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What is Dentin Hypersensitivity?

Imagine waking up in the morning, taking the first sip of your coffee, and instead of feeling that refreshing warmth, you feel sharp pain throughout your teeth. As you try to balance the warmth with a cold glass of water, the pain only intensifies. If you experience it regularly, you are likely to have dentin hypersensitivity. 

Dentin hypersensitivity is a condition that can turn your regular daily activities, like having a hot beverage, a sweet treat, or a soda into moments of discomfort. The surprising part, your teeth look just fine when you look in the mirror.

In this article, we will discuss dentin hypersensitivity, its causes, and how to manage it. So stay tuned!

Dentin Hypersensitivity

To better understand dentin hypersensitivity, let’s first understand normal tooth anatomy. Your tooth normally comprises four main parts. 

  • Enamel, is the hardest outermost part covering the crown part of the tooth.
  • Dentin, that lies under the enamel and protects the underlying pulp.
  • Pulp, the sensory and nutritive part, contains nerves and blood vessels.
  • Cementum, avascular part covering dentin and pulp inside the root.

Dentin, normally protected by the enamel in the crown portion and the cementum in the root portion, becomes hypersensitive when exposed due to enamel erosion, gum recession, tooth wear, or toothbrush abrasion. 

Dentin hypersensitivity is a condition that causes sharp, transient pain in response to non-toxic stimuli, like hot, cold, sweet, or acidic foods. Visually, the teeth look fine, and the pain cannot be explained as arising from any other dental disease or pathology. 

What Causes Dentin Hypersensitivity?

Several stimuli can trigger dentin hypersensitivity, such as, 

  • Hot, cold, sugary, or acidic foods and drinks
  • Tactile sensations like tooth brushing, scratching, flossing, or scaling
  • Cold air

But how are these regular daily activities causing those sharp jolts of pain? Well, to answer that, researchers have come up with three theories. These theories, individually or collectively, can be considered the causative agents behind it. 

  • Direct Innervation Theory
  • Odontoblast Receptor Theory
  • Hydrodynamic Theory

Direct Innervation Theory:

The dental pulp is considered to be the only part of the tooth with nerves so how does dentin feel pain if it doesn’t have nerves? 

The direct innervation theory states that some nerve endings from the pulp run into the dentin all the way to the dentin-enamel junction (surface of exposed dentin). Hence, when mechanically stimulated, these nerve endings get innervated directly and cause pain.

Odontoblast Receptor Theory:

dentin is formed by cells called odontoblasts, which after forming dentin, rest at the dentin-pulp junction and extend their processes throughout the dentin. 

The odontoblastic receptor theory states that odontoblasts can serve as sensory receptors and transmit painful sensations to the nerves in the pulp. 

Hydrodynamic Theory:

Dentin contains small canal-like structures called dentinal tubules containing a fluid called dentinal fluid. 

According to the hemodynamic theory, when a stimulus comes in contact with exposed dentinal tubules, the fluid inside them moves. This movement is felt by nerve endings inside the pulp, causing the painful sensation of dentin hypersensitivity. This theory is most widely accepted today. 

What are the Symptoms of Dentin Hypersensitivity?

When patients with its symptoms are evaluated pain is found to be the only consistent symptom. The intensity varies from mild discomfort to severe stabbing pain. The pain is quick in onset, sharp in character, and short-lived. 

However, some experts argue that ‘pain’ might not accurately describe the sensations felt in hypersensitivity. It is more of a feeling of discomfort and a complex experience triggered by various factors.

How to Diagnose it?

Since this hypersensitivity does not manifest physically in the oral cavity, most people tend to ignore it. When the pain intensifies, they report it to their dentist, but until then, dentin exposure factors exacerbate.

For appropriate treatment, accurate and timely diagnosis is of prime importance. A dentist will carry out a detailed medical and dental history and examination to rule out other conditions having similar symptoms, like,

  • Early caries
  • Cracked or fractured teeth
  • Faulty restorations
  • Pulp hyperemia
  • Sensitivity after tooth whitening
  • Periodontal disease

Your teeth will be closely inspected for signs of attrition, chemical erosion, toothbrush abrasion, abfraction, or gum recession. While examining, your dentist might perform some chairside tests, such as, 

  • A gush of air
  • Tactile probing
  • Thermal tests 
  • Biting on a stick
  • Transillumination test

If hypersensitivity is suspected, you will be asked questions about the onset of symptoms, triggering factors, extent and intensity of pain, etc. 

How to Prevent it?

Before looking for hypersensitivity treatment options, one should eliminate habits that cause it. Here are some dentin hypersensitivity self-care tips;

  • Overzealous brushing – Use toothbrushes with soft bristles and gently brush over all surfaces of your teeth.
  • Parafunctional habits – If you have a habit of clenching or grinding your teeth, get that treated first to prevent attrition.
  • Bite problems – Bite irregularities like premature occlusal contacts should also be treated orthodontically or with the help of mouthguards
  • Acidic food – Avoid acidic foods and beverages. Also, do not brush immediately after consuming them. Brushing post-vomiting can also erode your enamel.

How to Treat it?

To treat dentin hypersensitivity, your dentist might initially suggest some at-home desensitizing agents like toothpaste, dentifrices, mouthwashes, or chewing gums. These agents, desensitize nerve endings and occlude dentinal tubules. 

However, these at-home modalities take time. If you want instant relief, your dentist will carry out the following in-office procedures.

  • Fluoride application – fluoride decreases the permeability of dentin.
  • Oxalates – they too decrease permeability and occlude the tubules.
  • Adhesive resins – seal dentinal tubules.
  • Bioglass – infiltrate and calcify dentinal tubules.
  • Laser – occludes the tubules, solidifies the proteins inside, and stops the motion of the fluid. 

Conclusion

Managing dentin hypersensitivity is not just about alleviating pain but also protecting your teeth from any risks that may follow. Regular dental care, cleanings, and check-ups can help you diagnose and manage dentin hypersensitivity in the early stages. 

Take the first step towards addressing your dental health concerns today. Our qualified dental experts in Blairstown, NJ and Newton, NJ, are ready to tackle all your dental needs in a comfortable environment. Book your appointment now with dentists in Newton, NJ, and don’t let sensitivity hold you back!



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