hygiene the international C.E. magazine of dental hygiene

I 19hygiene 1_2013 C.E. article_ hypersensitivity I necessaryforongoingprotection,sotofavorpatient compliance, sensitivity dentifrices are available in a variety of formulations to meet the patients’ needs and desires, such as tartar control, whitening and sodium lauryl sulphate-free formulations. If the patient’s dentin hypersensitivity persists after four weeks usage of the OTC desensitizing toothpaste, a further dental examination should be carried out, and a professional treatment should be considered as the second line of treatment. Recentlydevelopedcalciumphosphatetechnolo- gies have also demonstrated effectiveness in tubule occlusion,includingACP,CPP-ACP,andNovaMin®,a calciumsodiumphosphosilicate.Theeffectivenessof NovaMin in occluding dentinal tubules is attributed to its unique mechanisms of action. Not only do the NovaMin particles immediately bind to exposed dentin and fill open tubules, the subsequent release and surface reaction of calcium and phosphate ions forms a protective hydroxyl carbonate apatite-like layer that provides tubule occlusion, which is resis- tant to the challenges of acidic environments.10,11 Treatment for dentin hypersensitivity should also be included in routine preventive and periodontal therapies. The instrumentation used during adult prophylaxis, perio maintenance and periodontal debridement (SRP) procedures can cause pain at pre-existing hypersensitive sites and may result in new sites of transient hypersensitivity. To manage hypersensitivity stimulated during andfollowingperiodontalinstrumentation,thecon- tinuous care treatment strategy can include usage of NUPRO® Sensodyne® prophylaxis paste with NovaMin. As detailed previously, the incorpo- ration of NovaMin particles into the prophy paste provides immediate tubule occlusion and formation of an acid-resistant hydroxyl carbonate apatite-like layer.14 NUPRO Sensodyne prophy paste with NovaMin, available in polishing and stain-removal grits, can be used for the immediate relief of tooth sensitivity andforlastingsensitivityreliefforupto28daysafter just one application.12,13 A thin, white residue might remain visible after rinsing. This is inherent in the product formulation and is considered normal. For localized hypersensitive sites that do not respond to the first or second lines of treatment, in-office treatments that are more complex and/ or more potent may be indicated. Such treatments involve use of adhesives, including varnishes, bond- ingagentsandrestorativematerials:iontophoreseis, lasersorgingivalgrafting.Oneoption,NUPROWhite Varnish (Fig. 1), is a uniquely formulated varnish for hypersensitivity relief; another option is Seal & Protect™, a protective light-cured sealant indicated for use in the treatment of hypersensitive cervical areas (Fig. 2).15 Effective prevention and management of dentin hypersensitivity requires a continuous care ap- proach.Thecontinuumofcarestartswithascreening assessmentforhypersensitivity,followedbyidentifi- cation and modification of causative factors to help prevent hypersensitivity. Acombinationofat-homeandin-officetherapies Fig. 2a, b_Seal & Protect, shown with silo and applicator stick, is a protective light-cured sealant indicated for use in the treatment of hypersensitive cervical areas. Fig. 2a Fig. 2b