Dentine Hypersensitivity and its Significance in the Dental Practice

Abstract

Preosjetljivost dentina nije nova bolest. Problemima njene simptomatologije, patogenetskih mehanizama, diferencijalne dijagnostike i liječenja bavili su se Gysi još prije stotinu godina i Brannström prije 40 godina i još mnogi drugi poslije njih. Danas obnovljeno zanimanje može se pripisati nastojanjima da se poboljša zdravlje usne šupljine i očuvanju većeg broja zuba u starijoj dobi, kao i smanjenoj učestalosti pojave karijesa. Otkrivanje dentinskih površina zbog povlačenja gingive, te zbog erozije i abrazije može izazvati ozbiljne poteškoće. Ono se javlja u oko 40 % odraslih osoba, premda se samo malobrojne zbog toga obraćaju stomatologu. Stoga stomatolozi koji rade u praksi moraju biti upoznati s mogućnostima liječenja te strategijama zbrinjavanja i prevencije. Među nove aspekte ubrajaju se pravodobno pranje zuba nakon konzumiranja acidogene, erozivne hrane i pića, kao i mogućnosti neinvazivnog (desenzibilizirajuće zubne paste s kalijevim nitratom/fluoridom) i invazivnog (rekonstrukcija s ispunama i prekrivanjem otkrivenih dijelova korijena) liječenja. Preporučuje se kontinuirana skrb o osobama s preosjetljivošću dentina, kako bi se sprječile teže posljedice (nadražaj pulpe).Dentine hypersensitivity is not a new disease. More than a hundred years ago Gysi, 40 years ago Brannström and since then many others have dealt with the problems of its symptoms, pathomechanism, differential diagnosis and therapy. The revived interest today may be attributed to improving oral health and to the presence of more teeth in older age, as well as decreasing caries prevalence. The exposure of dentine surfaces due to gingival recession, erosion and abrasion may cause serious complaints. It occurs in about 40% of the adult population, although, few of them turn to the dentist. Therefore, practising dentists should be aware of the possibilities of treatment, managing strategies and prevention. New aspects include the appropriate timing of toothbrushing after the consumption of acidogenic, erosive foods and beverages, as well as non-invasive (desensitising toothpastes with potassium nitrate/fluoride) and invasive (reconstruction with fillings, coverage of the exposed roots) treatment options. Continuous care of patients with dentine hypersensitivity is advisable in order to prevent more serious consequences (irritation of the pulp)