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REMEDY TO DENTINAL
 HYPERSENSITIVITY




       INDIAN DENTAL ACADEMY
    Leader in Continuing Dental Education
       www.indiandentalacademy.com
INTRODUCTION:
Dentinal Hypersensitivity
 • Definition:
It is a short or transient sharp pain arising from
exposed Dentin in response to stimuli typically
thermal, evaporative, tactile, osmotic or
chemical which cannot be ascribed to any
other form of dental defects or pathology.
 • A true pain syndrome
 • An enigma
 • Not Well Understood
THEORIES OF DENTINAL
       HYPERSENSITIVITY :
   Direct stimulation
    of nerve fibers
   Dentinal receptor
    mechanism
   Gate control
    theory and
    vibration
   Hydrodynamic
    theory.
CAUSES OF DENTINAL
 HYPERSENSITIVITY
     1. WASTING DISEASES




2. DEVELOPMENTAL ANOMALITIES
3. GINGIVAL RECESSION




4. ILL HABITS          5.TRAUMA




 SMOKING & TOBACCO
     CHEWING
6. IATROGENIC CAUSES




                8.PERIODONTAL
7.DENTAL           SURGERY
 CARIES
CURRENT EXISTING
  MANAGEMENTS OF DENTINAL
     HYPERSENSITIVITY:
1. Desensitizing agents.
    • Cavity varnishes
    • Anti-inflammatory agents
    • Protein precipitants
    • Tube occluding agents
    • Tubule sealants
2.Intraoral fluoride releasing device
3.Composite resin or Glass ionomer restorations.
4.Gluteraldehyde & hydroxyethylmethacrylate bonding
   agent system
5.Topical guanethidine.
6.Muco-gingival surgery.
7.Lasers – Nd:YAG, CO2 Laser irradiation.
AN ALTERNATE CLINICAL
TREATMENT FOR
DENTINAL
HYPERSENSITIVITY:
   Anode iontophoresis
 DEFINITION:
      The process of influencing ionic
 motion using an anode as the positive
 electrode through which current enters
 the electric circuit.
ANODE IONTOPHORESIS
      LITERATURE STATUS:
• Iontophoretic deposition of strontium in dentine
  was reported in 1980.
• The desensitizing effect and duration of action of
  anode iontophoresis using strontium chloride
  solution as the effective management of dentinal
  hypersensitivity was first reported by G.
  Ramachandran and Tom Jose.
• An extensive clinical trial was conducted under
  the support of Indian Council of Medical
  Research.
IONTOPHORETIC
DESENSITIZER:
IONTOPHORETIC
DESENSITIZER CIRCUIT
      DIAGRAM :
IONTOPHORESIS ON
SENSITIVE TOOTH :
        Two electrode made
        of stainless steel
        are used:
        • One    electrode    is
          fixed   to   patient’s
          forearm.
        • The other electrode
          is used to deliver
          the current to the
          tooth surface.
IONTOPHORETIC
DESENSITIZATION:
        MECHANISM OF ACTION
1. Stimulated deposition of secondary dentine
       Electrical
                 stimulus
       Low intensity current


2. Metathesis of strontium
       Formation of insoluble salts
       Deposition in exposed dentinal tubules


3. Electro coagulation- Dentinal fluid
4. Increased sensory adaptation
FACTORS AFFECTING
IONTOPHORESIS:

• Current strength


• Polar effect


• Ionic concentration
CLINICAL PROCEDURE:
   Tooth is made passive electrode
   Current flows from active electrode through
    strontium chloride solution.
   Current strength is measured in voltage
    and milliampere
   Anode iontophoresis produces Strontium
    chloride dissociation in solution.
   Current electricity forces strontium into the
    dentinal tubules preventing fluid movement
    within.
CONCLUSION :
• The desensitizing effect of dentin
  with strontium chloride solution by
  anode iontophoresis aims at sealing
  the exposed dentinal tubule by
  strontium deposition.
• Prevents fluid movement within the
  dentinal tubules.
• It is found to have a permanent
  effect.
SPECIAL THANKS TO:
          Dr.V.G.Sukumaran,MDS,
          Prof. & HOD of Endodontics.
          Dr.Narasimha Bharadwaj,MDS,
          Lecturer.

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Remedy to Dentinal hypersensitivity /certified fixed orthodontic courses by Indian dental academy

  • 1. REMEDY TO DENTINAL HYPERSENSITIVITY INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com
  • 2. INTRODUCTION: Dentinal Hypersensitivity • Definition: It is a short or transient sharp pain arising from exposed Dentin in response to stimuli typically thermal, evaporative, tactile, osmotic or chemical which cannot be ascribed to any other form of dental defects or pathology. • A true pain syndrome • An enigma • Not Well Understood
  • 3. THEORIES OF DENTINAL HYPERSENSITIVITY :  Direct stimulation of nerve fibers  Dentinal receptor mechanism  Gate control theory and vibration  Hydrodynamic theory.
  • 4. CAUSES OF DENTINAL HYPERSENSITIVITY 1. WASTING DISEASES 2. DEVELOPMENTAL ANOMALITIES
  • 5. 3. GINGIVAL RECESSION 4. ILL HABITS 5.TRAUMA SMOKING & TOBACCO CHEWING
  • 6. 6. IATROGENIC CAUSES 8.PERIODONTAL 7.DENTAL SURGERY CARIES
  • 7. CURRENT EXISTING MANAGEMENTS OF DENTINAL HYPERSENSITIVITY: 1. Desensitizing agents. • Cavity varnishes • Anti-inflammatory agents • Protein precipitants • Tube occluding agents • Tubule sealants 2.Intraoral fluoride releasing device 3.Composite resin or Glass ionomer restorations. 4.Gluteraldehyde & hydroxyethylmethacrylate bonding agent system 5.Topical guanethidine. 6.Muco-gingival surgery. 7.Lasers – Nd:YAG, CO2 Laser irradiation.
  • 8. AN ALTERNATE CLINICAL TREATMENT FOR DENTINAL HYPERSENSITIVITY: Anode iontophoresis DEFINITION: The process of influencing ionic motion using an anode as the positive electrode through which current enters the electric circuit.
  • 9. ANODE IONTOPHORESIS LITERATURE STATUS: • Iontophoretic deposition of strontium in dentine was reported in 1980. • The desensitizing effect and duration of action of anode iontophoresis using strontium chloride solution as the effective management of dentinal hypersensitivity was first reported by G. Ramachandran and Tom Jose. • An extensive clinical trial was conducted under the support of Indian Council of Medical Research.
  • 12. IONTOPHORESIS ON SENSITIVE TOOTH : Two electrode made of stainless steel are used: • One electrode is fixed to patient’s forearm. • The other electrode is used to deliver the current to the tooth surface.
  • 13. IONTOPHORETIC DESENSITIZATION: MECHANISM OF ACTION 1. Stimulated deposition of secondary dentine  Electrical stimulus  Low intensity current 2. Metathesis of strontium  Formation of insoluble salts  Deposition in exposed dentinal tubules 3. Electro coagulation- Dentinal fluid 4. Increased sensory adaptation
  • 14. FACTORS AFFECTING IONTOPHORESIS: • Current strength • Polar effect • Ionic concentration
  • 15. CLINICAL PROCEDURE:  Tooth is made passive electrode  Current flows from active electrode through strontium chloride solution.  Current strength is measured in voltage and milliampere  Anode iontophoresis produces Strontium chloride dissociation in solution.  Current electricity forces strontium into the dentinal tubules preventing fluid movement within.
  • 16. CONCLUSION : • The desensitizing effect of dentin with strontium chloride solution by anode iontophoresis aims at sealing the exposed dentinal tubule by strontium deposition. • Prevents fluid movement within the dentinal tubules. • It is found to have a permanent effect.
  • 17. SPECIAL THANKS TO: Dr.V.G.Sukumaran,MDS, Prof. & HOD of Endodontics. Dr.Narasimha Bharadwaj,MDS, Lecturer.