Modern Concepts of Treating Hyperesthesis of Hard Tooth Tissues (Review of Literature)

Abstract

Hyperesthesia (from the Greek hyper - increase and aisthesis - sensation) means any increase in pain sensitivity of the tooth tissues to external irritants of temperature, chemical and tactile nature. The number of the patients with hypersensitivity of the hard dental tissues has increased sharply in recent years and according to various authors’ findings it is from 60% to 90%. A wide range of prevalence fluctuations is observed in different age groups. The age of people with certain symptoms of teeth hypersensitivity is 25-50 years while the highest frequency is among the people aged 30-40 years. Starting from an earlier age women suffer more often than men. The generalized form of hyperesthesia is usually associated with such general causes as the functional state of the nervous system, endocrine diseases, disorders of mineral metabolism in the body. The localized forms of hyperesthesia are caused mainly by the defects in the hard tissues of individual teeth or periodontium. Rapid and effective treatment of hyperesthesia of the hard dental tissues is an important and urgent problem of modern practical dentistry. Therefore, a great amount of the techniques for the treatment of this pathology is constantly increasing. Now one of the most common methods is the local impact on the hard dental tissues.
 The aim of the study is to analyze the specialized medical literature that is concerned with modern methods and techniques for the treatment of hypersensitivity of the hard dental tissues.
 Materials and methods of the research. The review of the literature sources on modern concepts of the treatment of hyperesthesia of the hard dental tissues has been made and the information has been analyzed.
 Results. The problem of hypersensitivity of the tooth tissues has led to the invention of a whole class of the drugs aimed at its elimination. These medications have different chemical nature, the mechanism of the action on the tissues and even the indications for their use, but the purpose of all these medical preparations is common as they are aimed at reducing hypersensitivity of the tooth tissues.
 A wide range of the techniques is proposed to eliminate the problem of tooth sensitivity. One of the most common methods of the treatment is a local effect on the hard dental tissues which is aimed directly at the relief of the hydrodynamic mechanism. According to this theory, the stimulus which causes pain increases the flow of the fluid in the dentinal tubules that leads to the changes in osmotic pressure and increased activity of the nerve endings in its turn. Therefore, taking into account the mechanism of the action of desensitizing toothpastes they are divided into those ones that reduce the excitability of the nerve fiber and those ones that contribute to the obstruction of the dentinal tubules.
 Nowadays there have been also accumulated a sufficient number of clinical and experimental observations indicating that one of the main causes of dentin hypersensitivity is any disturbance of phosphorus-calcium metabolism of the hard dental tissues. A number of authors have shown that people with the generalized form of hyperesthesia has pronounced hypophosphatemia which is combined with the decrease in the content of inorganic phosphorus and calcium in the oral fluid. In this regard, the drugs of calcium (gluconate, chloride, glycerophosphate) and fluoride (sodium fluoride) are widespread in the treatment of dentin hyperesthesia and they are used by application and rubbing into sensitive areas, electro- and phonophoresis, in the form of varnishes and gels, as well as in toothpastes. Unfortunately, the mechanisms of dentinal pain have not been fully studied and its symptoms are nonspecific and subjective. Therefore, there is no ideal composition for the treatment of sensitive dentin. In addition, the result of the therapy occurs in many cases over a long period of time.
 Conclusion. Thus, according to modern ideas, the treatment of hypersensitivity of the hard dental tissues can be carried out in two ways: desensitization of the nerve fibers to reduce the corresponding response to irritation; obturation of the dentinal tubules to restore intra-tubular osmotic pressure. These days one hundred percent result in the treatment has not been achieved, so it is important to find and develop new techniques and methods to eliminate teeth hyperesthesia.