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Elimination of tooth neck hypersensitivity

Tooth neck hypersensitivity may have several underlying conditions, some of the most
common causes:
Hypersensitivity of the tooth neck
Dentin hypersensitivity
Hypersensitivity: painful condition of the teeth surface. More exactly: hypersensitivity of the
dentin.

Dentin hypersensitivity

Intense, shooting pain - what cannot be associated with any other tooth condition - is the
abnormal response of the exposed dentin to thermal, tactile, osmotic, chemical and other
stimuli. (Broken teeth, caries, secondary caries, broken fillings, outgrows may cause similar
symptoms). In most of the cases, affects patients with good oral hygiene. Its prevalence is
high in the age group of 30-60, but occurs above and below these ages. In Hungary 33% the
population 30-60 have sensitive teeth. 2/3 of them regularly, 1/3 of them occasionally suffers from the hypersensitivity.

The underlying causes may be

  • Receding of the gum, inflammation of the gum or parodontium, gum hyperplasia,
  • parodontologic treatments, occlusion trauma
  • Bad toot brushing practice, tooth wash with abrasive substance, toothpick
  • Loss of enamel, abrasion of the tooth
  • Chemicals, acidic erosion, regurgitation, abdominal surgery, acid replacement, foods, drinks,
  • juices, cola
  • Clasps - clasp of the removable denture abrades the tooth


Conditions predisposing to tooth sensitivity

  • Abraded teeth with exposed dentin, periodontitis gingivitis
  • Decayed teeth, big metal fillings,
  • Microscopic of visible cracks on the dental surface
  • Pulp disorders
  • Broken, abraded fillings
  • Dental development defects - enamel defects grinding of the teeth
  • Bad tooth wash technique
  • Dry mouth
  • Dietary problems - bad eating habits
  • Plaque - bad oral hygiene
Prevention
  • Timely treatment of tooth erosions
  • Timely treatment of the receding gum
  • Timely treatment of the dry mouth
  • Protection against acidic erosion
  • Sealing of the dentin channels
  • Hypersensitivity desensibilization

1. Surface layer

The dentin channels can seal themselves in a natural way; plaque building may cover and seal

the dentin surface


2. Intratubulary dentin

Substances of the saliva penetrate into the dentin channels and produce occlusions through

crystal building. Inner occlusions may develop by the sclerotisation of the root dentin.


3. Tertiary dentin

Dentin producing cells (odontoblasts) of the dental pulp secrete tertiary dentin when irritated.

They are sealing the dentin channels with a collagen like substance.

Treatment options
Desensitizing toothpaste in combination with in-office care; strontium chloride and potassium
chloride considerably alleviate hypersensitivity.
  • The fluoride treatment is efficient only with toothpaste containing more than 600 ppm of fluoride

Professional dental solutions
  • Application of fluoride to the sensitive areas
  • Covering with bond materials
  • Filling - covering with protective layer
  • Application of fissure sealants hardens the exposed dentin surface.
  • Laser therapy, “melting” the sensitive surface with ErYAG laser, diode laser, NdYAG laser - sealing the dentin channels with high output lasers.
  • Reducing nerve transmission by soft laser - pain killing effect
  • Desenzibilitation
  • Root canal treatment - removal of tooth nerve.
  • Tooth removal
  • Changing the flow of the biological fluid in the tubules Experiments have proved that the flow of the fluid can be changed.
  • Pulp tension - pulp tension can be reduced with vasoconstrictor containing numbing injection
  • to root tip.
  • Inflammation - even a minor trauma may irritate the pulp, resulting in inflammation. Tooth drilling, ultrasonic plaque removal may also trigger tooth hypersensitivity.