Management Of Dentine Hypersensitivity Research Articles

Brazilian undergraduates' and dentists' knowledge on preventing, diagnosing and managing dentin hypersensitivity: A cross-sectional questionnaire study.

To analyse the knowledge of dental undergraduates and dentists on the prevention, diagnosis and management of dentin hypersensitivity (DH); to compare their knowledge scores; and to understand the related variables using a regression model. An original online questionnaire investigated the attitudes, self-reported knowledge ('how much they thought they knew') and real knowledge ('how much they really knew') of 132 students and 338 dentists. Data were analysed descriptively, both knowledge scores were compared using Mann-Whitney and Wilcoxon signed-rank tests and data were subjected to two multiple linear regression analyses considering real knowledge scores as the dependent variable (α < 0.05). The self-reported knowledge on DH was higher than the real knowledge for both students and dentists, but dentists presented the highest scores. Gingival recession and acidic diet were reported as the main predisposing factors for DH by undergraduates and dentists. Students normally managed DH with dietary and hygiene instructions followed by a desensitizing agent application, while dentists managed with occlusal adjustments. The mechanism of glutaraldehyde/HEMA and bioactive fillers on DH is widely unknown by students and dentists. The majority of the questioned individuals cannot differentiate DH from sensitivity of caries or molar-incisor hypomineralization. Both students and dentists overestimate their knowledge of DH, revealing deficiencies in prevention, diagnosis and management. Students' knowledge improves towards the end of the Dentistry course, while younger dentists and PhD holders are more knowledgeable. Institutions should implement ongoing DH education for undergraduates and conduct interventions for experienced professionals, especially older ones.

Review of Selected Over-the-Counter Toothpastes in the Management of Dentine Hypersensitivity

Review of Selected Over-the-Counter Toothpastes in the Management of Dentine Hypersensitivity

Dentinal Hypersensitivity: An Overview, Pathogenesis and Management of Dentinal Hypersensitivity

Dentinal hypersensitivity might be one of the most common dental complaints encountered in our day to day practice. Although being so prevalent and a discomforting dental issue which affects the patient’s well being physically, mentally and in dietary choices, there are no said guidelines and treatment procedures especially designed for treating dentinal hypersensitivity. In this review article I will try to bundle up the pathogenesis, causes, treatment and management of dentinal hypersensitivity.

Comparison of the effect of propolis and Gluma desensitizer on the management of dentin hypersensitivity: A randomized controlled trial.

To compare the effect of propolis and gluma desensitisers on the management of dentin hypersensitivity. The single-blind, randomised controlled trial was conducted at the Department of Operative Dentistry, Dr Ishrat ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from October 2020 to September 2021, and comprised patients with dentin hypersensitivity who had pain scores of at least 2 on the visual analogue scale. The teeth were randomised into propolis group A and Gluma group B. Baseline pain scores were assessed using visual analogue scale and Schiff's sensitivity scores and compared with scores immediately after the intervention, and then after one week and one month of the intervention. Data was analysed using SPSS 23. Of the 22 patients, 12(54.5%) were females and 10(45.4%) were males. Of the 80 teeth, there were 40(50%) in each of the 2 groups. Significant reduction was observed in dentin hypersensitivity immediately after the application of the desensitising agents (p<0.05). However, after one month, Gluma was more effective than propolis (p<0.05). Both Gluma and propolis were found to be effective desensitising agents, but the effectiveness of propolis decreased over one month. Clinical Trials.gov: NCT04819867.

A novel mussel-inspired desensitizer based on radial mesoporous bioactive nanoglass for the treatment of dentin exposure: An in vitro study

ObjectivesThe dentin exposure always leads to dentin hypersensitivity and the acid-resistant/abrasion-resistant stability of current therapeutic approaches remain unsatisfatory. Inspired by the excellent self-polymerization/adherence activity of mussels and the superior mineralization ability of bioactive glass, a novel radial mesoporous bioactive nanoglass coated with polydopamine (RMBG@PDA) was developed for prevention and management of dentin hypersensitivity. MethodsRadial mesoporous bioactive nanoglass (RMBG) was synthesized by the sol-gel process combined with the cetylpyridine bromide template self-assembly technique. RMBG@PDA was synthesized by a self-polymerization process involving dopamine and RMBG in an alkaline environment. Then, the nanoscale morphology, chemical structure, crystalline phase and Zeta potential of RMBG and RMBG@PDA were characterized. Subsequently, the ion release ability, bioactivity, and cytotoxicity of RMBG and RMBG@PDA in vitro were investigated. Moreover, an in vitro experimental model of dentin hypersensitivity was constructed to evaluate the effectiveness of RMBG@PDA on dentinal tubule occlusion, including resistances against acid and abrasion. Finally, the Young's modulus and nanohardness of acid-etched dentin were also detected after RMBG@PDA treatment. ResultsRMBG@PDA showed a typical nanoscale morphology and noncrystalline structure. The use of RMBG@PDA on the dentin surface could effectively occlude dentinal tubules, reduce dentin permeability and achieve excellent acid- and abrasion-resistant stability. Furthermore, RMBG@PDA with excellent cytocompatibility held the capability to recover the Young's modulus and nanohardness of acid-etched dentin. ConclusionThe application of RMBG@PDA with superior dentin tubule occlusion ability and acid/abrasion-resistant stability can provide a therapeutic strategy for the prevention and the management of dentin hypersensitivity.

A Drop-By-Drop Self-Assembled All-Natural Hydrogel as a Desensitizer for Rapid and Enduring Management of Dentin Hypersensitivity.

Dentin hypersensitivity (DH) is a prevalent dental condition arising from the exposure of dentin tubules (DTs), leading to discomfort upon external stimuli. However, achieving swift and profound occlusion of these exposed DTs for immediate and enduring relief remains challenging due to the intricate dentin structure and oral environment. Herein, a pioneering and facile drop-by-drop strategy involving an in situ generated natural supramolecular hydrogel formed by self-assembling silk fibroin (SF) and tannic acid (TA) within the narrow DT space is proposed. When SF and TA aqueous solutions are applied successively to exposed dentin, they penetrate deeply within DTs and coassemble into compact gels, robustly adhering to DT walls. This yields a rapid and compact occlusion effect with an unprecedented depth exceeding 250µm, maintaining stable occlusion efficacy even under rigorous in vitro and in vivo erosion and friction conditions for no less than 21 days. Furthermore, the biocompatibility and effective occlusion properties are verified through cell studies in simulated oral settings and an in vivo rabbit model. This study, for the first time, demonstrates the translational potential of hydrogel-based desensitizers in treating DH with prompt action, superior occlusion depth and enduring treatment benefits, holding promise as clinical-friendly restorative solutions for delicate-structured biosystems.

Single-session associative protocol for dentin hypersensitivity management: a 1-year randomized, blinded clinical study.

This study aimed to establish a single-session associative protocol for non-restorative management of dentin hypersensitivity (DH). Twenty-four individuals with DH and a minimum sensitivity level of 4 on the visual analog scale (VAS) were selected. The study was conducted in a split-mouth design, with each participant (n = 20) having at least 1 affected tooth in all quadrants. The management protocols consisted of control group: universal adhesive, Neural Desensitizing Protocol group: 5% potassium nitrate, Mixed Desensitizing Protocol (PAM) group: 5% sodium fluoride and 5% potassium nitrate, Remineralizing Desensitizing Protocol (PDR) group: surface-partially reacted glass technology photopolymerizable varnish. Evaluations were performed immediately after application, at 1 week, 1 month, 2 months, and 12 months using the VAS sensitivity test. The scores were subjected to statistical analysis using the Friedman test (p < 0.05), Durbin-Conover test (p < 0.05), and Wilcoxon test (p < 0.05). At the 12-month evaluation, all groups showed statistically significant differences compared to the initial assessment. For the evaluation after 12 months, there was a statistically significant difference between the PAM group, the control group, and the PDR group. It can be concluded that all groups were effective in controlling DH, but there were significant results in the control group and PDR group. The clinical relevance of this study is to demonstrate that the application of single-session desensitizing protocols can be effective in controlling DH for up to 12 months. Brazilian Clinical Trials Registry Identifier: RBR-4r63d7s.

Pathogenesis, diagnosis, and management of dentin hypersensitivity

Dentin sensitivity is a problem characterized by brief sharp pain that occurs in response to things like changes in temperature, sweet or sour substances and mechanical factors. This condition significantly affects the lives of patients leading to restrictions and changes in oral hygiene routines. It is crucial for care to understand the causes, symptoms, diagnosis and management of dentin sensitivity. The development of dentin sensitivity is closely related to the structure of teeth which involves the exposure of tubes in the dentin that contain nerve endings sensitive to stimuli. Different theories, such as the theory and direct innervation theory provide insights into how this pain occurs. Diagnosis involves an evaluation of signs and symptoms along with patient history and specific tests to confirm sensitivity. Management options include adjusting behaviors using desensitizing toothpaste or fluoride applications utilizing bonding agents or even undergoing procedures like gingival grafts. These approaches aim to reduce pain and improve the quality of life for individuals affected by dentin sensitivity. Dental professionals play a role, in diagnosing, treating and educating patients about this condition to ensure results and better oral health.

A novel clinical protocol for dentin hypersensitivity management based on regenerative dental gel associated with calcium: A case study in a patient with periodontal disease

Introduction: Dentin hypersensitivity (DH) is defined as pain caused by dentin exposure in response to various stimuli. Patients with periodontal disease (PD) frequently report DH due to root surface exposure or after periodontal treatment. Bioactive agents derived from calcium and/or silicon-based systems, such as REFIX technology, have been used to promote tooth regeneration, with focus on tooth sensitivity treatment. Case Report: Based on this, the efficacy of REFIX gel combined with calcium on the treatment of a DH was evaluated in a PD 45-year-old male patient. The patient’s right and left sides were randomly selected to use one of the prophylaxis dental protocols: REFIX dental gel/calcium (RDGCa) (experimental: 13, 14, 15 teeth) or Pumice Stone (PS) (control: 23, 24, 25 teeth). The products were applied using dental polishing brush during 10 seconds in each tooth surface. Schiff Air Index (SAI) for sensitive teeth (0–3) were performed by applying air jet to each tooth’s vestibular surface for 5 seconds after and before the prophylaxis. The patient reported pain and interruption of the stimulus before and after PS prophylaxis (SAI 3 and 3 respectively). There was a reduction in pain when RDGCa protocol was used (SAI 3—before/SAI 1—after). In this instance, the patient felt the stimulus but did not request to be interrupted. This contrasted with the outcomes of the initial stimulus as well as PS. Conclusion: The results showed that the RDGCa strategy was successful in lowering DH in PD patients.

How are bioactive ceramics shaping the future of dentin hypersensitivity management through glass ionomer cements and laser therapy?

Restorative dentistry comprises approaches to repair the tooth structure or manage conditions like dentin hypersensitivity, which all require biomaterials. Restorative clinical approaches are primarily based on bioactive materials, such as glass-ionomer cement (GIC) and resin-modified glass-ionomer cement (RMGIC). Although these cements show in vivo bioactivity, it is possible to increase their bioactive behavior, fastening and increasing the establishment of chemical bonds between the tooth and the cement, decreasing the risk of failure. Here, we reported how bioactive ceramics have been used to treat dentin hypersensitivity, either by being directly applied to the dentin, modifying GIC and RMGIC, or combined with other therapeutic approaches like laser therapy. Overall, bioactive ceramics have improved the bonding of composites to mineralized tooth structures, which is desired in restorative dentistry, and in some cases, they are likely to replace restorative with regenerative approaches.

Effectiveness of Cyanoacrylate in the Treatment of Dentin Hypersensitivity: A Systematic Review.

To compare the effectiveness of cyanoacrylate to other treatments or placebo in the management of dentin hypersensitivity (DH). The present review was organized based on the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. The search aimed to answer the following question: is cyanoacrylate effective in the treatment of DH when compared to other treatments or placebo? The following databases were used: PubMed/MEDLINE, Scopus, BVS, Web of Science, Cochrane, Clinicaltrials.gov, Portal Periódicos Capes, Google Scholar, and manual search. The evaluation process started with the information collected from the selected articles according to the Consolidated Standards of Reporting Trials (CONSORT). Two randomized and five nonrandomized clinical trials were analyzed in the qualitative synthesis. The studies presented different cyanoacrylate formulations, different scales for evaluating pain, and different methods for provoking a painful stimulus. Cyanoacrylate-based products reduce DH in shorter follow-up periods and this reduction persisted throughout the study. The results varied according to the methods used to stimulate the pain. Only two articles showed a low risk of bias and a high level of scientific evidence. Although there is a limited number of studies in the scientific literature with appropriate methodological quality, the available evidence proves the effectiveness of cyanoacrylate in the treatment of DH. Clinical Relevance. Cyanoacrylate is easy to access, effective, easily applicable, and a low-cost product with satisfactory results.

Effectiveness of 980nm diode Laser in reduction the diameters of exposed dentinal tubules for hypersensitive tooth

Abstracts: Background: The oral cavity is a complex environment, both structurally and functionally, the hard and soft tissues are in close a proximity. Oral tissues subjected to wear throughout the life, that threatened the vitality of the pulp or increase the sensitivity of dentinal tubules. One of the common dental problems is loss of enamel or cementum, which stimulate the nerve ending in or near the pulp and manifested as pain sensation. Aim of the study: This study had done to evaluate the effects of 980nm diode Laser in diameters reduction of exposed dentinal tubules analyze the results and morphological changes of irradiated dentine surface by FE-SEM (field emission scanning electron microscope) analysis. Material and Method: Thirty-nine human extracted impacted 3rd molar teeth were tested in this study and divided into control Group (N=15), pilot study (N=9) and study group (N=15). The study group irradiated with 980nm diode Laser to the occlusal surface of the teeth after the application of 17% EDTA (Ethelyn diamine tetra acetic acid) for smear layer removal. The intra-pulpal temperature recorded for every second and monitored for 120s from the first second of irradiation by a thermometer (prośket MT-1820, 1st Edition, 2016, Taiwan), for detection the recovery time of initial tooth temperature. FE-SEM analysis to all teeth (control, pilot and study groups) for assessment the morphological changes after surface irradiation. Results: FE-SEM analysis to the irradiated surface show significant reduction in diameters of the exposed dentinal tubules irradiated by 980nm diode Laser. Conclusion: The selected parameters (1.5W/10s, 276.3W/cm2) were able to seal exposed dentinal tubules without any sign of cracks or fissures. Suggestion: The parameters used with this study (1.5W, 10s, 276.3W/cm2) can be utilize in the future treatment protocol to the management of dentinal hypersensitivity.

Dentin Hypersensitivity Management Using Herbal Products: A Systematic Review

Introduction: Dentin hypersensitivity is a common and clinically significant issue, that many clinicians come across. There is currently a variety of available treatments. Over the past years, the use of herbal products in the medical and dental field has increased. The aim of this systematic review was to assess if the use of herbal products is more effective than conventional products, which are currently being used, in the management of dentin hypersensitivity. Methods: A systematic electronic search was performed in MEDLINE-PubMed, Scopus, and Web of Science up to December 2022. The quality of studies was assessed using the Risk of Bias tool version 2. Results: A total of 2325 publications were identified, and 10 studies fulfilled all the inclusion criteria. Only randomized controlled trials addressed the management of dentin hypersensitivity using herbal oral products, while fulfilling the inclusion criteria. Conclusion: Within the limitations of this review, it was concluded that herbal products may not provide superior benefits reducing the symptoms of dentin hypersensitivity when compared with conventional products. Future studies, properly designed, are needed to determine the safety and efficacy of herbal products.

In vitro evaluation of remineralizing agents on dentinal tubule occlusion: A scanning electron microscopic study.

Over the years, numerous treatment modalities have been researched for the management of dentinal hypersensitivity. A recent remineralizing agent containing a phase of amorphous calcium phosphate combined with fluoride has shown the ability to rapidly convert into biomimetic hydroxyapatite. This potential can be utilized in occluding the dentinal tubules for the treatment of hypersensitivity. The present study aims to compare the effectiveness of biomimetic hydroxyapatite-based tooth mousse and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) tooth mousse as desensitizing agents on dentinal tubule occlusion. The in vitro study design involved 30 prepared dentin specimens that were divided into three groups: Group A: negative control, Group B: CPP-ACP tooth mousse (GC tooth mousse™), and Group C: fluoride-doped amorphous calcium phosphate (F-ACP) tooth mousse (Curasept Biosmalto Denti Sensibili Tooth Mousse). The specimens were observed under a scanning electron microscope (SEM) and an attached energy-dispersive X-ray (EDX) spectroscopy apparatus after 1 week. The data were analyzed using Kruskal-Wallis test and post hoc Mann-Whitney test for intragroup and intergroup analysis, respectively. The SEM analysis of the F-ACP group showed statistically greater percentage of tubule occlusion (40.21%) compared to the CPP-ACP group (38.15%). EDX analysis of both F-ACP and CPP-ACP groups revealed calcium, phosphorus, carbon, oxygen, and silica with an additional fluoride element in the F-ACP group. In the present study, both remineralizing agents were able to occlude the dentinal tubules. Among the two, the F-ACP tooth mousse showed greater tubule occlusion, and therefore, appears promising as an upcoming remineralizing agent in the management of dentinal hypersensitivity.

Comparison of Vantej and Dente 91 Toothpastes in the Management of Dentin Hypersensitivity: A Randomised Clinical Trial

Introduction: Dentinal hypersensitivity is a prevalent and distressing dental condition characterised by acute, transient pain or discomfort arising from exposed dentin in response to external stimuli, such as variations in temperature, mechanical stimuli, or consumption of acidic or sweet foods. Dentinal Hypersensitivity (DH) impacts daily activities, such as eating, drinking, and oral hygiene practices. Dentifrices are commonly used in the treatment of hypersensitivity, as they relieve sensitivity by obstructing nerve pathways through the formation of compounds. Aim: The aim of the study is to evaluate and compare the efficacy of two types of desensitising toothpastes, Vantej and Dente 91, in treating DH. Materials and Methods: A randomised controlled clinical trial was conducted with 40 patients who had a minimum of two hypersensitive teeth. The clinical investigation took place in a dental set-up in Bhubaneswar, Odisha, from July to August 2022. The patients were randomly allocated to two groups (20 in each group) in a 1:1 ratio for the Vantej and Dente 91 groups. Over a four-week period, the patients were instructed to use the prescribed toothpaste twice daily. DH assessment techniques included a Verbal Response Scale (VRS), air blast stimulation, and cold stimulation, both at baseline and after the four-week duration. Statistical analyses were performed using the Mann-Whitney U test and Wilcoxon signed-rank test, with the significance level set at p&lt;0.05. Results: The fourth-week scores compared to baseline scores for the verbal scale, air blast stimulus, and cold sensitivity methods in both groups showed a reduction in DH. In the inter group comparison, the Dente 91 group exhibited greater effectiveness compared to the Vantej group, with a significant reduction in VRS (p=0.02) and air blast stimulus (p=0.01), but not in cold sensitivity (p=0.09). Conclusion: Both Vantej and Dente 91 toothpastes significantly reduced dentinal hypersensitivity. However, the percentage reduction was higher in the latter group, suggesting more effective management of DH. Dente 91 could be considered a promising alternative to the existing over-the-counter desensitising toothpastes.

Twelve-Month Follow-Up of Different Dentinal Hypersensitivity Treatments by Photobiomodulation Therapy, Nd:YAG and Nd:YAP Lasers.

In this retrospective study, data for three different laser-assisted approaches for the management of dentinal hypersensitivity (DH) was collected (n = 920 teeth). In total, 387 teeth were treated with photobiomodulation (PBM) therapy with 660 nm red light laser (PBM group), 327 were treated with the Nd:YAG laser (1064 nm) and 206 were treated with the Nd:YAP laser (1340 nm). To assess the effectiveness of each treatment, a visual analogue scale (VAS) was used, where zero represented no pain at all and ten represented the greatest pain. VAS was used before (T0), immediately after (T1), one week after (T2), four weeks after (T3), six months after (T4) and one year after treatment (T5). Means and standard deviations of VAS at different follow-up times were calculated. Values were compared within and between groups. Statistical significance was considered to be achieved when p-value was less than 0.05. Confidence level was proposed to be 99% with a P value lower than 0.001. Within groups, a statistically significant reduction was obtained when the mean value of VAS at T0 was compared with T5. At T5, the PBM group had the highest reduction of VAS (with mean value of 0), while the Nd:YAG and Nd:YAP groups had scores of 1.065 ± 0.674 and 4.665 ± 0.674, respectively. Conclusion: this retrospective study showed that PBM therapy and irradiation with Nd:YAG and Nd:YAP lasers are effective in managing DH pain. However, PBM therapy was the only procedure that showed complete pain relief at six and twelve months after treatment.

Clinical Evaluation of the Use of Desensitizing Agents in the Management of Dentinal Hypersensitivity

Dentinal hypersensitivity represents one of the most widespread dental problems and symptoms in the general population. It mainly affects the age group between 18 and 65 years old, presents an incidence of 35%, and may negatively affect the oral health-related quality of life of these patients. This longitudinal study aims to measure dentinal hypersensitivity in adult patients after the use of domiciliary desensitizing devices. In this study, 52 patients were included (32 females and 20 males, mean age: 53 ± 9.4) At T0 (baseline), patients were instructed to use a desensitizing toothpaste and, at T1, 27 patients reported using sodium monofluorophosphate (1450 ppm) and arginine 8% product (product A), while 25 patients reported using a toothpaste containing n-HAp (nano-hydroxyapatite) in effective dose 2.25% and 0.15% fluoride (1500 ppm) (product B). The study was carried out through three follow up appointments, 14 days apart from one another (T1 and T2). Results showed that the air sensitivity test did not exhibit a significant difference between the time points (p &gt; 0.05), while a significant improvement of DH was recorded for tactile, osmotic, cold thermic, acid, and omni-comprehensive tests in both groups. Both desensitizing agents were effective in reducing DH for different stimuli.

Successful management of dentin hypersensitivity: A narrative review.

The prevalence of dentin hypersensitivity (DH) is increasing around the world. At least one in 10 individuals in the general population has been diagnosed with DH. It is a diagnosis that has significant negative effects on a person's oral health-related quality of life. This condition, which is characterized by sharp, short tooth pain in response to thermal, chemical, tactile, and evaporative stimuli, is more commonly seen in adults. DH has a tremendous impact on the social and financial aspects of patients and society at large. It is essential to recognize the factors that can contribute to a successful treatment outcome to guarantee the overall well-being of DH patients. The aim of this narrative review was to highlight strategies that can lead to successful DH treatment outcomes, along with current updates on DH mechanisms, treatment options, and the latest management approaches. A positive treatment outcome for DH requires a concerted effort from both the patient and the dental practitioner. Highly motivated patients and dental practitioners with sound knowledge of DH diagnosis and available treatment options will ensure successful long-term improvement of DH symptoms.

Effectiveness of Diode Laser Compared with Sodium Fluoride Varnish in Management of Dentin Hypersensitivity Associated with Gingival Recession

Using laser for treatment of dentin hypersensitivity (DH) have recently shown promising results and better immediate reduction in pain scores. However, its efficacy and mechanism of action is controversial. Thus, this study aimed to evaluate the effectiveness of diode laser compared with sodium fluoride varnish in treating DH in patients with gingival recession. Eighteen patients with Miller’s class I and class II gingival recession and hypersensitivity in at least two non-adjacent teeth were included in the study. Test surfaces (n = 25) were treated with diode laser, whilst control surfaces (n = 23) were treated with 5% sodium fluoride varnish. Visual Analogue Scale (VAS) scores were recorded for air and tactile stimulus for both groups at baseline, 15 min, 1 month and 3 months post-treatment. Results showed significant (p &lt; 0.05) reduction in VAS scores at 15 min, 1 month and 3 months compared with baseline in both test and control surfaces, with no significant intergroup differences. However, the percentage reduction in DH was more in laser at all evaluation periods. The use of diode laser and sodium fluoride varnish showed good immediate and prolonged results. Further studies are needed to come up with more effective treatment methods.

Comparative Evaluation of the Outcome of Diode Laser 810 nm with 8% Arginine and Calcium Carbonate for the Management of Dentinal Hypersensitivity

Comparative Evaluation of the Outcome of Diode Laser 810 nm with 8% Arginine and Calcium Carbonate for the Management of Dentinal Hypersensitivity