Page 70 - Journal of Laser Dentistry 1

One cause of sensitive teeth can be traced to nocturnal gastroesophageal reflux disease (acid reflux). Stomach acid can reach the teeth and cause enamel loss and prevent re-mineralization

Prevalence

A study conducted at Queen's University, Belfast, determined that the prevalence of reported sensitivity was 57.2%. In most cases the incidence occurred in the 30-39 year age group. Although the majority of individuals reported that cold was the major stimulus for pain, other causes such as toothbrushing, hot, and sweet stimuli were reported as well. This study found the prevalence of dentine sensitivity to be much higher than in previous reports. These results suggest an increase in the levels of sensitivity within the general population.

Prevention

Before the proper treatment for a patient is defined, it is important to first prevent, modify, eliminate or control etiologic factors such as plaque, improper toothbrushing, and a diet high in fermentable carbohydrates and/or acidic foods.

Some examples of acidic foods are fruits, fruit juices and wine whose acids can remove smear layers and open dentinal tubules. Toothbrushing with abrasive toothpaste may abrade the dentin surface which may open up dentinal tubules if combined with erosive agents. One recommendation for patients is to avoid toothbrushing for at least two to three hours after consuming the above mentioned acidific foods or drinks.

Treatments

There are different options to treat dentine hypersensitivity that can be divided in at-home treatments, those the patient can apply,

and in-office treatments, those applied by the dentist.

At-home treatments

At-home treatments include: desensitizing toothpastes or dentifrices, potassium salts, mouthwashes and chewing gums. Nowadays, most desensitizing toothpastes contain either potassium nitrate, potassium chloride or potassium citrate. It is believed that potassium ions diffuse along dentinal tubules and therefore decrease the excitability of intradental nerves by altering their membrane potential. However there is not sufficient literature to support the efficacy of potassium nitrate.

In-office treatments

In-office treatments might be much more complex and they may include the application of dental sealants, having fillings put over the exposed root that is causing the sensitivity, or a recommendation to wear a specially made night guard or retainer if the problems are a result of teeth grinding.

Other possible treatments include fluorides are also used because they decrease permeability of dentin in vitro. Also, potassium nitrate can be applied topically in an aqueous solution or an adhesive gel. Oxalate products are also used because they reduce dentin permeability and occlude tubules more consistently. However, while some studies have showed that oxalates reduced sensitivity, others reported that their effects did not differ significantly from those of a placebo. Nowadays, dentine hypersensitivity treatments use adhesives, which include varnishes, bonding agents and restorative materials because these materials offer improved desensitization.