Dental hypersensitivity occurs daily and is caused by a variety of factors. It can be due to poorly adjusted restorations, in bruxomaniacs, in places where there is a lack of hard dental tissue, from some conservative treatments, etc.

There are two most common causes for sensitive teeth: the loss of hard tissue which can result in attrition, abrasion, erosion and bruxism; and gingival recession which can be caused by periodontal disease, bad brushing, periodontal interventions, or even some trauma.

Microscopic studies show that dental hypersensitivity is clinically found in places where dentine is exposed due to all the possible causes already mentioned.

When a dental treatment is performed, the symptoms of dental hypersensitivity may be initiated or aggravated.

When performing periodontal treatments, exposure of the root surfaces can result, which can induce or accentuate the dental hypersensitivity.

Sensitive teeth can result from the dentist making preparations for small restorations. Crowns can cause dental hypersensitivity due to the carving. Teeth whitening is also a factor.

Between 9% and 30% of adults have sensitive teeth between 20 and 30 years of age, and decreasing after 40 years of age due to the sclerotic changes present in the dentinal tubules, gradually decreasing its diameter, which results into a reduction in the movement of dentinal fluid.

Cold is the most common stimulus that causes hypersensitivity, being more marked in the incisors, followed by the premolars and the molars.

This variation in intensity between the teeth is due to the thickness of the enamel and dentin.

Hypersensitivity also occurs on the occlusal surfaces when there is a partial or total loss of enamel, either due to bruxism or poor dental bite.

Most of the treatments performed by the dentist affect the dental tissue in different magnitudes, which results in dental hypersensitivity in some reversible cases and in others not.

• The exposure of the root dentin is a pulpal pathology caused by iatrogenesis that results from performing some periodontal treatment.

• Dental Hypersensitivity may result after scaling and root planing and from inflammatory or hemorrhagic changes in the pulp.

• The best way to avoid harming the internal dentine is to maintain an intact cement.

• Dental hypersensitivity can vary from mild to intense. Some people can describe it as tolerable while for others it can be unbearable and even affect their daily life.

1. • Hypersensitivity can be classified: No sensitivity

2. • Moderate sensitivity

3. • Extreme sensitivity

4. There are three types of stimuli which can cause hypersensitivity:

5. 1. MECHANICS: can occur when there is a incorrect brushing, when a tooth is instrumented, in patients with bruxism.

6. 2. CHEMICALS: caused by the acids that we ingest in the diet or in some other substances such as when the teeth whitening is performed.

7. 3. THERMAL: which can be caused by the intake of cold or hot food or when the air hits our teeth.

EROSION

Erosion is the loss of enamel and dentin produced by acids or chelating agents. It produces almost no pain and is classified as a chemical aggression where bacteria do not intervene.

It is more common in young people and in the female gender.

There are different types of erosion:

1.- erosion related to environmental factors:

Occurs in places where there is daily exposure to acids (wine tasters, swimmers, printers, etc.)

2.- erosion by diet: by the intake of food and acidic beverages (citrus fruits, low PH drinks).

The damage depends on the frequency and duration of the intake.

There are wear on the palatal and buccal surfaces of the teeth of the upper arch.

3.- Erosion due to medications: results when certain medications are used for a long time or at high doses (iron tonics, vitamin C, aspirin, etc.)

4.- Erosion due to gastric acid: present in people with diseases of the digestive tract (gastritis, ulcers, reflux, bulimia, etc).

ATTRITION

It is the wearing away of dental tissue caused by the contact between the teeth; either physiological: which is a gradual and regular loss caused by chewing; or the pathological which is caused by the abnormal contact of the teeth when there are bad dental positions, malocclusions, parafunctions, in alterations of the mineralization of the teeth, xerostomia and abrasive foods.

It is usually found more in adult men.

ABRASION: is the pathological wear caused by the friction of a foreign object. It is not caused by the occlusion.

It is an abnormal mechanical process which can be caused by:

Brushing: commonly occurs in the cervical areas on the vestibular faces of incisors, canines and premolars, most commonly in the upper jaw. There is usually a lot of dental hypersensitivity.

This is due to poor brushing technique, the bristles of the brush and the degree of abrasiveness of the toothpastes.

- Retainers of prosthesis/dentures: which contribute to the accumulation of food and the production of acids in the area of the retainers.

-By acquired habits: they are mechanical stimuli that are acquired in some activities such as: seamstresses, stylists, shoemakers, glass blowers, etc.

It can manifest at any age and mainly in men.

- Teeth whitening: Sensitive teeth results when a teeth whitening is performed. The dental hypersensitivity is usually reversible after 24 hours of remineralizing the teeth with the mouthwash Enamelin.

Sometimes whitening is not the cause of dental hypersensitivity, but it can increase it if it already exists.

The dental clearance is related to the hypersensitivity during the treatment either by dehydration of the teeth, air pressure, changes in temperature and PH and desiccation.

Studies show that the pulp is not irreversibly affected by teeth whitening.

DISCUSSION

There is evidence that in addition to dental cavities, there are different destructive processes that affect dental tissue in an irreversible way such as abrasion, erosion, attrition and bruxism.

The lesions can be natural or physiological or pathological caused by some mechanism other than the oral cavity.

Although it is known that these destructive processes have existed for a long time, the resultant dental hypersensitivity corresponds with the habits acquired.

Sensitive teeth results when dentin or cement are exposed to external thermal, tactile and chemical stimuli.

CONCLUSION

It is necessary for health professionals to have the knowledge and be attentive to the clinical manifestations of these dental problems in order to act in a timely manner to prevent irreversible damages and to be able to solve the problem in a preventive manner. ENAMELIN is the best treatment for dental hypersensitivity. ENAMELIN is a dental remineralizer that strengthens teeth and eliminates hypersensitivity completely.