Tooth Sensitivity

KatieM

Katie Moynihan RDH

Tooth Sensitivity

Sensitive teeth is one of the most common concerns among dental patients. Tooth sensitivity occurs due to enamel loss or gum recession which exposes the underlying dentin structure of the tooth. The dentin layer of your tooth is found underneath the enamel and contains several tiny tubes which run from the nerve to the outside of the tooth. When exposed, these tubes are highly sensitive to temperature changes, sweets, or mechanical forces. Not to mention very painful!

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Tooth sensitivity can be caused by several factors. Aggressive brushing can wear away your enamel at the gumline leading to gum recession and exposed tooth root. Another cause of sensitivity can be from continuous grinding of the teeth to the point that the enamel is completely worn down to the dentin layer. Cracked teeth or worn fillings can create passageways to the nerve of the tooth. Periodontal disease, or severe gum disease, can contribute to sensitivity because the gums around the teeth break down and lead to gum loss and bone loss.

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There are several ways to help reduce tooth sensitivity either at home or at the dental office. The type of treatment will depend of what is causing the sensitivity.

At home treatments include:

  • using a soft or extra-soft toothbrush while brushing gently in order to avoid toothbrush abrasion at the gumline (take a good look at your toothbrush…if the bristles are pointing in multiple directions, you’re brushing too hard!)
  • using a toothpaste that contains potassium nitrate, which penetrates the exposed dentin and soothes the nerve endings
  • using a fluoride toothpaste to help strengthen the tooth and exposed dentin
  • using MI Paste (available at your dental office) to block dentin tubule openings
  • limit acidic foods and drinks because they can remove small amounts of enamel over time

In office treatments include:

  • application of a fluoride varnish – helps seal the tubules and rebuild exposed dentin
  • application of a fluoride foam – provides a high dose of fluoride to help strengthen teeth
  • bonding agents can be placed at the gumline if necessary to seal exposed dentin and reduce sensitivity
  • restorative treatment if needed to correct the tooth that is causing the sensitivity
  • periodontal treatment if needed to keep gums healthy around the teeth

A mix of potassium nitrate and fluoride is your best solution for desensitization. Some products which include these active ingredients include Sensodyne, Pronamel, Colgate Sensitive Pro Relief, and Colgate Prevident 5000 Sensitive. These products must be used on a regular basis for at least 30 days before any therapeutic benefit will take place. Whitening and tartar control toothpastes contain abrasive ingredients that can damage tooth enamel and may be too harsh for those with sensitive teeth. The application of a fluoride varnish is always available in-office at your request. If you suffer from tooth sensitivity, feel free to ask us which desensitizing agents will work best for you!

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Want to learn more? Visit us at

http://www.shalimarfamilydentistry.com

http://www.northstapleydentalcare.com

http://www.alamedadentalaz.com

http://www.dentistingilbert.com

Sources:

http://www.ada.org/~/media/ADA/Publications/Files/patient_33.ashx

https://us.sensodyne.com/faq.aspx

http://www.colgate.com/en/us/oc/oral-health/conditions/tooth-sensitivity/article/treatment-options-for-tooth-sensitivity

http://www.mouthhealthy.org/en/az-topics/s/sensitive-teeth

Toothpaste

Kara

Kara Johansen BSRDH

The dental isle in the grocery store can be very overwhelming. Rows and rows of toothpastes, mouth rinses, and floss. We are here to help make that isle less confusing.  In a previous post Julie West BS RDH wrote about mouth rinses, thanks Julie! So here is the breakdown of toothpaste.

What is the purpose of toothpaste?

There are 4 reasons to use toothpaste. 1. Fluoride 2. Bacterial Plaque reduction 3. Tartar Inhibition 4. Desensitization. Here is the breakdown of each type of toothpaste.

Fluoride-

  • Fluoride has been the greatest public health venture in the United States. The most rampant form of disease in children is dental decay. Fluoride can cause a 20-30% decrease in decay (451, Wilkins). The fluoride remineralizes areas of decay that are in the beginning stages. When your dentist says they are going to “watch” a tooth it means that the he/she understands the decay can remineralize with good oral hygiene, great nutritional habits and fluoride use.
  • Here is a tip: switch up your oral hygiene routine.
  1. Mouthwash
  2. Floss
  3.  Brush for 2 min with fluoridated toothpaste.
  4. Walk away. Do not rinse after you brush. You want the fluoride to stay on your teeth and remineralize that weak spot that the dentist is watching.
  • Fluoride also helps with: tooth sensitivity, deceases tooth loss, promotes less frequency of periodontal diseases, overall bone health and bacterial reduction.

Bacterial Plaque Reduction-

  • There are different products in toothpastes to decrease the amount of bacteria in the mouth. Some of these products are: Triclosan, fluoride, Chlorhexidine, peroxide and bicarbonate, sanguinaria, and essential oils.
  • Brushing and flossing is the best way to reduce the majority of cavity causing bacteria in the mouth. Plaque is like pancake batter, it is sticky. Mechanical Removal will have the greatest affect on decreasing plaque levels in the mouth.

Dental plaque

http://mpkb.org/home/pathogenesis/microbiota/biofilm

Tartar Inhibition

  • The goal of these toothpastes are to reduce the production of tartar. These toothpastes however, do not have any effect on existing tatar. The toothpastes is meant to reduce the amount of tartar initially created. The only true way to get rid of tartar is mechanical removal by your dentist or hygienist. Come for you cleanings, they would love to help you out with that part. If you don’t love the scrapping do you part at home, brush with an electric toothbrush and floss two times per day.

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http://colgate-sensitive-pro-relief.colgateprofessional.com.hk/patienteducation/Plaque-and-Periodontal-Disease/article

Desensitization

  • Sensitive teeth are no fun. Cold, hot , sweet foods or drinks, and mechanical forces can cause sensitivity.
  • How did I get sensitive teeth? This can be caused by multiple factors. The most common is tooth root exposure. When the gums recede a part of the tooth called dentin is exposed. It is a much more porous structure and sensitivity happens frequently.
  • pated_GingivalRecessionWithExposedRootDentine
  • colgateprofessional.com
  • When you are seeking out a toothpaste for sensitivity look for the active ingredients. Flip that tube of toothpaste over and take a peek. Potassium Nitrate calms down the nerve that is more sensitive with exposed dentin.  Sodium and stannus fluoride strengthen and occlude the more porous dentin.  A mix of Potassium Nitrate and fluoride is your best bet for desensitization.
  • MI Paste RECALDENT (CPP-ACP) has been found to help with sensitivity. Like fluoride it blocks the small porous openings of dentin. You can get a prescription for it from your dentist.
  • Other Products: Sensodyne, Pronamel, Colgate Sensitive Pro Relief, etc. Scan the dental isle.

images

http://www.recaldent.com

sensodyne-group-products-page-10_9_2013

pronamel-packshots_nonew-mock

us.sensodyne.com/products.aspx

Colgate-Sensitive-Pro-Relief-TP-triBox

http://www.colgatesensitiveprorelief.com.sg/products/toothpaste

What is in my toothpaste?

Cleaning and Polishing 20-40%

  • An abrasive is used to clean and the polish smooths the surface of the tooth. These agents help to decrease the adherence of stain and plaque buildup.
  • Possible agents: Calcium carbonate, IMP, dicalcium phosphate, hydrated aluminum oxide, and silica

Detergents 1-2%

  • Detergents make your toothpaste foam and are surfactants. They lower the surface tension, loosen stains, foam, and emulsify debris.
  • Possible agents: sodium laurel sulfate, sodium cocomonoglyceride sulfonate
  • Sodium Laurel Sulfate can cause sloughing of the tissue, make one more prone to canker sores and decreases healing time of mouth sores for some people. Patients who experience this should avoid Sodium Laurel Sulfate. Sensodyne does not use sodium laruel sulfate, this product would be a good choice for you.

Binders 1-2%

  • Binders keep your the solid and liquid ingreadients together

Now the next time you walk down the dental isle hopefully you will know exactly what type of toothpaste is perfect for you and your needs. If you have more questions ask your dentist or dental hygienist.  Watch out for the next post on what type of floss to choose, its going to be a duesy. Happy brushing and don’t forget to floss.

 

Sources:

GC America Professional Dental Site. Frequently Asked Questions. Retrieved from http://www.mi-paste.com/faq.php

Wilkins, E. M. (1994). Clinical Practice of the Dental Hyginienist: Seventh Edition. Media, PA: Williams and Wilkins.