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2nd August 2017

Chilling out

Victoria Pedgrift gives the low-down on sensitive teeth and offers home care advice to pass on to patients.

Sensitive teeth can cause patients to have reactions from a mild irritation or a familiar twinge when they eat certain foods, to a more serious pain that affects their quality of life.

A degree of sensitivity is, of course, normal, and pain may come and go, for example, when a person eats or drinks something cold, like ice cream, or if cold air catches the teeth. It may also be sudden, such as the sharp sensation an individual may feel during probing or periodontal scaling. When the problem is ignored, or rather tolerated, the daily oral care routine may be adapted. The patient might avoid cleaning properly around the sensitive area, or stop brushing entirely around a particularly sensitive spot. This can have a potentially disastrous impact on the general standard of dental health, increasing the risk of problems such as plaque build-up and halitosis.

It is important that people understand that there are simple solutions for them to try at home and that sensitive teeth do not have to be a problem.

Causes of sensitivity Causes of sensitivity include incorrect brushing technique: abrasion when the teeth are brushed too vigorously in the mistaken belief that scrubbing will remove more bacteria and make the mouth cleaner. Brushing from side to side may wear the enamel away and the freshly-exposed dentine will be more sensitive as a result. Adjunctive products used incorrectly may also impact on sensitivity. For example, multiple studies have shown that potassium-containing toothpastes can reduce dentine hypersensitivity, but rinsing the mouth too soon after brushing may reduce their efficacy.

The best time interval between brushing and using a chlorhexidine (CHX) mouthwash is more than 30 minutes and up to two hours after brushing (Kolahi, Soolari, 2006). Acidic foods and drinks are another cause of sensitivity. What a patient consumes generally will have an impact on their oral health, but there are some foods that you would not expect to have a low pH value and are classified as ‘acidic’. These include some cheeses, pickles and nuts, vinegar, coffee and chocolate, as well as more obvious culprits like soft and carbonated drinks.

Patient advice
• Talk to your patients about any sensitivity issues, even if temporary.
• Recommend solutions that they can try such as non-invasive, simple treatments that can be carried out at home.
• Demonstrate good brushing technique at every appointment.
• If at-home solutions fail to work, it may mean there is a more serious underlying problem, which can be investigated accordingly.
• Educate your patients on foods and drinks that are acidic.
• Investigate if they need treatment for any cause of acid reflux
• Explain that adjunctive products are only effective if they are used correctly
and compliantly.

Good habits
Sensitivity is a common problem and has a range of causes. Before you are able to rule out any serious underlying issues, give your patients some solutions to try between appointments. Changes to diet and brushing technique can be used alongside adjunctive products for a clean, healthy mouth and the more care an individual takes with his or her daily routine, the more likely the
chance of sensitivity will decrease. Using hard-working, all-round products correctly, alongside good habits will help your patients to banish the problem for good.

For more articles like this, visit the Dentistry website.


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