As dentists, when we diagnose patients with periodontitis, our first priority is to treat that disease and help our patients address their oral health problems, including through behaviour change. However, the consequences of periodontitis and treatment can impact patients' quality of life even if their oral health is stabilised. How? Due to dentine hypersensitivity (DHS).
Gingival recession and loss of clinical attachment results in dentine being exposed. When that exposed dentine has open dentinal tubules, patients can experience sensitivity to hot, cold, sweet and acidic stimuli. Dentists must address DHS in addition to treating patients' periodontitis, in order to help ensure that patients are satisfied and that it does not affect their quality of life. It has been shown that the prevalence of dentinal hypersensitivity one week post debridement varies between 37% and 55% in patients1. This can make patients believe that their dental treatment has worsened their oral health instead of improving it.
Should patients complain of pain typical of DHS, it is important to evaluate and rule out other causes, and then to explain to patients what their diagnosis of DHS means. This helps us reassure our patients that the treatment provided is helping their oral health, not worsening it, and we can also let them know that we have solutions to address their symptoms. Having an active dialogue prior to periodontitis treatment about treating possible DHS is recommended, or it is even better to put measures into place prior to debridement in order to reduce the risk of patients experiencing this.
Be reassured that DHS can often be prevented and managed by simple interventions. These include:
Recommendation of a suitable desensitising toothpaste, such as Colgate Sensitive Pro-Relief with Pro-Argin technology. This unique formulation blocks the dentinal tubules, and also contains fluoride.It can relieve sensitivity in one minute when rubbed into the tooth surface with a fingertip. With twice-daily home use, it provides lasting relief from dentine sensitivity. Due to its instant effect following fingertip application, it can also be used for in-surgery applications prior to debridement to help prevent the patient from experiencing DHS during treatment.
Another option for a desensitising toothpaste, is Colgate Neutrafluor 5000 Sensitive toothpaste which can be recommended for home use. This contains 5% potassium nitrate for sensitivity relief as well as 5,000 ppm fluoride to provide for increased protection against dental caries for patients with an elevated risk for caries.
Another option is in-surgery application of Colgate Duraphat Varnish which is also clinically proven to relieve sensitivity.
It is important to be able to diagnose and treat DHS as this condition can impact your patient's quality of life and, in fact, its management can be very simple with the use of effective products.
1.https://www.hindawi.com/journals/ijd/2012/407023/
https://downloads.hindawi.com/journals/ijd/2012/407023.pdf
Duraphat Varnish
Contains: Sodium fluoride 5mg/mL
Indications: Prevention of caries. Treatment of sensitive teeth.
Colgate Sensitive Pro-Relief toothpaste
For the relief of tooth sensitivity.
Colgate-Palmolive Pty Ltd. Sydney NSW 2000
Neutrafluor 5000 Sensitive Toothpaste
Contains: Sodium Fluoride 11.05mg/g and Potassium Nitrate 5mg/g
Indications: Assist in the management of sensitive teeth. Relieves the pain of sensitive teeth with regular use, to provide long term sensitivity protection. Dental caries preventive for individuals at high risk for caries, when used as part of a preventive regimen recommended by a dental professional or doctor.
Directions for use: Use daily in place of a regular toothpaste. Apply a thin ribbon of toothpaste to soft small
toothbrush. Brush teeth thoroughly for 2 minutes and then spit out. For best results, refrain from eating,
drinking or rinsing for 30 minutes.
Always review the full Product Information before recommending. Available from Colgate-Palmolive.
Colgate-Palmolive Pty Ltd. Sydney NSW 2000
