Dental Hypersensitivity

Front 1

What is dentin hypersensitivity?

Back 1

Pain from exposed dentin tubules as a response to external stimuli (cold, heat, air, sweet, sour)

Front 2

What are some patient behaviors that can trigger a hypersensitivity pain response?

Back 2

Bulimia, whitening, brushing hard, or clenching/grinding

Front 3

What condition precedes the development of dentinal hypersensitivity?

Back 3

Recession

Front 4

Describe the role of dentinal tubules in the development of hypersensitivity?

Back 4

If they are exposed, the stimuli moves through the tubes to the pulp causing the pain

Front 5

There are many factors that contribute to gingival recession, subsequent root exposure, and potential dentin hypersensitivity. Name as many as you can.

Back 5

Oral piercings, narrow zone of attached gingiva, improper OHI, facial orientation of teeth, erosion, periodontal disease and treatment, restorative treatment, attrition, tight or short labial frenum, periodontal surgery, improper brushing, whitening

Front 6

What are two factors that can contribute to erosion on an exposed root surface?

Back 6

citrus drinks, carbonated drinks, acid reflux, bulimia

Front 7

How does abfraction occur?

Back 7

A microscopic lesion commonly found on the gingival margin and looks like a V-shaped notch in the cervical area

Front 8

Which natural desensitization mechanism is related to narrowing of the inside wall of the dentin tubules?

Back 8

Sclerotic Dentin

Front 9

A smear layer can reduce dentin hypersensitivity by blocking the dentin tubules, what causes a smear layer?

Back 9

It accumulates after root instrumentation using toothpaste with abrasive particles, attrition or abrasion cutting with a burr

Front 10

What is a negative effect of a smear layer?

Back 10

May increase your risk for hypersensitivity by root planning and exposing the collagen fibers which may increase the migration and attachment of PDL cells

Front 11

Two different patients can experience pain from hypersensitivity in different ways. Why is pain perception subjective?

Back 11

It doesn't feel the same for everyone and everyone feels is differently, what is painful to one may be tolerated by one

Front 12

What are some components to include in your patients dental history of hypersensitivity?

Back 12

Self report of symptoms, scales, diet analysis, parafunctional habits, stressors, what they are sensitive to, when the sensitivity started, where it is located, what they are sensitive to

Front 13

What are 2 patient response-related diagnostic tests that can be used to determine location and severity of tooth pain?

Back 13

Biting forces on bite stick, percussion test

Front 14

What are some trigger questions you can ask your patient about?

Back 14

Hot or cold, stop immediately upon removal of the stimuli, how bad is your pain, how long it lasts, where it is located, when it started, what are you sensitive to

Front 15

You can use VRS to rate the level of pain your patient is feeling. If your patient describes her tooth-related pain as a level 3, what does she mean?

Back 15

significant discomfort and lasted longer than 10 seconds

Front 16

Identify at least 5 clinical techniques used to differentiate among the variety of potential causes for dental pain

Back 16

radiographic exam, occlusal exam, dental history, percussion, clinical exam, transillumination

Front 17

Not one best method has been identified for the treatment of hypersensitivity. Treatment options offered to the patient should begin with the most _________ and least ___________ measures.

Back 17

Conservative, least invasive

Front 18

List five factors that you can take into consideration when selecting a desensitizing agent

Back 18

no staining, consistent, acceptable taste, prescribe an agent that takes little time, no pulp irritation, rapid lasting effect, easy to apply and no harm

Front 19

What patient action, if used as part of daily oral hygiene regimen, can contribute to the formation of a smear layer or reparative dentin and thereby reduce hypersensitivity?

Back 19

burnishing with wooden pick

Front 20

identify the ingredients in over-the-counter (OTC) desensitizing dentifrices

Back 20

Potassium nitrate

Front 21

Identify therapeutic ingredients that block the pain response by occluding the dentinal tubules

Back 21

fluorides, oxalates, gluteraldehyde, calcium carbonate, arginine

Front 22

List 3 means of covering exposed dentinal tubules at the CEJ

Back 22

Unfilled or partial resins, dentin bonding agents, composite and glass ionomer, soft tissue gates

Front 23

The highest prevalence of hypersensitivity is found in __________. Prevalence and severity ___________ in older folks due to the occurrence of natural mechanisms of desensitization.

Back 23

Periodontally involved patients, decreases

Front 24

What are 5 stimuli that elicit pain reaction?

Back 24

Tactile, thermal, evaporative, osmotic, chemical

Front 25

What is currently the accepted explanation for the transmission of stimuli from the outer surface of the dentin to the pulp?

Back 25

Hydrodynamic theory