1. dintine sensitivity LI RUI DEPARTMENT OF PREVENTIVE DENTISTRY

2. Your company slogan LOGO Contents 1 Conception 2 Causes and pathology 3 Diagnosis and treatment

3. Your company slogan LOGO conception dentin sensitivity has been defined as dentin sensitivity has been defined as “a short sharp pain arising from exposed dentin “a short sharp pain arising from exposed dentin in response to stimuli typically thermal, in response to stimuli typically thermal, evaporative,tactile,osmotic or chemical and which cannot be ascribed to any other form of dental defect or pathology.” evaporative,tactile,osmotic or chemical and which cannot be ascribed to any other form of dental defect or pathology.” (Addy,1983) (Addy,1983)

4. Your company slogan LOGO Etiopathogenesis The hydrodynamic theory is the most widely accepted physiopathological theory of DS (Brannstrom,1972) stimuli → centrifugal fluid flow within the dentinal tubules → a pressure change → Aδ intradentinal nerves(pulp-dentinal interface or within the dentinal tubules) → pain

5. Your company slogan LOGO causes tooth brushing brushingdietacidage text1 attrition abrasion abrasionerosion text2 loss of enamelor periodontal periodontal tissue tissue text3

6. Your company slogan LOGO Diagnosis 1)one investigator 2)should be calibrated - ideally 3)initial stimulus should be as low as possible 4)gradual escalation to the threshold level 5)repeated after some time to obtain an average of values of values

7. Your company slogan LOGO Diagnosis Mechanical (tactile) stimuli: 1)a sharp-tipped probe 2)mechanical pressure stimulators 3)Yeaple probe ps:Periodontal probes → variability(no) perpendicular scratch,gradually increased, no to over Yeaple probe:the applied force is increased in 5-g steps until 70g

8. Your company slogan LOGO Diagnosis Cold air currents: environmental temperature of 19-24ºC a pressure of 45 psi at a distance of 1 cm perpendicular to the surface one second the screening and initial selection of teeth and subjects destined for study

9. Your company slogan LOGO Diagnosis If tactile and thermal stimuli are jointly employed in one same individual, the tactile stimulus generally should be applied first to avoid doubts as to whether he pain produced after thermal stimulation is due to the low temperature or to dehydration induced by the air current

10. Your company slogan LOGO Diagnosis Chemical (osmotic) stimuli: hypertonic solutions of glucose and sucrose Acid solutions → low pH → demineralization(no) a cotton stick during 10 seconds osmotic pressures → intratubular fluid not advised difficulty of controlling the response obtained

11. Your company slogan LOGO Methods for evaluating response after stimulation Verbal rating scale (VRS): The patient uses a numerical code from 0 to 3 to rate perceived sensation 0 = no discomfort 1 = mild discomfort 2= important discomfort 3 = important discomfort lasting more than 10 seconds only these few options,no detailed description

12. Your company slogan LOGO Methods for evaluating response after stimulation Visual analog scale (VAS): 10-cm straight line 0 = no pain 0 = no pain 10 = extreme, unbearable pain practical and useful does not distinguish between the sensory and affective components of pain

13. Your company slogan LOGO treatment productions self-appliedproducts professional use therapeutic products products

14. Your company slogan LOGO treatment productions adequate counseling on foods the prescription of desensitizing toothpastes and/or toothpastes and/or oral rinses occluding the dentinal tubules (strontium salts, oxalates or fluoridate dagents) or agents capable of modulating nerv e excitability (potassium salts) patientswith low or mild low or mildsensitivity

15. Your company slogan LOGO treatment productions high-concentrationfluoridatedvarnish or lacquer can offer good results moderate intensity intensity DS DS