Periodontal aspect of dentine sensitivity and its management
Dentine sensitivity can be a distressing problem and hinder effective plaque control by patients. Therefore, it is important for clinicians to recognize the problem and offer some remedy to the patient. Pain can come from many conditions in the mouth and understanding the aetiology and nature of dentine sensitivity will help in the differential diagnosis in order to avoid unnecessary restorative treatment. Dentine sensitivity is associated with open dentinal tubules exposed to oral stimuli. The hydrodynamic theory proposes that fluid movement in the dentinal tubules serves as the transducing medium for conveying thermal, tactile and chemical stimuli to free nerve endings of A-delta fibers that terminate near the odontoblastic layer. Majority of teeth with exposed dentine do not have sensitivity due to the natural desensitizing mechanisms in these teeth. In those teeth with clinical sensitivity, management involves the occlusion of the tubules and many desensitizing agents have been developed and are available for use.