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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dentine hypersensitivity can be a frustrating condition to treat. The most common form of treatment is use of a desensitizing dentifrice, but for many patients this may provide only partial pain relief and recurrence is common. Recent research has provided several important findings which may serve as a basis for refining the approach to dentine hypersensitivity management, and for improving the success of treatment. This paper reviews the research and outlines a management system which transfers readily to clinical practice.
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PMID:Dentine hypersensitivity: its prevalence, aetiology and clinical management. 130 54

Dentine hypersensitivity is a common painful condition about which relatively little is known. A review of the literature reveals that most research has been concerned with the clinical assessment of therapeutic agents. However, even here there is little information concerning the actual mode of action of such agents. Many clinical aspects of the condition also appear anecdotal at best and there is always a need to consider a differential diagnosis to exclude other causes of dentinal pain. Detailed prevalence figures are not available for dentine hypersensitivity as it affects different groups, although age and possibly gender differences are apparent. Additionally, the condition shows predilections for certain oral sites which may be of aetiological relevance. Consistent with the hydrodynamic theory hypersensitivity lesions reveal large numbers of widened dentinal tubules at the surface and patent to the pulp. The use of dentine replica techniques could prove useful in objectively studying the condition and monitoring treatments. It is apparent that in clinical management little attention has been paid to factors which expose dentine and open tubules. Without consideration of aetiological factors the management of Dentine Hypersensitivity may be compromised.
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PMID:Clinical aspects of dentine hypersensitivity. 150 79

Dentine hypersensitivity is a relatively common pain condition. Local pulpal inflammation, traumatic oral hygiene and dietary habits have been considered in the etiology of dentine hypersensitivity. Dentine hypersensitivity is probably caused by a change in fluid flow in the dentinal tubules, which in turn excites the nerve endings located at the pulp-dentine border. Consequently, treatment success would depend on the prevention of fluid flow across the dentinal tubules (sodium fluoride, stannous fluoride, sodium monofluorophosphate, strontium chloride, sodium citrate, potassium oxalate, and resins/adhesives), or on the desensitization of the nerve endings located at the pulp-dentine border (potassium nitrate). Although a wide variety of treatment methods have been available, clinical data is characterized with ambiguity, warranting further research of the factors which could possibly be implicated in the occurrence of dentine hypersensitivity.
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PMID:Dentine hypersensitivity: a review. 191 27

Tooth hypersensitivity is associated with exposure of the dentine to the external environment of the mouth. This exposure can result from loss of enamel by processes including abrasion and erosion, or by denudation of the root surface as a result of gingival recession or periodontal treatments. Dentine hypersensitivity can be described as an adverse reaction or pain in one or more teeth resulting from either a thermal, chemical, bacterial or mechanical stimulus. Painful symptoms arising from exposed dentine are a common finding in adults and reportedly affect as many as one in every seven patients attending for dental treatment. Although predisposition to dentinal hypersensitivity is multifactorial, enamel loss as well as gingival recession may be more severe with advancing age. Because of the greater longevity of people who are also keeping their teeth longer, hypersensitivity is a growing concern. Clinical studies show that individuals with less than adequate plaque control experience more root hypersensitivity to air stimuli than others with better oral hygiene. Although plaque does not alter the pulpal threshold, i.e. has no effect on the pulp, it seems that microbial plaque has an effect on root sensitivity.
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PMID:Symptomatology and clinical features of hypersensitive teeth. 770 64

The clinical trial was carried out on 34 'hypersensitive' teeth in 10 subjects. Dentine sensitivity was measured as the pain perception thresholds to controlled air and probe stimuli. In each subject, pairs of teeth of comparable initial sensitivity were randomly assigned to a test (T) or control (C) treatment. All teeth were cleaned and a conditioning paste applied. Group T was treated with a topically-applied light-cured resin; Group C received a placebo, sham light-cured. Air sensitivity was remeasured after treatment, and the procedures were repeated after 1, 2, and 3 weeks. When comparing air thresholds before and after treatment at each visit, the test agent caused significantly greater reduction in sensitivity than the control. The median increase in air threshold in the test group was 2.5 s at visit no. 1, 1.3 s at visit no. 2 and 0.8 s at visit no. 3. Comparisons of the initial thresholds at each visit showed no significant long-term changes in sensitivity in either group.
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PMID:Pilot clinical study of a fluoride resin and conditioning paste for desensitising dentine. 835 26

Dentine hypersensitivity still represent a major clinical problem only partially solved. The presence of exposed opened dentinal tubules has been demonstrated increase the dentine permeability and it is the responsible for pain and sensitivity. Stannous fluoride solution has been recently proposed to reduce dentine hypersensitivity. The aim of the present study was to evaluate the dentinal permeability of a new stannous fluoride gel proposed for the therapy of dentine hypersensitivity. Human extracted teeth have been used and mounted and connected with a hydraulic pressure apparatus working at 1 psi (70 cm of water pressure). It was calculated the permeability of untreated smear layer, treated smear layer (after gel application) and after acidic treatment. It was observed that gel treatment was able to reduce dentine permeability. Scanning electron microscopy demonstrated the presence of a homogeneous smear layer after treatment with gel. This in vitro study confirms that stannous fluoride treatment has the capacity to modify dentine permeability of sensitive dentine.
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PMID:[Treatment of dentin sensitivity with stannous fluoride gel. Electron microscopic study and evaluation of dentin permeability]. 956 15

Dentine sensitivity is a painful clinical conditions that can affect up to 35% of the population at any one time. Both professionally available (in-office) or commercially available (over-the-counter) products have been used to treat dentine sensitivity. The aim of the present study was to investigate whether selected in-office desensitizing agents occluded dentine tubules in the dentine disc model. Both surface effects and tubule penetration of the five selected test products were examined by scanning electron microscopy. The results of the present study appeared to demonstrate that all of the applied desensitizing agents produced some occlusion of the tubules although the level of coverage and occlusion varied between the products. Of all the agents tested, ferric oxalate, the active ingredient of Sensodyne Sealant, produced crystal-like structures which occluded a higher proportion of the tubules across the dentine disc surface. ALL-BOND 2 and One-Step (both light-cured primer systems) produced similar crystal-like structures and, although coverage was not uniform across the disc surface, there was some reduction in tubule diameter. These three products, however, appeared to be more effective than either Butler Protect (potassium oxalate) or Oxa-gel (potassium oxalate in a gel) where there was a marked decrease in both the level of coverage and tubule occlusion. Both quantitative and functional studies are required in order to determine the effects of these agents on dentine permeability (fluid flow) as well as clinical studies to determine their effectiveness over time in reducing pain arising from dentine sensitivity.
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PMID:Scanning electron microscopy (SEM) investigation of selected desensitizing agents in the dentine disc model. 1082 26

Cervical dentine hypersensitivity is the most frequent complaint among reported odontalgias. Thus, this study evaluated the effectiveness of two types of lasers (660 nm wavelength red, and 830 nm wavelength infrared) as dentine desensitizers, as well as both the immediate and late therapeutic effects in individuals 25 to 45 years of age. A total of 40 teeth with cervical exposure were treated in 4 sessions. They were divided into 2 groups according to treatment. A 660 nm wavelength red diode laser and an 830 nm wavelength infrared diode laser were used. Dentine sensitivity to cold nociceptive stimulus was evaluated by means of a pain numeric scale from zero to 10 before each treatment session, at 15 and 30 min after irradiation, and in a follow-up period of 15, 30 and 60 days after the end of treatment. Significant levels of dentinal desensitization were only found in patients ranging in age from 25 to 35 years. The 660 nm red diode laser was more effective than the 830 nm infrared laser and a higher level of desensitization was observed at the 15 and 30 minute post-irradiation examinations. The immediate and late therapeutic effects of the 660 nm red diode laser were more evident in 25-35-year-old patients compared with those of the 830 nm infrared diode laser, in terms of the different age groups.
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PMID:Laser therapy in the treatment of dentine hypersensitivity. 1577 98

Dentine hypersensitivity is recognized as a pain arising from fluid movement within dentine tubules that are open to the oral environment. Blocking the tubules is considered to be the principal aim of treatment, and the accurate assessment of tubule occlusion is the primary goal of many in vitro studies. This assessment usually comprises either measuring tubule permeability or scanning electron microscope examination of the dentine surface. Several scanning microscopy studies have claimed to quantify tubule occlusion, but are descriptive, qualitative or semi-quantitative evaluations. The present study was undertaken to assess the use of digital image analysis in quantifying the effectiveness of a selected desensitizing agent from micrographs of control and treated dentine surfaces. Using a dentine disc model, an accurate methodology was sought to investigate the occluding potential of Butler Protect (J.O. Butler, Chicago, IL, USA). Subjective examination of the images indicated there was little difference after a single application, but considerable effect after 20 applications. Quantitative digital analysis of a test image, demonstrated reproducibility between two examiners when used in fully- and semi-automated mode. After a single application of Butler Protect, multilevel statistical modelling demonstrated decreases in tubule area and maximum, minimum and mean diameter measurements (P < 0.001), whereas single level analysis showed increases in area and maximum and mean diameters. Multiple application of Butler Protect demonstrated even greater decreases in all parameters (P < 0.001). This quantitative methodology was reproducible between examiners and, when combined with good controls and multilevel statistical modelling, was able to discriminate a single application of desensitizing agent.
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PMID:In vitro quantification of changes in human dentine tubule parameters using SEM and digital analysis. 1601 38

Dentine hypersensitivity is a relatively common problem experienced in clinical dental practice. This condition may disturb the patient during eating, drinking, brushing and sometimes even breathing. Therapeutic intervention by desensitising agents may provide only partial pain relief and recurrence is common. Much remains unknown about dentine hypersensitivity, even the terminology can be questioned. Most of the literature over decades has been concerned with reporting clinical trials proving the efficacy of numerous treatments for dentine hypersensitivity. Indeed, besides haemorrhoids, there can be few other diseases or conditions known to man that can apparently be successfully treated by so many and extremely varied agents and formulations applied topically. This paper will discuss the epidemiology, mechanisms of pain production and aetiological factors for the condition in the hope of developing ideas for more realistic prevention and management strategies.
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PMID:Dentine hypersensitivity - an enigma? A review of terminology, mechanisms, aetiology and management. 1616 81


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