Sensibilitate dentara. Cauze, tratament si preventie

Tooth sensitivity (dentine hypersensitivity) is defined as an intense, sharp, short-lasting, sharp pain due to the action of thermal, tactile, osmotic or chemical stimuli that cannot be associated with any other dental disorder. This is one of the most common reasons why patients come to the dentist in dental clinics.

It is manifested by teeth that are sensitive to environmental stimuli that are generally not harmful. Light touching, hot or cold food, some acidic substances or beverages can induce an intense and brief toothache that can interfere with the patient's daily activities such as eating, drinking, talking or brushing. 

Causes of tooth sensitivity

Tooth sensitivity is more common in females than males, it can occur in all age groups, but is more common in the 20-50 age range, with a prevalence between 4% and 74%. It is most commonly localized in the canines and premolars of both the maxillary and mandibular arches, especially the vestibular surface of the tooth (the surface facing the lip) at the level of the dental coplet (the boundary between the crown and the root of the tooth).

Inside the tooth is the dental pulp (nerve), which is surrounded by hard tissue called dentin. This, in turn, is surrounded by enamel at the crown and cement at the root.

Dentin is a hard but essential material for the tooth, with many canaliculi. These canaliculi connect the inside and surface of the tooth and contain extensions of the dental nerve. When these canaliculi are stimulated, the fluid in them moves, activating the nerves and causing pain. Essentially, tooth sensitivity is caused by the exposure of dentin, through the loss of the dental tissues that cover it, and its contact with the oral environment.

Another cause is also gingival recession which occurs either as a result of very aggressive brushing or incorrect flossing, or secondary to periodontal diseaseafter subgingival curettage or following periodontal surgical treatment.

How do I prevent tooth sensitivity?

The prevention of this condition is very important, and this involves a correct brushing technique, optimal oral hygiene, avoiding acidic foods and drinks, treating conditions involving acid regurgitation. 

Always your dentist should make the differential diagnosis with other dental conditions that present similar painful symptoms, in this category include dental caries, reversible pulpitis, dental fracture or tooth sensitivity following tooth whitening.

Tooth sensitivity is identified by using an air jet or by palpating the tooth surface with an exploratory probe in the area where the patient feels pain.

What treatment do I need?

Treatment methods for tooth sensitivity include:

1. The patient uses desensitizing agents at home for 3-4 weeks in the form of toothpaste or mouthwash. These may contain potassium salts or sodium fluoride which are intended to block the dentinal canaliculi or to decrease the excitability of the nerve fibers present in these canaliculi.
2. The use of PROPOLIS on sensitive dental surfaces has been found to have an effectiveness comparable to the use of sodium flower flower, being a very good natural alternative.
3. If tooth sensitivity persists, treatment in the dental office is indicated, using desensitizing varnishes or adhesive restorative materials such as glass ionomer or composite materials for sealing the dentin canals.
4. When gingival retractions are present with indication for muco-gingival surgery, gingival grafts can be used to restore the gingival level by covering the root areas initially exposed.
5. A very fast and effective treatment option is the use of dental laser which helps to precipitate proteins from the dentinal canaliculi, obstructing them and preventing the movement of dentinal fluid, but also decreasing the nervous excitability of the nerve extensions.
6. In cases in which hypersensitivity does not yield to any treatment method, even tooth devitalization may be resorted to, which is why it is very important for patients to go to the dental clinic at the first signs of tooth sensitivity, when the chances of it being treated are very high. 

Studies show that although there is no specific treatment that is universally valid for all cases, the most effective method is the combination of desensitizing agents with the effect of dental laser.