According to statistics, dentinal sensitivity affects 1 in 5 people, and with the increases in tooth-whitening procedures, clinicians can expect more sensitivity over time. Rather than providing palliative treatment, clinicians can actively help patients ease sensitivity by suggesting products with potassium nitrate and/or fluoride ingredients. Dentinal sensitivity occurs when fluid in the tubules moves in response to applied stimuli. The movement of the fluid—the change in the direction of flow—causes the sharp pain. Food or liquids that are hot, cold, sweet, or sour, cold air, and heavy-handed brushing can be the stimulus. Patients who have never had sensitivity can first experience it in response to whitening treatments, whether they are chairside or at-home procedures, gels or strips. In fact, 75% of whitening patients may be affected. The sensitivity can occur during and after treatments, with all teeth being affected, but most often affected are the maxillary lateral incisors and all mandibular incisors. A common treatment for sensitivity is use of any toothpaste with 5% potassium nitrate concentration. The ingredients work by depolarizing the dentin/pulp junction nerves, interrupting the impulses. In addition, toothpastes with 4% fluoride concentration remineralize decalcified (exposed) areas, and toothpastes with a concentration of 5,000-ppm fluoride seal the tubules against stimuli. Rinses and foam application are also effective. If at-home products are not sufficient for patient comfort, there are inoffice desensitizers (gels and varnishes) that can be applied. Patients who will receive whitening should be informed in advance of possible sensitivity and proactively prescribed agents, which will be helpful prior to and throughout the process.
(Source: Modern Hygienist, October 2006)
