DENTIN HYPERSENSITIVITY - REVISITED

Hypersensitive tooth is an old age complaint. It can be defined as pain arising from exposed dentin typically in response to chemical, thermal or osmotic stimuli that cannot be explained as arising from any other form of dental defect or pathology. This enigma of hypersensitivity commonly affects buccal cervical areas of premolars & canines. It affects the population at an age range of 20-40 yrs with peak at end of third decade. Sensitivity occurs when dentinal tubules are exposed. Four theories have been proposed to explain this mechanism, which are transducer, modulation, gate control and hydrodynamic. Hydrodynamic theory is widely accepted. Old remedies and materials used for management of hypersensitivity includes lung ash from mice, dried livers from lizards, salt lavage, potassium nitrate, alum, anodynes such as cocaine hydrochloride, menthol, phenol, eugenol, morphine or codeine sulfate. Caustics such as zinc chloride, absolute alcohol, trichloroacetic acid, silver nitrate and others such as carbolic acid, calcium compounds such as calcium hydroxide, dicalcium phosphate, oxalates. Stannous or sodium fluoride, fluoride iontophoresis or leukomscy's paste, glass ionomers, resins, cyanoacrylates and corticosteroids. Recent methods include dentin treatment by lasers, CCP- ACP, Pro-Argin technology.