed by chairside strategies canbeimplemented.Thisisthecontinuumofcarefor tooth sensitivity. What is the first line of treatment in the con- tinuumofcarefortoothsensitivity? First,instructthepatienttoconsumeacidicdrinks quickly and not to hold them in the mouth for an extended period of time. Using a drinking straw will keeptheacidawayfromthetoothsurfaceandlowers the time the acid beverage is on the tooth. Instruct the patient to avoid brushing immedi- atelyafterconsumingacidicdrinks,allowingasmear layer to accumulate on the tooth. Although it is logi- cal to encourage tooth brushing immediately after consumption of sugared acidic beverages, research suggests that brushing enamel immediately after exposure to acidic beverages increases tooth loss.10 Next, recommend brushing twice a day with a desensitizingtoothpastesuchasSensodyne®aspart oftheat-homemanagementoftoothsensitivity.The activeingredient,potassiumnitrate,desensitizesthe nerveendingsresponsibleforthesensitivity.Thiscre- atesabarrieraroundthetoothprotectingthepatient from generalized sensitivity. Sensodyne purchased overthecounter(OTC)couldbeasuggestedfirstline of care delivered at home twice a day. What is the second line of treatment in the con- tinuumofcarefortoothsensitivity? When the first line of treatment is not enough to relieve dentinal hypersensitivity, a dental office Encourage patients to brush twice a day with a desensitizing toothpaste such as Sensodyne — but not immediately after drinking soda. (Photo/Provided by www.dreamstime.com)