The pain of hypersensitivityUncategorised
Posted by: The Probe 3rd February 2021
We are currently experiencing some chilly wintery weather in the UK. For a most of us, it is time to wrap up warmly or turn the heating up. But for some people, cold breezes mean pain. Whether exercising, socialising or working outdoors, the exhilaration of a winter activity can be completely ruined for patients with dentine hypersensitivity. Obviously, a crack, break, cavity, a missing restoration or an exposed root is likely to cause pain. However, if there is no explainable dental defect or pathology, the chances are that the sensitivity derives from exposed dentine.
As we know, the sensitive parts of teeth are protected by an outer coating of enamel. However, loss of hard tissue can expose the dentinal tubules to the dentine surface. When the tubules are then exposed to appropriate stimuli such as cold, hot, chemical, tactile or osmotic, the pulpal nerves produce a short, sharp painful response., Usually the pain of hypersensitivity is localised and short in duration but the distress that it can cause depends upon the individual and can range for minor to severe. Furthermore, it is not just a blast of cold air that can cause discomfort, patients have reported that pain is often initiated by hot or cold drinks as well as sweet foods and toothbrushing.
Dental hypersensitivity is thought to affect up to 85 percent of the population and the prevalence of the condition is increasing in the UK. This is partly due to an ageing population as people are retaining their teeth for longer, but recently there has been a rise in the number of younger adults that present with this problem. This is primarily due an increase in tooth wear and in particular, dental erosion 
Erosion is the progressive loss of dental hard tissue by acid from a non-bacterial source. Modern diets and the high consumption of foods and drinks with a variety of acids such as carbonated beverages, citrus fruits, fruit juice and pickles have been implicated as a contributing factor in 40 percent of patients with tooth surface loss.  Generally, saliva helps to neutralise dietary acids but consuming an excessive amount of acidic foods and drinks can result in irreversible loss of tooth surface structure. In addition, dental erosion is common in patients with eating disorders and gastroesophageal reflux disease as stomach acids flow back into the mouth causing loss of tooth enamel due to vomiting or regurgitation.
Other causes of tooth wear have also been indicated. For instance, dental tubules can become exposed as a result of enamel loss if patients use the teeth as a tool, hold objects in the mouth or have habits such as nail-biting or pen chewing. Rough or overenthusiastic toothbrushing as well as periodontal treatment (scaling and root planning) and the use of at home tooth-whitening agents may also contribute to gingival recession, cementum loss, dentine exposure and subsequently, hypersensitivity.
Dental attrition or the wearing of occlusal surfaces due to tooth to tooth contact is commonly regarded as a natural part of ageing. However, the friction caused by grinding the teeth or bruxism as a result of anxiety or sleep disorders for example, can cause significant tooth wear. Similarly, patients with periodontitis also have a relatively higher prevalence of dentine hypersensitivity as the condition predisposes them to a greater risk and extent of root exposure.2
It is clear that in order to care for patients with dentine hypersensitivity, clinicians must first take all possible causes and predisposing factors into account, before treating the condition and implementing strategies to prevent further dentine exposure. However, the most common therapy and first line treatment is the use of a fluoride toothpaste with specific ingredients to reduce dentine hypersensitivity. Research indicates that toothpastes that contain sodium fluoride and calcium phosphates can dramatically reduce dentine hypersensitivity and Arm & Hammer™ has developed Sensitive Pro™ daily toothpaste specifically to address the cause of sensitive teeth. This specially formulated toothpaste contains both sodium fluoride and calcium phosphates, which when used regularly for 8 weeks, offers lasting relief from dentine hypersensitivity for up to 16 weeks. The secret is the patented Arm & Hammer™ Liquid Calcium™ technology that not only fills and repairs tooth enamel, but also forms a shield on the surface of the teeth to protect exposed dental tubules and reduce pain.
As the wintery weather begins to bite, growing numbers of patients are likely to seek your help for dentine hypersensitivity. By recommending a simple but effective change to the products that they use at home, you may be able to reduce their risk of experiencing pain. In addition, using a specially formulated toothpaste that is tailored to their needs is likely to give their oral hygiene routine the edge.
Arm & Hammer™ oral healthcare products are available at Boots, Superdrug, Sainsbury’s, Tesco, Asda and Morrisons throughout the UK.
 Addy M. Dentine hypersensitivity: New perspectives on an old problem. International Dental Journal Oct 2002. Vol 52 S5P2 367-375. https://onlinelibrary.wiley.com/doi/epdf/10.1002/j.1875-595X.2002.tb00936.x [Accessed 12th October 2020]
 Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc 2003; 69:221-226. https://www.cda-adc.ca/jcda/vol-69/issue-4/221.pdf [Accessed 12th October 2020]
 Trushkowsky R. D. Diagnosing and treating dentin hypersensitivity. Journal of Multidisciplinary Care Decisions in Dentistry. Oct 10 2018. https://decisionsindentistry.com/article/diagnosing-and-treating-dentin-hypersensitivity/ [Accessed 12th October 2020]
 Paryag A. et al. Dental erosion and medical conditions. An overview of aetiology, diagnosis and management. West Indian Med J. 2014 Sep; 63(5): 499–502. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4655683/ [Accessed 12th October 2020]
 Cunha-Cruz J. et al. The prevalence of denin hypersensitivity in general dental practices in the northwest United States. J Am Dent Assoc. 2013 Mar; 144(3): 288–296. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3819160/#!po=76.6667 [Accessed 12th October 2020]
 Davari A.R. et al. Dentin Hypersensitivity: etiology, diagnosis and treatment: A literature review. J Dent (Shiraz). 2013 Sep; 14(3): 136–145. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927677/#!po=83.3333 [Accessed 12th October 2020]
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