The oversensitivity of teeth insufficiently diagnosed, insufficiently treated?

The oversensitivity of teeth is defined as a different clinic entity which is manifested through an acute pain and it doesn’t persist for a long period at the level of the dentine which is exposed. This pain is like a response to the thermic, tactile, chemical or osmotic stimulus. This pain cannot be explained by another imperfection of the dentine or by the pathology associated. The majority of the unhealthy persons are between 20 and 50 years. The monitoring studies shows that 36% from the unhealthy patients suffer from oversensitivity of the teeth, especially the women compared to men.
The existing data suggest an association between the teeth brushing, withdrawal of the gums and the hipersensitivity of teeth. The hipersensitivity produced by the bacterial plaque seems to be a distinct illness. The combination between the abrasive and the erosive factors which action on the dentine detrmine the tubes openning and the accelerated loss of the dentine. Even if the incidence of the illness is great, the majority of patients don’t know that this is easy to be diagnosed and is easy to be treated. At the present moment, the responsibility of people education in what concerns this illness and its therapeutic approach is on the medical comunity shoulders.
The epidemiological data prove us that the hypersensitivity of the dentine is insufficient diagnosed and insuffiecient treated. The hypersensitivity of the dentine has a much more importance compared to that estimated by the doctor until now. The check of the dentine sensitivity is a part of the routine clinical exam performed by the doctor in order to avoid the practical underevaluation of this illness.

Causes and Risk Factors

The main not healthy modification – the exposure of the teeth fosses - may be the result of one abrasion process at the teeth level.
The erosion is a process of chemical dissolution of the tooth under the action of the acid substances and the gastric sap. It is known at present that the gastro-esophagus low tide determines a teeth erosion. The gastric sap may get into the mouth cavity in a pasive way in different clinical situations as the illness of gastro-esophagus low tide, anorexia, bulimia and chronic dipsomania. This mechanism is associated to the most severe cases of teeth erosion: alimentary acids and the professional exposal to acids.
The abrasion is a process of the tooth destruction with the help of physical factors, a phenomenon which is most associated with cervical injuries. The abrasion is determined by the direct contact between teeth. The compromise of teeth structure is not probable during the performance of the normal functions of teeth. The prolonged contact between teeth is met at the patients with bruxism and it represents the main cause of the teeth abrasion of people.
The abrasion seems to be the most representative factor which operates in synergy with other mechanisms in the way that they contribute to subsatntial destruction of the smalt and of the dentine and it has as a consequence the openning of the teeth channels. The retraction of the gum and also the smalt loss produce the dentine exposure.
The hypersensitive dentine presents 8 times more teeth channels at its surface. Even more, the channels diameter is doubled compared to the normal dentine, in this way light stimulus determines an impresive increase of the dentine flux and as a consequence of the associated pain.
The hypersensitivity of the the dentine can be prevented through simple gestures made by the doctor and made by the patient too. The doctor will avoid the agressive utilisation of the instruments at the teeth suface during the professional ultrasonic scaling and during other operations performed such as the whitening or the teeth abrasion; he’ll avoid the destruction of the biological barrier when assembling the tooth crown; he’ll use the agents to decrease the teeth sensitivity when performing a whitening or when performing a treatment for the cronical hypersensitivity with the help of the impress spoon; he’ll avoid to place the margins of the tooth crown under the gum because the bacteriological plaque may be retained; he’ll periodically oversee the patient in what concerns the erosion and the abrasion of the teeth. The patient will use too an accurate brushing teeth technique, he’ll follow the instructions of using special toothpaste for the sensitivity, he’ll avoid the usage of harsh toothbrush and the immediate brushing of teeth after the food consume and acid drinks, the patient will avoid the excessive usage of the cleanning between teeth methods and the brushing with an exaggerate pression for a long period of time and also he’ll avoid the usage of the toothpick at the gums level.
The hypersensitivity of the dentine is much more frequent met and the patients with a parodontal illness, as a consequence of the ilness and also as a consequence of the treatment applied (including the scaling, polishing and the surgical pulling out of the parodontal sacs).

The clinical advantages are multiple: the procurement of the hypersensitivity controll in a simple and an easy manner to apply, it has a good reply after the treatment, the avoidance of the restoring methods.
The clinical practise shows us that the usage of a toothpaste special for sensible teeth based on potassiun nitrate give good results at the majority of the patients. Potassiun nitrate may be associated to natrium fluorine in order to protect for a long time the teeth. When the restoring methods are needed for the teeth integrity rellocation the association between the two substances together with special toothpaste for the teeth that are sensible is favourable for the pain removal in a rapid manner.
The usage of the teeth whitening at home contributes to the increase of the hypersensitivity of the dentine. The clinical studies shows that the frequency of the hypersensitivity of the dentine increases at this type of users at 55% - 75%. The hypersensitivity of the dentine may be reduced if special toothpaste for sensible teeth are used before the teeth exposal to whitening agents