Amelia Grant

Sensitive teeth are a common condition found in more than half of people. It occurs when eating sour, sweet, salty, cold, or hot food or while brushing your teeth. This causes a feeling of discomfort, leads to a decrease in the quality of life, and requires complex treatment. 

What are the Causes of Dental Sensitivity?
The causes of pathology are different. By origin, they can be related to:
- Loss of hard tissues
- Periodontal disease (bone and gum)

Pain occurs due to a violation of the integrity of the enamel and demineralization of the dentin. The destruction is due to the following:
- Generalized tooth decay
- Injuries leading to cracks, chips
- Increased abrasion
- Destruction of the cement of the neck of the tooth and root
- Wedge-shaped defects
- Cracks and erosion of the outer layer of enamel
- Inflammatory and degenerative periodontal disease
- Too hard toothbrush
- Poor oral hygiene
- Periodontal treatment – removal of supra- or subgingival stones;
- The action of acids (gastric with esophageal reflux or from food, drink, drugs)

Increased sensitivity may also result from the following:
- Wearing braces and orthodontic systems
- The effect of galvanization caused by metal structures and crowns
- Complications after extensive restorations

Pain is caused by thermal, chemical, and mechanical excitation of nerve endings, abundantly penetrating the inner part of the tooth – the pulp. It is protected from damage by dentin and enamel. In the subgingival part, the outer protective layer is represented by cement. To protect the nerve of the tooth, the thinnest tubules – dentinal tubules – are designed. They begin in the pulp and end at the border of the dentin-enamel junction.

The cavities are filled with a nutrient liquid with organic substances – dental liquor. When the outer barrier is destroyed, irritants influence the liquid medium. A change in the composition or pressure of the CSF causes a response from the processes of the nerve bundle. The signal in the form of pain sensations of varying severity enters the central nervous system.

Hypersensitivity can be:
- Generalized - spread to ½ or more teeth of one or both jaws
- Local - cover from 1 to 8 units of dentition

Unpleasant sensations can be strong or weak. It depends on individual tolerance (pain threshold level), and physical and emotional factors. In some cases, the symptoms may disappear on their own due to natural remineralization, leading to the closure of the pores. But the symptoms can return after a while due to the destruction of the protective film by the acid of food and drinks, which explains the cyclical nature of the disease.

Ignoring the problem can lead to the development of various forms of acute or chronic pulpitis. If signs of pathology appear, you should immediately contact your dentist, who will tell you in detail what to do if your teeth become sensitive and develop a therapy strategy.

How to Treat Tooth Sensitivity?
Modern therapies include:
- Medicines
- Physical therapy
- Dental treatment of the dentogingival system

The strategy should include a set of methods and technologies.

Medicines have a symptomatic effect – eliminate soreness. The doctor prescribes one of the types of analgesics:
- Affecting the central nervous system – sedatives, analgesics, psychotropic drugs
- Weakening nerve conduction - local anesthetics

Desensitizing agents. They differ in the following:
- method of action
- method of application – in the clinic or at home
- chemical composition
- reversibility
- release form - gel, toothpaste, rinses, varnishes, composite materials, dentin adhesives, etc

Their purpose is to stop the hydrodynamic mechanism:
- Blockage of pores and microcracks by substances of desensitizers
- Reduction of the cavity (obliteration) of the tubules by mineralizing complexes

Desensitizing agents used in the treatment of sensitive teeth include:
- strontium chloride
- potassium nitrate
- sodium citrate
- sodium fluoride
- sodium monofluorophosphate
- tin fluoride, etc

Their operation is based on the ability of phosphates to deposit on the walls of the tubules and reduce the susceptibility of nerve fibers to irritation. Some therapeutic agents contain abrasive particles - silicate, carbonate, calcium phosphate, etc. They can also clog micro-holes.

The combination of potassium ions with fluorides and abrasives, which is part of the structure of toothpaste, effectively reduces the susceptibility of dentin to external pathogenic agents.

Physical therapy
To increase the effectiveness of desensitizers, electrophoresis is used. Microcurrents increase the permeability of materials and facilitate the penetration of macro- and microelements into the tooth structure. In the program for the elimination of hyperesthesia, the following are prescribed:
- Magnetotherapy
- Low-intensity laser reflexology
- Darsonvalization

Laser is also popular in the relief of symptoms of dentin hypersensitivity. High-intensity laser radiation seals pores without changing the structure of the pulp and hard shells - enamel and dentin.