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At least 487 records · Page 27Linked to original sources
PubMed2002

Understanding and managing dentin hypersensitivity.

Dental hygienists frequently encounter clients who present with one or several sensitive teeth. These clients often rely on the dental hygienist to help determine the cause and to provide supportive treatment to relieve their discomfort. Therefore, it is essential for dental hygienists to fully understand the complexity of dentin sensitivity, be well informed about treatment approaches, and have an appreciation of the difficulties inherent in designing and conducting clinical hypersensitivity trials. Difficulties in designing hypersensitivity research have precluded a definitive answer concerning a best treatment approach. The purpose of this course is to present dental hygienists with current information about the pain of sensitive teeth and the associated differential diagnosis. The theory of pain transmission, etiology of dentin sensitivity, professional and self-care treatment modalities, and natural remission of tooth sensitivity will be discussed. Tooth and pulp biology will be reviewed as a means of explaining treatment and management approaches. At completion of this course, as measured by a post-test, participants with be prepared to apply the knowledge gained to their evidence-based practice to positively impact the oral health of their clients.

Dental Hygienists↗
PubMed2002

A systematic review of the prevalence of root sensitivity following periodontal therapy.

OBJECTIVES: To systematically review the evidence on the prevalence of root sensitivity following periodontal therapy. MATERIAL AND METHODS: Cross-sectional and longitudinal clinical studies were searched for in electronic databases, hand searched journals and through contact with authors directly. The screening and data extraction were conducted by several reviewers independently. The main outcome measure was prevalence of root sensitivity following periodontal therapy. RESULTS: The prevalence of root sensitivity was 9-23% before and 54-55% after periodontal therapy. An increase in the intensity of root sensitivity occurred 1-3 weeks following therapy, after which it decreased. CONCLUSIONS: It is concluded that there are insufficient randomized controlled trials to adequately address the stipulated question. However, based on the scarce evidence from only two studies, root sensitivity occurs in approximately half of the patients following subgingival scaling and root planing. The intensity of root sensitivity increases for a few weeks after therapy, after which it decreases. In clinical practice, it may be recommended that patients should be made aware of the potential for root sensitivity prior to treatment. In research, it may be recommended to conduct randomized controlled and prospective studies with both short and long follow-up periods. Furthermore, to investigate the effects and the relationship of root instrumentation with the aetiology of root sensitivity, the efficacy of preventive and therapeutic regimes for root sensitivity, and the incidence and severity of root sensitivity by subjective patient-reporting, and the response to different modes of stimuli. Protocols should follow the criteria used in dentine hypersensitivity studies.

Clinical Trials as Topic↗
PubMed1991

The effectiveness of sodium fluoride iontophoresis in patients with sensitive teeth.

This study investigated the use of iontophoresis in altering the sensitivity level of teeth that displayed thermal and tactile hypersensitivity. A total of 95 teeth were treated with an iontophoresis instrument. Forty-eight of these teeth were treated with a placebo of deionized water, and 47 were treated with a 2% sodium fluoride solution. Two of the 47 teeth receiving sodium fluoride had identical pretreatment and posttreatment sensitivity ratings, while 40 teeth (85.1%) demonstrated a reduction in sensitivity. Twenty-nine of the 48 teeth receiving the placebo demonstrated no change in sensitivity. All teeth receiving the placebo were re-treated with sodium fluoride. Forty-seven (97.9%) responded with reduced levels of sensitivity.

Chi-Square Distribution↗
PubMed1990

Accuracy in radiographic diagnosis: Dutch practitioners and dental caries.

The effective diagnostic accuracy of dentists is the missing link in models for calculating the optimal frequency for radiographic recall. The purpose of this study was to describe the accuracy of Dutch general dental practitioners using bitewing radiographs for the diagnosis and treatment of approximal caries in dentine. Practitioners from a 10 per cent (n = 444) national random sample were sent a set of simulated bitewings, a patient description and a diagnostic response form. The radiographs showed tooth surfaces with (n = 45) and without (n = 60) dentine caries. Microradiography of the sectioned teeth was used as a diagnostic reference standard. The participants were asked to diagnose dentine caries using a five-point certainty scale and decide if restorative treatment was indicated. The response was 62 per cent (n = 276). The area under a mean receiver operating characteristic curve for the practitioners was 88 per cent of the area representing optimal accuracy. Diagnostic accuracy, however, varied considerably between dentists. For caries considered to be 'probably' in the dentine mean sensitivity was 54 per cent (s.d. 14 per cent) and specificity was 97 per cent (s.d. 5 per cent). The pooled restorative treatment decisions of the dentists had a mean sensitivity of 62 per cent and a specificity of 96 per cent. More surfaces were considered in need of treatment than were diagnosed as 'probably' having dentine caries. Treatment decisions were more accurate than diagnostic ability might indicate. Paradoxically this may be because errors in visual ability were partly compensated for by 'over treatment' decisions.

Decision Making↗
PubMed1992

Dentin wetness, permeability and thickness and bond strength of adhesive systems.

This study evaluated the shear bond strength of Scotchbond 2, Clearfil PhotoBond, Tenure, All-Bond and Vitrabond and their sensitivity to dentin permeability, wetness and thickness. Occlusal dentin was prepared from extracted human teeth that were connected to a hydraulic pressure apparatus. Dentin permeability was calculated as a fluid flow rate and dentin surface wetness was evaluated using the Periotron device. Dentin thickness was measured using a pincer caliper. Shear bond strength was tested after 24 hours storage under hydrostatic pulpal pressure. Several significant correlations were found between dentin wetness, dentin permeability and remaining dentin thickness and the shear bond strengths of Scotchbond 2, Tenure and All-Bond/no etch. No apparent correlations were observed for the other adhesive systems.

Acid Etching, Dental↗
PubMed1994

Comparison of patient-perceived postcementation sensitivity with glass-ionomer and zinc phosphate cements.

Numerous investigators have reported patients' postcementation sensitivity with glass-ionomer luting agents. This information has been predominantly anecdotal and unsupported by data. This paper reports on the actual perceptions of patients who had restorations cemented with both glass-ionomer and zinc phosphate luting agents. Forty-five patients were randomly selected and received two cast restorations, one cemented with glass-ionomer cement and the other with zinc phosphate cement, also by random assignment. After 1 week, patients returned to complete a self-administered evaluation of perceived sensitivity. Neither luting agent resulted in greater sensitivity when used according to its manufacturer's instructions.

Crowns↗
PubMed2000

Dental post-operative sensitivity associated with a gallium-based restorative material.

INTRODUCTION: This study forms part of a 2-year longitudinal clinical trial to compare the performance of a gallium-based restorative material (Galloy) with a high copper, mercury based (Dispersalloy) control material. METHOD: Following Ethical Committee approval, 25 galloy restorations and 25 Dispersalloy controls were placed in 14 adult patients, by a single operator. The cavities were of moderate size, indicating the use of amalgam as the restorative material. All restorations were polished within 1 week of placement, photographed and a silicone impression of the tooth and restoration recorded. In addition, a visual analogue scale (VAS), indicating the extent of any post-operative sensitivity, was completed by each patient for each restoration, immediately prior to polishing. A score of 0 indicated no sensitivity, while a score of 10 indicated the greatest possible sensitivity. At 6-month recall, the VAS scores, silicone impressions and photographs were repeated. RESULTS: The mean sensitivity scores for the galloy and Dispersalloy restorations at 1 week were 5.1 (+/- 3.4) and 1.0 (+/- 1.5), respectively and at 6 months, 1.8 (+/- 3.0) and 0.2 (+/- 0.1) respectively. The differences between these means at 1 week and at 6 months were significant (P < 0.01). CONCLUSION: Galloy restorations were associated with a much greater severity of post-operative sensitivity than Dispersalloy restorations.

Adult↗
PubMedDate not supplied

Clinical trials on the use of whitening strips in children and adolescents.

Vital tooth bleaching is becoming increasingly popular. Both professionally supervised and over-the-counter tooth whitening systems are being utilized. Recently, a tooth whitening system became available where a gel containing hydrogen peroxide was delivered via a flexible polythene strip. Three clinical trials were conducted using whitening strips to treat tooth discoloration on 132 children and adolescents. Results indicated the strip bleaching system to be an effective means for tooth whitening. Minimal sensitivity was associated with this whitening system, with most of the reported sensitivity being noted as mild. All sensitivity was relieved upon discontinuance of the whitening agent.

Adolescent↗
PubMed2005

Treating sensitivity during tooth whitening.

The most common side effect of tooth whitening is tooth sensitivity. There are a number of materials and techniques for reducing sensitivity. This article focuses on potassium nitrate applied either by brushing before initiating whitening or by application via a tray during whitening to reduce sensitivity. A detailed step-by-step procedure for managing hypersensitive patients is described.

Dentin Sensitivity↗
PubMed1994

Evaluation of a new dentifrice for the treatment of sensitive teeth.

A dentifrice containing 5% potassium nitrate, 1.3% soluble pyrophosphate, 1.5% polyvinylmethyl ether and maleic acid (PVM/MA) copolymer and 0.243% sodium fluoride in a silica base (Sensitive/Tartar Control) has been developed to concomitantly control tartar, caries and dentinal hypersensitivity. In vitro and animal studies show that the fluoride in this product effectively inhibits formation of enamel and dentine caries. In vitro studies also demonstrate that this dentifrice effectively reduces hydraulic conductance by occluding dentine tubules with a mixed surface deposit of copolymer and silica. Using an in vitro model that simulates in vivo conditions, this dentifrice also allows a rapid penetration of potassium nitrate through the dentine matrix. These findings demonstrate a correlation under in vivo conditions between the occlusion of dentine and the ability to deliver topically applied agents to target sites within or below dentine. The results indicate that this new dentifrice should provide multiple clinical therapeutic benefits including controlling tooth decay and tartar formation, and reducing and preventing dentinal hypersensitivity.

Animals↗
PubMed2004

Desensitizing agent efficacy during whitening in an at-risk population.

BACKGROUND: Nightguard vital bleaching (NGVB) has gained acceptance among dentists and patients as a simple and effective procedure to lighten discolored teeth. Although the efficacy and predictability of NGVB have been well established, it has been documented that patients undergoing the procedure may experience side effects such as tooth sensitivity (TS) and gingival irritation (GI). A previous NGVB study suggested that selected participants might benefit from a regimen of a desensitizing agent (DSA) to decrease or prevent TS during whitening. PURPOSE: The purpose of this study was to determine whether the daily use of an active DSA (UltraEZ, Ultradent Products Inc., South Jordan, UT, USA) during NGVB would decrease TS in a population at risk for TS when compared with a placebo. MATERIALS AND METHODS: Forty subjects participated in this single-blind randomized clinical trial. All participants had indicated that they had preexisting TS or other risk factors for TS during NGVB. To evaluate TS caused by the tray alone, participants wore custom-fitted maxillary whitening trays containing no DSA or whitening solution during week 1. Next, participants were randomly assigned to apply either the active DSA or placebo daily for 14 days in the trays for 30 minutes prior to whitening. The placebo was the same formulation as UltraEZ but without the desensitizing agents (3% potassium nitrate and 0.11% by weight fluoride ion). The bleaching solution was a 10% carbamide peroxide whitening solution (Opalescence, Ultradent Inc.). Post treatment, participants were followed up for 1 week, during which time they used neither trays nor solutions. Throughout the study, participants completed a daily diary to record their perceptions of TS and the time spent wearing the tray with the whitening solution. RESULTS: Forty-one percent of the active group had at least 1 day of TS during treatment compared with 78% of the placebo group. The difference was statistically significant (p = .027) using the two-tailed Fisher exact test. CLINICAL SIGNIFICANCE: This study suggests that the use of an active 3% potassium nitrate and 0.11% fluoride desensitizing agent for 30 minutes prior to whitening may decrease tooth sensitivity when compared with a placebo in a population at risk for tooth sensitivity.

Administration, Topical↗