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The Importance of Preventing and Managing Dentin Hypersensitivity in Patients with Periodontitis

Date: March 2021

Author: Natalie Bradley BDS DSCD MFDS RCSEd

As dentists, when we diagnose patients with periodontitis, our first priority is to treat that disease and help our patients address their oral health problems, including through behavior change. However, the consequences of periodontitis and treatment can impact patients' quality of life even if their oral health is stabilized. How? Due to dentin hypersensitivity (DHS).

Gingival recession and loss of clinical attachment results in dentin being exposed. When that exposed dentin has open dentinal tubules, patients can experience sensitivity to hot, cold sweet and acidic stimuli. Dentists must address DHS in addition to treating patients' periodontitis, in order to help ensure that patients are satisfied and that it does not affect their quality of life. It has been shown that scaling and root planing leads to DHS in 50% of patients - this can make patients believe that their dental treatment has worsened their oral health instead of improving it.

Should patients complain of pain typical of DHS, it is important to evaluate and rule out other causes, and then to explain to patients what their diagnosis of DHS means. This helps us reassure our patients that the treatment provided is helping their oral health, not worsening it, and we can also let them know that we have solutions to address their symptoms. Having an active dialogue prior to periodontitis treatment about preempting possible DHS is recommended, or even better to put measures into place prior to SRP in order to reduce the risk of patients experiencing this.

Be reassured that DHS can be prevented and managed by simple interventions. These include:

  1. Recommendation of a suitable desensitizing toothpaste, such as the Pro-Argin technology in Colgate Sensitive Pro-Relief toothpaste. Where available, this unique formulation locks in calcium and phosphate and blocks the dentinal tubules, also contains fluoride, and relieves sensitivity in one minute with a fingertip application. With twice-daily home use, it provides lasting relief from dentin sensitivity. Due to its immediate effect following fingertip application, this can also be used for in-office applications prior to scaling and root planing to help prevent the patient from experiencing DHS during treatment.
  2. Another option for a desensitizing toothpaste, where available, is Colgate PreviDent 5000 Sensitive toothpaste which can be prescribed for home use. This contains 5% potassium nitrate for sensitivity relief as well as 5,000 ppm fluoride to provide for increased protection against dental caries for patients with an elevated risk for caries.
  3. In-office application of Colgate Anywhere Anytime Sensitivity Relief Serum prior to dental treatment. This contains Pro-Argin technology which is fast-acting, working in one minute with a fingertip application. Patients can then take the rest of the tube home for on the go and at-home application.
  4. Another option is in-office application of Colgate PreviDent Varnish (Colgate Duraphat Varnish) which is also clinically proven to relieve sensitivity.
  5. Use of an anti-hypersensitivity mouthwash may also be recommended, where available. Elmex SENSITIVE PROFESSIONAL Mouthwash, which contains Pro-Argin mouthwash technology, provides effective and lasting relief from DHS when used for one minute twice-daily.

It is important to be able to diagnose and treat DHS as this condition can impact your patient's quality of life and, in fact, its management can be very simple with use of effective products.