Advances in the treatment of root dentine sensitivity: mechanisms and treatment principles

Abstract

There are limited studies specifically on the prevalence of root dentine hypersensitivity or root sensitivity per se; most of the published information relates to the prevalence of dentine hypersensitivity (DH). Several investigators have suggested that there may be some justification on the basis of differing pathologies of distinguishing between those individuals complaining of DH who have relatively healthy mouths with those who complain of DH as a result of periodontal disease and/or its treatment. It is generally recognized that those individuals diagnosed with periodontal disease and having periodontal therapy including scaling procedures may have a higher prevalence than those who present with healthy mouths and evidence of gingival recession. The availability of a vast array of treatments, however, would indicate either that there is no one effective desensitizing agent for completely resolving the discomfort or that the condition, due to its highly subjective nature, is difficult to treat irrespective of the available treatment options. The importance of implementing preventative strategies in identifying and eliminating predisposing factors in particularly erosive factors (e.g. dietary acids) cannot be ignored if the practitioner is going to treat this troublesome clinical condition successfully. This paper will review the published literature and provide information as to the prevalence of the condition, its etiology and causal factors, as well as recommendations for the clinical management of the problem.

Clinical Efficacy of Fluoride Varnish and Low-Level Laser Radiation in Treating Dentin Hypersensitivity

“…In this respect, varnishes containing a high concentration of fluorine are the most widely used products that provide highly satisfactory results. The short-term efficacy of fluoride varnish has been demonstrated in the literature (4,6,17,18), but long-term results have been questioned because saliva may dissolve calcium fluoride crystals and pain from sensitive teeth will reappear (6). In the present study, fluoride varnish resulted in a satisfactory reduction of CDH to both tactile (83.1%) and thermal-evaporative stimuli (81%) (Fig.…”

“…Different ways of fluoride administration for the treatment of CDH have been reported (6). In this respect, varnishes containing a high concentration of fluorine are the most widely used products that provide highly satisfactory results.…”

“…In general, the multiple treatment options for CDH available in the literature leave professionals confused, a fact resulting in a lack of confidence to treat it efficiently (6,7). Within this context, the objective of the present clinical study was to compare the use of low-level galliumarsenide-aluminum (GaAlAs) laser radiation and fluoride varnish (Fluorniz ® ) for the treatment of CDH.…”

“…Recent studies have obtained satisfactory results with laser radiation therapy. This treatment provides immediate results considering its analgesic and longlasting action due to its ability to stimulate formation of secondary dentin (6).…”

Strontium effects on root dentin tubule occlusion and nanomechanical properties

“…Pashley suggested KNO 3 works by potassium salt reducing the excitability of intradental nerves by altering the extracellular potassium concentration [11]. Occlusion agents are less widely employed but can be favored over nerve depolarization primarily due to the rapid onset of pain reduction associated with the occlusion approach [12]. Several chemicals such as fluoride help to deliver Ca and P into tubules [13], and strontium salts, either strontium chloride or strontium acetate, are found to be very effective in reducing dentin hypersensitivity [14].…”