By Jeff Riggs
It is estimated that 22 percent of American adults suffer from dentinal hypersensitivity.(1) One might think the facts about such a common problem would be well known, but many dental professionals find themselves having to correct patients' outdated ideas about the causes of sensitivity and the most effective treatment options.
Data suggests that up to 42 percent of dentinal hypersensitivity sufferers don't discuss the problem with their dental professional,(2) so the first step in correcting misconceptions is identifying sufferers. Ask your patients if they experience discomfort when consuming hot or cold foods and beverages, or whether there are any foods that they avoid due to tooth pain. Once you know you have a sufferer in your chair, you can review the following information with him or her, but remember — you can't help if you don't ask.
"How long does it take to work?"
Many dentists offer in-office desensitizing treatments, which work by occluding dentinal tubules. While these treatments provide immediate relief, they are generally brushed off the teeth within a matter of weeks, after which sensitivity returns. A dentifrice containing 5 percent potassium nitrate — Sensodyne®, for example — works by depolarizing nerve endings within the tubules. The effect builds over time, so when patients brush with it twice daily, they should feel relief within two weeks. Patients who require both immediate and long-term relief can use both occluding and depolarizing treatments.
"But is it safe for long-term use?"
The FDA requires sensitivity toothpastes to carry a statement cautioning against use for more than four weeks. Naturally, this leads some patients to believe they shouldn't rely on a sensitivity toothpaste for long-term use. The reason for the statement, however, is that sensitivity sufferers need to seek a professional evaluation, rather than self-medicate indefinitely. Once a dentist rules out any serious underlying cause of the sensitivity, patients are safe to use a desensitizing dentifrice as long as they wish.
"I tried that toothpaste in the 1980s, and I couldn't stand the taste!"
Patients who tried anti-sensitivity toothpastes years ago may recall an unpleasant taste and a flat or gritty feel in the mouth. Earlier generations of these products used strontium chloride as an active ingredient, which did contribute to a different texture and taste. However, potassium nitrate is the active ingredient in most modern formulations of desensitizing dentifrices, and should not interfere with the taste.
"My friend said I should dab it on and leave it overnight."
Some patients may believe desensitizing dentifrices should be used like other oral pain relievers, such as those made for aphthous ulcers. But a desensitizing dentifrice should be used like any other dentifrice. Instruct patients to brush with it twice daily; they need not only the desensitizing benefits, but also the anti-caries properties of fluoride.
The author can be contacted at [email protected].
References
(1) Data on file, GlaxoSmithKline
(2) Data on file, GlaxoSmithKline