Dentinal Hypersensitivity Stimuli
Dentinal hypersensitivity is characterized by a short, sharp pain in response to stimuli. Dentinal hypersensitivity, which is more commonly seen in adults in the 20 – 40 – year old age group, has several etiological factors. Gingival recession and enamel loss both contribute to the prevalence of this condition, resulting in the exposure of dentin.
Dentinal hypersensitivity is believed to occur due to the movement of fluid within the dentinal tubules occurring in response to:
Tactile: Contact with a toothbrush and other oral hygiene devices, eating utensils, periodontal and dental instruments, and friction from prosthetic devices.
Thermal: Temperature changes caused by hot and cold food and beverages and cold air as it contacts the teeth. Cold air is the most common stimulus for pain.
Evaporative: Dehydration of oral fluids as from high volume evacuation or applying air to dry the teeth during intraoral procedures.
Osmotic: Alteration of osmotic pressure I dentinal tubules due to isotonic solutions of sugar and salt.
Chemical: Acids in foods and beverages such as citrus fruits, spices, wines and carbonated beverages; acids produced by acidogenic bacteria following carbohydrate exposure; acids from gastric regulation. (Wilkins, BS, RDH, DMD, 2013)
stimuli, according to Brannstroms Hydrodynamic Theory. Anatomically, the areas of the tubules closer to the pulp activates the nerves associated with the odontoblasts at the end of the tubule, resulting in pain response.
Tooth brushing techniques causing gingival trauma are a significant factor for gingival recession. The frequency, duration and force of brushing all contribute to recession. Excessive force and improper technique may lead to ...
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..., as well as erosion, abrasion and abfraction. Females tend to be prone to hypersensitivity and it has been hypothesized that this is because females tend to be more frequent attenders for treatment and perform more extensive home care oral hygiene in comparison to males. Hypersensitivity tends to be most prevalent on the buccal and cervical regions of the teeth. The most common sites for dentinal hypersensitivity are the cervical margins of the buccal and labial surface of the teeth. These areas of the teeth are a common site for recession and the enamel is also thinner in these areas. Canines and first premolars, followed by incisors, second pre-molars and molars are commonly affected by recession. Lastly, patients with moderate to severe sensitivity tend to have gingival recession more prevalent on one side of their mouth compared to the contralateral side.
However, on the a recent visit dated 23/12/13 the patient’s gingival condition had deteriorated, presenting with an increased plaque scores of 34% and bleeding scores to 63%. Intra oral examination also showed generalised oedema and erythema throughout in the mouth in response to this increase in plaque bacteria. The presence of supra-gingival calculus on lower anterior teeth and both sites of upper buccal molars and the patients BPE now reads 212 /121, putting the patients caries risk at a ‘High’ status.
Epithelial tissues work as the prime line of safety between the host and the external environment, which includes multiple bacteria of oral cavity in question. The main issue and motive of study remains how PAR receptors function in the epithelia when they respond to different bacteria to provide innate immune reactions. The detailed mechanisms underlying the effects mediated by the major PARs in human gingival tissues, including their correlation with cytokines require further research. This information will provide a better understanding of the development of periodontal diseases and inform the strategy for identification of therapeutic approaches for these diseases.
We all fear pain and it’s a well-known reason for people to avoid seeing the dentist. Most end up having severe periodontal problems leading to loss of teeth. Approximately 4-11% people suffer from dental phobias and avoid seeking dental care at all costs. Many of them end up in emergency situations that require invasive procedures like extraction or pulpotomy, which further reinforces their phobia.
It is regarded as a great challenge to be achieved in adhesive dentistry. The root dentin differ from the coronal dentin, thus the bonding will be different. The achievement of good infiltration and micromechanical retention remain a challenge because of limited access and vision, regional variation in bond strength, presence of a thick smear layer. The bond strength differs along the root canal and it is lower than coronal dentin.
15-Mutneja. P, Dhawan. P, et al. Menopause and the oral cavity. Indian Journal of Endocrinology and Metabolism (2010); 16(4): 548-551.
As I started my new journey of becoming a dental hygienist, I came into the program with no background of dental. I came into this program with an open mind and willing to embrace new concepts as well as develop new skills. During my time at the Canadian Academy of Dental Hygiene (CADH), I learned that as a dental hygienist that I am committed to promoting and helping each individual achieve their optimal oral health goals. In support of my client’s goals, I may assume any or all of the roles included in the dental hygiene scope of practice. My goal throughout this program was to help my clients achieve their optimal oral health goals through education, health promotion and providing preventive and clinical therapy.
Over time as individuals age and are faced with access to care issues they may begin to neglect their oral health. As time passes between dental hygiene cleanings or dentist visits the presence of oral disease may begin to increase.
Introduction: In Canada, general dental health is not part Canada’s national system of health insurance (Medicare) (1) except for some dental surgical procedures that are performed at hospitals. Since Oral health does not come under the Health Act about ninety-five percent of the oral health care services are offered on a fee-for-service basis. Oral health care is under provincial or territorial jurisdiction like other health care services and publically financed dental care programs provide the remaining five percent of oral health care services (2). Thus, majority of Canadians receive oral health via privately owned dental clinics. Privately owned dental care gives these services providers control over dental service charges, types of available treatment for the patients and number of follow-up appointment for treatments or routine care. Service users pay for the dental expenses from their own pockets or utilize insurance coverage (1).
The prevention of periodontitis is straightforward for patients. The first step in prevention is to assure that the patient is brushing twice a day utilising the proper brushing technique. Patients who fear the contraction of periodontitis are not encouraged to brush too much however, as excessive brushing with poor technique can lead to other oral problems such as the reduction of the gums (gingival recession). Brushing at least twice a day help inhibit the growth of unwanted bacteria and prevents plaque, and thus tartar from forming. Patients who wish to prevent periodontitis should also floss daily. Flossing daily includes the spaces between each tooth, as well as behind the last two molars on the mandibular and maxillary arches. Flossing should get in below the gum line to prevent bacteria from congregating just below the surface. The last at home, over-the-counter treatment available for the prevention of periodontitis is the use of an antiseptic mouthwash. While proper use of mouthwash in conjunction with the other techniques can help cure gingivitis, once periodontal disease has elapsed stage 1 of periodontal disease, no amount of mouthwash or brushing can restore attachment lost in the periodontium.
However, there are several signs to look for that can show you may have some form of periodontal disease. A strong indication is persistent and strong bad breath, as diseased tissue exudes a foul odor. The diseased gums will also start receding as bone loss increases, causing your teeth to look longer. Other indications include red or purplish swollen gums, bleeding, loose adult teeth, or spaces forming between your teeth. Your teeth might also become increasingly more sensitive to temperature changes. This is because your roots are now exposed to any elements when they are usually covered with bone and gingiva tissue. It is important to know that anyone can get periodontal disease but something things may increase your chances of this. Smoking of course is the number one contributor, but also many medications, over the counter or prescription, can reduce the amount of saliva you produce. In turn this can increase the amount of bacteria in your mouth as saliva rinses the bacteria from your mouth over the course of the day. Diabetics also have a higher risk as they are more prone to
Periodontal disease, or periodontitis, is an “inflammation of the gums that leads to multiple dental diseases…caused by infections or by plaque that adheres to the surface of the teeth” (Blake 86). Gingivitis is an “early form of periodontal disease that involves gum swelling, bleeding, and oral pain” (Blake 86). Thus, periodontal disease typically moves from the early stage of gingivitis to more progressive stages, gradually worsening until teeth are potentially lost or separated from the gums or jaw bone. Subsequently, the risk of heart attack, stroke, and other health problems can occur (Nordqvist 1).
Dental plaque is broadly classified as supragingival or subgingival based on its position on the tooth surface toward the gingival margin. Supragingival plaque is found at or above the gingival margin. Therefore, it can be further differentiated into coronal plaque, whi...
This concept advocated a proximal cavity preparation extending toward the buccal and lingual aspects of the tooth so that contact with adjacent teeth would not be at the margins. The separation of the margins, along with proper restoration contours, according to this concept was thought to promote natural cleansing of the embrasures with saliva and fluids in the diet.2
“Gingivitis.” Magill’s Medical Guide, 4th Rev. ed.. 01 Dec. 2008. eLibrary. Web. 15 Oct. 2010.
For example, when placing composite materials or sealants an etchant has to be placed before the actual restorative material. An etchant is used to partially demineralize enamel rods. This is critical for micromechanical retention of material to adhere to the tooth surface. If these microscopic cavities were to be filled by saliva and debris from contact with the tongue, the material bonding process would fail. The oral cavity is a very hostile environment. In order to achieve maximum function of dental materials, the environment has to be stabilized. In some cases stabilization of the oral cavity involves temporary elimination of those conditions by tooth