Table of Contents

Endodontics
Periodontics
Restorative

Inside Dentistry

May 2007, Volume 3, Issue 5
Published by AEGIS Communications

Using Sensodyne® To Alleviate Dentin Hypersensitivity

Dentin hypersensitivity is a condition that affects 1 in 5 adults in the United States, and 42% of those suffering do not seek treatment from their dental professional.1 With a simple series of questions, dental professionals can detect dentin hypersensitivity and recommend a treatment that is effective and reliable.

WHAT IS DENTIN HYPERSENSITIVITY?

Dentin hypersensitivity is defined by a short, sharp pain arising from exposed dentin in response to stimuli that is not due to any other form of defect or pathology. The pain, described as transient, is caused by stimuli that are typically thermal, evaporative, tactile, osmotic, or chemical in nature. Although any tooth can be affected by dentin hypersensitivity, reports typically conclude that the highest incidences of pain are found on the canines and premolars.2

According to the hydrodynamic theory, which is based on the flow of fluid found within the dentinal tubules, when a stimulus is applied to a tooth surface having open or patent dentinal tubules, the fluid moves (Figure 1).2 This changes the pressure on the nerve endings within the pulp. Depending on the particular stimulus, the fluid may flow either away from or towards the pulp. This change in fluid flow creates a painful response for the patient. Instead of seeking treatment, patients often will avoid certain drinks, foods, and practices. They change their behavior and live with the pain.

Other triggers of dentin hypersensitivity include cosmetic tooth whitening or bleaching, periodontal disease, bruxism, and gingival recession.

DIAGNOSING DENTIN HYPERSENSITIVITY

Documented research determined that patients avoid telling their dental professionals they are experiencing sensitivity, often because they are not aware that easy and effective treatment options are available.3 Recommendations for proactively diagnosing the problem include:

Ask open-ended questions.
Be proactive in asking detailed questions about dentin hypersensitivity; enlighten patients that the sensitivity could have occurred earlier today, yesterday, or last week.
Inquire about a patient’s reaction to a specific hot or cold food and/or beverage, or reaction to sweet or sour foods and/or beverages.

If the patient’s answers to any of these questions indicate they experience sensitivity, a review of the patient’s habits may reveal improper brushing techniques or other habits contributing to the sensitivity.

After the dialogue, perform a thorough clinical examination to exclude secondary causes of dentin hypersensitivity such as dental caries, pulpitis, cracked- or chipped-tooth syndrome, and/or changes in restorations.

SIMPLE, EFFECTIVE TREATMENT

After all of the relevant data has been collected, and treatment plans are created with acceptance by the patient, the necessary course of therapy should be initiated to achieve relief of the patient’s dentin hypersensitivity. The most common and professionally endorsed treatment for the relief of dentin hypersensitivity is the use of a desensitizing toothpaste containing 5% potassium nitrate. Data support that the use of a dentifrice containing 5% potassium nitrate and sodium fluoride significantly reduces dentin hypersensitivity pain and provides caries protection.4

Sensodyne® toothpaste (GlaxoSmithKline, Research Triangle Park, NC) contains the maximum amount of potassium nitrate allowed under the Food and Drug Administration (FDA) monograph. The mode of action for a toothpaste containing 5% potassium nitrate is that the potassium nitrate depolarizes the nerves that innervate the dentinal tubules. Potassium ions from the potassium nitrate diffuse through the dentinal tubules to the nerve endings in the pulp cavity and stop the repolarization of the nerve fibers. With the nerve now in a resting state, the pain cycle is broken and the patient’s pain is relieved.

Patients should be instructed to brush with Sensodyne at least twice a day, every day. The desensitizing effect of the toothpaste builds over time, and noticeable results are felt within 2 weeks. Sensodyne toothpaste can be used as the patient’s regular toothpaste. Sensodyne offers an extended line of formulas to satisfy patients’ desire for everyday toothpaste benefits.

TREATING SENSITIVITY IN WHITENING PATIENTS

Sensitivity is the most common side effect of professionally dispensed and over-the-counter (OTC) whitening treatments. In fact, data suggests that up to 75% of tooth-whitening patients may experience sensitivity.5 Research shows that as many as 41% of dental professionals recommend that patients discontinue their whitening procedures to alleviate related sensitivity.6

What Causes Whitening-Related Sensitivity?

Sensitivity occurs when the chemical by-products of carbamide and hydrogen peroxide used in whitening treatment pass through the enamel and dentin and into the pulp.7 Companies manufacture dentist-dispensed and OTC whitening products containing peroxide (carbamide or hydrogen peroxide), which work to whiten tooth enamel.

New Data

A recent study,4 conducted in dental offices, demonstrated that patients who brushed with Sensodyne® Fresh Mint Toothpaste twice daily for 2 weeks before and 2 weeks during professional whitening treatment experienced significantly less sensitivity compared to a control group using regular toothpaste.

Patients brushing with Sensodyne were significantly more sensitivity-free during the first 3 days of their whitening treatment, which is typically when they experience the greatest degree of whitening-related sensitivity.

Study results revealed that those using Sensodyne were more satisfied with their whitening experience overall, and would be more willing to repeat whitening treatment in the future. Results were based on patient satisfaction surveys and diary entries.

Whitening results were not affected by the desensitizing toothpaste.

To reduce bleaching-induced sensitivity, dental professionals should recommend that whitening patients use Sensodyne twice a day for 2 weeks before and 2 weeks during whitening treatment. Recommending this brushing protocol can help patients be more comfortable during tooth whitening and help to reduce the number of patients who discontinue whitening treatment due to whitening-related sensitivity.

By routinely and proactively screening patients for dentin hypersensitivity, dental professionals can help to relieve a common, yet undertreated cause of dental pain. A desensitizing toothpaste, such as Sensodyne, is recommended as a first-line treatment because it is a painless, effective, and easy-to-apply treatment for the relief of dentin hypersensitivity.

References

1. Data on file, GlaxoSmithKline.

2. Addy M. Dentine hypersensitivity: new perspectives on an old problem. Int Dent J. 2002;52(5):367-375.

3. Kielbassa A. Dentine hypersensitivity: Simple steps for everyday diagnosis and management. Int Dent J. 2002;52(5):386-396.

4. Haywood VB. Dentine hypersensitivity: bleaching and restorative considerations for successful management. Int Dent J. 2002;52(5): 376-385.

5. Data on file, GlaxoSmithKline.

6. Haywood VB. Dental erosion and its impact on dentin hypersensitivity. Available at: www.agd.org/library/articles/?ArtID=91. Accessed April 10, 2007.

7. Data on file, GlaxoSmithKline.

For more information, contact:
GlaxoSmithKline
Phone: 888-825-5249
Web: www.dental-professional.com

DISCLAIMER

The preceding material was provided by the manufacturer. The statements and opinions contained therein are solely those of the manufacturer and not of the editors, publisher, or the Editorial Board of Inside Dentistry. The preceding is not a warranty, endorsement, or approval for the aforementioned products or services or their effectiveness, quality, or safety on the part of Inside Dentistry or AEGIS Communications. The publisher disclaims responsibility for any injury to persons or property resulting from any ideas or products referred to in the preceding material.

Figure 1 Hydrodynamic theory. A) Resting outward pressure B) Flow in response to stimuli.