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Dr. Parvez A. Khan

Authors : Dr. Parvez A. Khan

Wishing all reader a year filled with great joy, peace and prosperity Have a wonderful year ahead …..HAPPY NEW YEAR 2016

Dentin hypersensitivity is dental pain which is sharp in character, of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmotic chemical or electrical; and which cannot be described to any other dental disease. The pain is sharp and sudden, in response to an external stimulus .The most common trigger is cold with application of a cold stimulus. Other stimuli may also trigger pain in dentin hypersensitivity are hot and cold drinks and foods ,cold air, coolant water jet from a dental instrument.

The main cause of dentin hypersensitivity is gingival recession with exposure of root surfaces, loss of the cementum layer, smear layer and tooth wear. Receding gums can be a sign of long-term trauma from excessive or forceful tooth brushing, or brushing with an abrasive toothpaste or a sign of chronic periodontitis. Other less common causes are acid erosion and periodontal root planning, dental bleaching, smoking, cracked teeth or grinding of teeth . Dentine contains many thousands of microscopic tubular structures that radiate outwards from the pulp; these dentinal tubules are typically 0.5–2 mm in diameter. Changes in the flow of the plasma-like biological fluid present in the dentinal tubules can trigger mechanoreceptors present on nerves located at the pulpal aspect, thereby eliciting a pain response.

This hydrodynamic flow can be increased by cold, air pressure, drying, sugar, sour (dehydrating chemicals), or forces acting onto the tooth. Hot or cold food or drinks, and physical pressure are typical triggers in those individuals with teeth sensitivity. Most experts on this topic state that the pain of dentin hypersensitivity is in reality a normal, physiologic response of the nerves in a healthy, non-inflamed dental pulp in the situation where the insulating layers of gingiva and cementum have been lost. The diagnosis of dentin hypersensitivity may be challenging. A thorough patient history and clinical examination are required.

The examination includes a pain provocation test by blasting air from a dental instrument onto the sensitive area, or gentle scratching with a dental probe .If a negative result for the pain provocation test occurs, no treatment for dentinal hypersensitivity is indicated and another diagnosis should be sought, such as other causes of orofacial pain. Inflammation of the dental pulp termed pulpitis , produces true hypersensitivity of the nerves in the dental pulp. Reversible pulpitis may not be so readily distinguishable from dentin hypersenstivity, however usually there will be some obvious sign such as a carious cavity, crack, etc. which indicates pulpitis. In contrast to pulpitis, the pain of dentin hypersensitivity is short.

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Dr. Parvez A. Khan
Dr. Parvez A. Khan