Susan Hutson considers how to ease pain for hypersensitive patients.
Tooth sensitivity, or dentine hypersensitivity, can be highly uncomfortable and painful, interfering with everyday activities such as eating, drinking and even speaking. The condition can vary in severity, from mild twinges every so often to chronic discomfort. Dental professionals likely encounter many patients on a day-to-day basis who complain of sensitivity. Treating mild manifestations can be relatively straightforward, but prolonged and persistent pain could be a sign of a more serious issue.
The pain caused by sensitivity could incentivise patients to get to the root of the issue as quickly as possible and approach their dental practice for help. But many may simply put up with the pain, either through lack of time, dental anxiety or uncertainty as to whether it warrants a trip to the dental practice. As such, it’s important to educate patients and equip them with the tools they need to prevent or treat their tooth sensitivity.
What is it?
Sensitivity has been described as a sensation or pain “arising from exposed dentine, typically in response to chemical, thermal, tactile or osmotic stimuli”. There are three proposed hypotheses to explain this phenomenon – direct innervation theory, odontoblast receptor and fluid movement/hydrodynamic theory. The hydrodynamic theory, which describes “fluid movement in response to stimuli within exposed dentinal tubules”, seems to carry weight over the other options.
Dental sensitivity is thought to predominately affect those aged between 20 and 50,
impacting women more than men. For instance, research has demonstrated that sensitivity is experienced more by women after tooth preparation than men, although the reasoning for this is not clear and requires more thorough research. It’s thought that around 31 per cent of Britons experience tooth sensitivity, but the exact figures are hard to gauge, as many individuals likely ignore the issue or avoid seeking professional help.
The causes
The causes of tooth sensitivity are manifold, which makes getting to the principal cause a challenge.
Dentine exposure can be caused by bruxism, a condition that causes intense wear to the tooth and complications that include orofacial pain, fractures and pulpal pathology, in addition to tooth sensitivity. Bruxism can occur both while the patient is awake and asleep, and many patients may be unaware that they even have it. Thus, experiencing tooth sensitivity, alongside other tell-tale signs, could indicate another oral issue is at play.
Forceful and/or prolonged brushing can also cause damage to the teeth and gingiva, in addition to using a hard-bristled toothbrush. As you know, too much force on the tooth’s surface can cause tooth wear and gingival recession – two key players in the development of tooth sensitivity. A study found that, while manual toothbrushes with harder bristles removed more plaque, they also caused more trauma to the soft tissues when compared to a softer-bristled brush. As such, dental professionals need to work together with patients to devise a suitable method of removing plaque, while being gentle on the teeth and gingiva.
Most oral issues can be triggered by a poor diet, namely one that is high in sugars and acids. Overconsumption of soft drinks, for instance, is a leading extrinsic cause of dental erosion. Research has shown that the availability and marketing of soft drinks have exposed young children and adolescents to acidic foods/drinks at early ages. The literature concluded that exposing young individuals to sour tastes can increase their partiality to acidic foods and drinks in adulthood. A poor diet is a risk factor for periodontal disease, too, which induces a host of unpleasant symptoms for the individual. Included in the long list of indications of periodontitis is tooth sensitivity, with both conditions being associated with one another in the literature. As the gingival tissues begin to recede in the developmental stages of periodontitis, the exposed dentine can become aggravated and trigger sensitivity.
Tooth whitening is another well-known cause of tooth sensitivity. This treatment option has become a popular choice for patients seeking to enhance their smile – it’s minimally invasive, can be cost-effective and demonstrates to patients that they don’t need extensive cosmetic work in order to boost their confidence. However, sensitivity to both the teeth and gums can occur, largely due to the use of hydrogen peroxide, often in high concentrations when performed in practice. These agents can penetrate into the dental pulp, causing discomfort and pain.
The treatment
Several methods have been developed to reduce the impact of sensitivity, such as fluoride treatments, dental bonding and, in some cases, a root canal treatment. Of course, if the cause is due to another oral complication, such as bruxism or periodontitis, then other procedures may be indicated. This is why it’s important to encourage patients to take their sensitive teeth seriously and speak to a dental professional for guidance – it could help them catch another, potentially more serious issue.
There are things that patients can do at home to alleviate their symptoms, including introducing a softer toothbrush into their oral hygiene routine; limiting their consumption of sweet and acidic foods/drinks; ensuring that they maintain a thorough oral hygiene routine; and invest in a fluoridated toothpaste specially developed for sensitive teeth. The Arm & Hammer Sensitive Pro Baking Soda toothpaste offers up to 16 weeks of pain relief, with eight weeks of regular use. This solution helps to fix the cause of sensitive teeth, by sealing and protecting exposed nerves with patented Liquid Calcium technology. The inclusion of baking soda means your patients will receive a deep, gentle clean, while also promoting a neutral pH level to aid in the prevention of caries. Containing 1100ppm of fluoride, it also fights caries – recommend the Arm & Hammer Sensitive Pro Baking Soda toothpaste to your patients today.
All gain, no pain
Consuming cold and hot foods/drinks, biting down on something and/or sucking cold air between the teeth is enough to trigger discomfort in the mouth. Despite the relatively small affected area, the impact of tooth sensitivity on a person’s life can be profound. Not only that, but it could be a sign of another oral complication. As such, it’s vital that dental professionals encourage their patients to speak up if they’re experiencing tooth sensitivity.
For more information visit www.armandhammer.co.uk/