Dental Hypersensitivity

Dental hypersensitivity is an oral condition characterized by a sharp pain in the affected tooth or teeth. It occurs when the dentin is exposed to any stimuli. It is reported more in females than males. It majorly impacted canines, premolars of both arches. Its prevalence peaks among the age group of 20 to 40 years.

Causes of Dental Hypersensitivity:

Dentin exposure progresses in phases, initially starting as a local lesion with the erosion of enamel, and then further progressing to exposure of dentin tubules. Major factors leading to this are:

  1. Gingival recession: Gingival recession is the exposure of dentin in the roots of the teeth from loss of gum tissue over the root of the teeth. It usually occurs in people with poor oral hygiene and happens due to improper tooth brushing or excessive brushing.
  2. Tooth wear and tear:
  •       Tooth abrasion – Tooth loses its enamel if exposed to vigorous brushing, or consumption of low pH oral fluids.
  •       Tooth attrition – Tooth to tooth contact during excessive teeth grinding or jaw clenching causes damage to the tooth enamel.
  •       Tooth erosion – Repeated exposure of teeth to anaerobic chemical processes or acids whether by consumption of acidic foods or by regurgitation
  1. Age: With increasing age, primary dentin starts wearing off but secondary dentin is deposited and restored throughout life.

Risk factors of dental hypersensitivity:

  • People who have heavy acidic diets or drinks or have frequent munching habits are at high risk.
  • Consuming large amounts of beverages in the form of carbonated drinks, canned juices, beer, flavored waters, machine prepared tea or coffee, energy drinks, sour candies, are at high risk.
  •  People with a history of gastroesophageal reflux disease, gastritis, pregnant women, and people on chemotherapy are at high risk.
  •  Dry mouth disorder, that is people with inadequate saliva formation are at high risk

Diagnosis of Dental Hypersensitivity:

Diagnosis depends on a thorough clinical examination.

  • Response to pain upon tapping the teeth to rule out inflammation of the dental pulp
  •  Response to pain on biting a hard surface, like a wooden stick to rule out a fracture
  •  Dental X-ray  diagnoses fractures of the tooth
  •   The affected area is exposed to a jet of air to examine if there is any pain.

Treatment for Dental Hypersensitivity:

If it is in the initial stages, the doctor would recommend some self-care measures like:

  •  Many over the counter toothpaste available in the market are the most cost-effective way of dealing with dental hypersensitivity.
  •   Brushing is an important part of oral hygiene, great attention needs to be given to the correct way of brushing the teeth.
  • Teeth need to be brushed twice a day with a soft bristled brush.
  • The size and the shape of the brush are very important as it should fit in the mouth properly.
  • A toothbrush needs to be changed every three or four months. If the bristles of the toothbrush are frayed, it needs to be changed immediately.
  • Dental Associations recommend only fluoride toothpaste should be used.
  • The toothbrush should be placed at an angle of 45-degree to the gums and brushing needs to be done back and forth in short strokes in a smooth way.
  • The entire mouth needs to be brushed, the outer, inner and chewing surfaces of the teeth.
  • Do not put excessive pressure while brushing.
  • Use toothpaste containing sodium fluoride and calcium phosphates. The most recommended ones are the toothpaste containing potassium nitrate.
  • Use mouthwash containing potassium or sodium salts to gurgle following any food intake.
  • Reduce the quantity of acidic and high carbonated food intake.
  • Avoid brushing teeth following intake acidic food or drinks.
  • Keep a gap between food intake, and after every meal rinse your mouth with water.

The dentist may recommend the application of desensitizing agents or nerve desensitization therapies to reduce the pain such as

  •         Occlusive therapy
  •         Laser therapy
  •         Ozone therapy
  •         Application of resin-based materials
  •         Use of oxalates
  •         Gingival Grafts

-Dr.Surampally Bhavani Sagar

References:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3010026/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927677/

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