Desensitizing Effect of Sodium Bicarbonate Mouthwash in Patients with Dentinal Hypersensitivity–A Clinical Trial| Stephy Publishers
Introduction
Dentin
Hypersensitivity (DH) is a major complaint of the general population. Reports
have indicated the incidence of DH is 4 to 74 percent of the population.1 It poses a challenge for clinicians because its
presentation is ambiguous with no specific signs.2 Dentists rely on the patient’s clinical and dietary
history and a thorough intraoral examination using thermal and tactile stimuli.
Dentin receptors have a unique feature of eliciting pain as a response to any
environmental stimulus. The sensory response in the pulp cannot differentiate
between heat, touch, pressure or chemicals, because they lack specificity.
Irrespective of the type of stimulus, the patient perceives any stimulus as a
pain.3 Hence careful examination should be
performed to rule out other condition s which present in a similar manner to
DH. These include cervical caries, leakage around and fractured restorations,
cracked tooth and palatogingival grooves.4 Continual
research takes place to check the efficacy of desensitizing agents to treat DH
as no treatment modality is widely accepted as the gold standard.
Various terminologies
have been used for this condition including dentin sensitivity, tooth
sensitivity, cervical dentin sensitivity, cemental sensitivity or
hypersensitivity and tooth hypersensitivity. The term hypersensitivity
represents a pathological situation in which treatment of DH is essential.5 The incidence of DH in most of the population groups
ranges from 10 to 30 percent of the general population with an age range of 20
to 50 years. The peak prevalence is reported at the end of the third decade of
life and decreas es during the fourth and fifth decades. This may be explained
by the decrease in the permeability of dentin and neural sensitivity, natural
desensitization due to sclerosis and secondary dentin formation with increasing
age. Even the prolonged use of fluoridated dentifrices may cause occlusion of
dentinal tubules resulting in decreased sensitivity.4 The higher incidence of DH as seen in females than males
can be attributed to hormonal influences and dietary habits, although the
results are statistically insignificant. DH may involve a single tooth, group
of teeth, area of the mouth or it can be generalized. The most commonly
affected teeth are premolars and canine of both arches, followed by maxillary
first molars and incisors reported being the least sensitive. Cervical regions
on the facial aspect are the most commonly involved areas.4
Various theories and
mechanisms responsible for DH have been proposed for over a century. Gysiin
1900 attempted to explain the hypersensitivity of teeth and described fluid
movement in the dentinal tubules.6 The hydrodynamic
theory was proposed by Brännström in 1963.7 This is the most
widely accepted theory which is based on fluid movement inside the dentinal
tubules as a response to various stimuli. Any change in temperature or physical
or chemical changes create a disturbance in the fluid which is present inside
the dentinal tubules. This movement of the fluid acts as a stimulus for
baroreceptors causing neural discharge which is ultimately perceived as a DH or
pain by the patient. Stimuli like cold, drying, hypertonic chemicals and evaporation
cause outward movement of the dentinal fluid (i.e. away from the dentin-pulp
complex) whereas heat or mechanical stimulation causes fluid to flow towards
the pulp.
To read more #Dental #OralDisorder
https://www.stephypublishers.com/sojdod/fulltext/SOJDOD.MS.ID.000502.php
More #openaccessjournals
https://www.stephypublishers.com/
Introduction
Dentin
Hypersensitivity (DH) is a major complaint of the general population. Reports
have indicated the incidence of DH is 4 to 74 percent of the population.1 It poses a challenge for clinicians because its
presentation is ambiguous with no specific signs.2 Dentists rely on the patient’s clinical and dietary
history and a thorough intraoral examination using thermal and tactile stimuli.
Dentin receptors have a unique feature of eliciting pain as a response to any
environmental stimulus. The sensory response in the pulp cannot differentiate
between heat, touch, pressure or chemicals, because they lack specificity.
Irrespective of the type of stimulus, the patient perceives any stimulus as a
pain.3 Hence careful examination should be
performed to rule out other condition s which present in a similar manner to
DH. These include cervical caries, leakage around and fractured restorations,
cracked tooth and palatogingival grooves.4 Continual
research takes place to check the efficacy of desensitizing agents to treat DH
as no treatment modality is widely accepted as the gold standard.
Various terminologies
have been used for this condition including dentin sensitivity, tooth
sensitivity, cervical dentin sensitivity, cemental sensitivity or
hypersensitivity and tooth hypersensitivity. The term hypersensitivity
represents a pathological situation in which treatment of DH is essential.5 The incidence of DH in most of the population groups
ranges from 10 to 30 percent of the general population with an age range of 20
to 50 years. The peak prevalence is reported at the end of the third decade of
life and decreas es during the fourth and fifth decades. This may be explained
by the decrease in the permeability of dentin and neural sensitivity, natural
desensitization due to sclerosis and secondary dentin formation with increasing
age. Even the prolonged use of fluoridated dentifrices may cause occlusion of
dentinal tubules resulting in decreased sensitivity.4 The higher incidence of DH as seen in females than males
can be attributed to hormonal influences and dietary habits, although the
results are statistically insignificant. DH may involve a single tooth, group
of teeth, area of the mouth or it can be generalized. The most commonly
affected teeth are premolars and canine of both arches, followed by maxillary
first molars and incisors reported being the least sensitive. Cervical regions
on the facial aspect are the most commonly involved areas.4
Various theories and mechanisms responsible for DH have been proposed for over a century. Gysiin 1900 attempted to explain the hypersensitivity of teeth and described fluid movement in the dentinal tubules.6 The hydrodynamic theory was proposed by Brännström in 1963.7 This is the most widely accepted theory which is based on fluid movement inside the dentinal tubules as a response to various stimuli. Any change in temperature or physical or chemical changes create a disturbance in the fluid which is present inside the dentinal tubules. This movement of the fluid acts as a stimulus for baroreceptors causing neural discharge which is ultimately perceived as a DH or pain by the patient. Stimuli like cold, drying, hypertonic chemicals and evaporation cause outward movement of the dentinal fluid (i.e. away from the dentin-pulp complex) whereas heat or mechanical stimulation causes fluid to flow towards the pulp.
To read more #Dental #OralDisorder
https://www.stephypublishers.com/sojdod/fulltext/SOJDOD.MS.ID.000502.php
More #openaccessjournals
https://www.stephypublishers.com/
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