-
The Journal of Evidence-based Dental... Jun 2014Current research about tooth whitening shows that it is safe and effective when manufacturer's protocol is followed, yet there are risks of which the profession and... (Review)
Review
UNLABELLED
Current research about tooth whitening shows that it is safe and effective when manufacturer's protocol is followed, yet there are risks of which the profession and users should be aware. This update provides a summary of current research and assessment of the safety and efficacy of tooth whitening regimens.
BACKGROUND
Tooth whitening has become one of the most frequently requested dental procedures by the public. The public has come to demand whiter, more perfect smiles and in response many choices for tooth whitening have been made available. These include home-based products such as toothpastes, gels, and films, as well as in-office based systems where products containing highly concentrated bleaching agents are applied under professional supervision. The profession and public have been aware of certain risks related to tooth whitening such as increased tooth sensitivity and gingival irritation. New research has shown that there are other risks such as tooth surface roughening and softening, increased potential for demineralization, degradation of dental restorations, and unacceptable color change of dental restorations. The new research is also focused on optimizing whitening procedures to reduce tooth sensitivity and to increase the persistence of the whitening.
METHODS
Current reports in the literature are reviewed that are related to the use of peroxide based whitening methods. These reports include in vitro studies for method optimization and mechanism as well as clinical studies on effects of various whitening regimens.
CONCLUSIONS
When manufacturer's instructions are followed, hydrogen peroxide and carbamide peroxide based tooth whitening is safe and effective. Patients should be informed of the risks associated with tooth whitening and instructed on identification of adverse occurrences so that they may seek professional help as needed.
Topics: Dentin Sensitivity; Gingiva; Humans; Risk Factors; Tooth Bleaching; Tooth Bleaching Agents; Tooth Demineralization
PubMed: 24929591
DOI: 10.1016/j.jebdp.2014.02.006 -
Indian Journal of Dental Research :... 2018Among the number of vital bleaching techniques currently available to the clinicians, home bleaching and in-office bleaching are widely used in dental practice.
BACKGROUND
Among the number of vital bleaching techniques currently available to the clinicians, home bleaching and in-office bleaching are widely used in dental practice.
AIM AND OBJECTIVES
The aim of this in vivo study was to compare the clinical performance, durability, and related tooth sensitivity with two vital bleaching procedures (in-office and at-home bleaching), in a split-mouth design.
PATIENTS AND METHODS
Thirty adult participants having teeth shade mean of A2 or darker were selected for the study. One-half of the maxillary arch of each patient received in-office bleaching with 35% hydrogen peroxide gel, and the other half received 16% carbamide peroxide night guard bleaching. Shade evaluation was done with shade guide and spectrophotometer at 1, 2, 3, and 4 week intervals during bleaching and postoperatively at 3 and 6 month intervals. Tooth sensitivity was recorded using the visual analog scale during the experimental period.
STATISTICAL ANALYSIS
Collected data of color and sensitivity readings were subjected to statistical analysis using SPSS/PC version 20 software. Intergroup comparison through unpaired t-test and within the groups using paired t-test was done.
RESULTS
At-home and in-office bleaching procedures are equally effective in producing tooth whitening. Color evaluation after 3 and 6 months showed more color decline for in-office bleaching procedure. For sensitivity parameter also, in-office procedure recorded higher sensitivity compared to home bleaching (P < 0.05).
CONCLUSION
Both the bleaching procedures are equally effective in producing tooth whitening. In-office bleaching recorded higher levels of tooth sensitivity and greater color rebound than home bleaching.
Topics: Adolescent; Adult; Aged; Carbamide Peroxide; Color; Dentin Sensitivity; Female; Humans; Hydrogen Peroxide; Male; Middle Aged; Spectrophotometry; Time Factors; Tooth; Tooth Bleaching; Tooth Bleaching Agents; Visual Analog Scale; Young Adult
PubMed: 30127190
DOI: 10.4103/ijdr.IJDR_688_16 -
BMC Oral Health Aug 2020Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential... (Review)
Review
Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential diagnosis as well as selection of reliable treatment modalities for this condition. The neurosensory mechanisms underlying DHS remain unclear, but fluid movements within exposed dentinal tubules, i.e., the hydrodynamic theory, has been a widely accepted explanation for DHS pain. As several dental conditions have symptoms that mimic DHS at different stages of their progression, diagnosis and treatment of DHS are often confusing, especially for inexperienced dental practitioners. In this paper we provide an up-to-date review on risk factors that play a role in the development and chronicity of DHS and summarize the current principles and strategies for differential diagnosis and management of DHS in dental practices. We will outline the etiology, predisposing factors and the underlying putative mechanisms of DHS, and provide principles and indications for its diagnosis and management. Though desensitization remains to be the first choice for DHS for many dental practitioners and most of desensitizing agents reduce the symptoms of DHS by occluding patent dentinal tubules, the long-term outcome of such treatment is uncertain. With improved understanding of the underlying nociceptive mechanisms of DHS, it is expected that promising novel therapies will emerge and provide more effective relief for patients with DHS.
Topics: Dentin; Dentin Sensitivity; Dentists; Humans; Professional Role; Risk Factors
PubMed: 32762733
DOI: 10.1186/s12903-020-01199-z -
Clinical Oral Investigations Mar 2013The paper's aim is to review dentin hypersensitivity (DHS), discussing pain mechanisms and aetiology. (Review)
Review
OBJECTIVES
The paper's aim is to review dentin hypersensitivity (DHS), discussing pain mechanisms and aetiology.
MATERIALS AND METHODS
Literature was reviewed using search engines with MESH terms, DH pain mechanisms and aetiology (including abrasion, erosion and periodontal disease).
RESULTS
The many hypotheses proposed for DHS attest to our lack of knowledge in understanding neurophysiologic mechanisms, the most widely accepted being the hydrodynamic theory. Dentin tubules must be patent from the oral environment to the pulp. Dentin exposure, usually at the cervical margin, is due to a variety of processes involving gingival recession or loss of enamel, predisposing factors being periodontal disease and treatment, limited alveolar bone, thin biotype, erosion and abrasion.
CONCLUSIONS
The current pain mechanism of DHS is thought to be the hydrodynamic theory. The initiation and progression of DHS are influenced by characteristics of the teeth and periodontium as well as the oral environment and external influences. Risk factors are numerous often acting synergistically and always influenced by individual susceptibility.
CLINICAL RELEVANCE
Whilst the pain mechanism of DHS is not well understood, clinicians need to be mindful of the aetiology and risk factors in order to manage patients' pain and expectations and prevent further dentin exposure with subsequent sensitivity.
Topics: Dentin; Dentin Sensitivity; Disease Susceptibility; Humans; Hydrodynamics; Pain; Periodontal Diseases; Risk Factors; Tooth Cervix; Tooth Wear
PubMed: 23224116
DOI: 10.1007/s00784-012-0887-x -
Journal of Dentistry Feb 2019The purpose of this study was to estimate the prevalence of dentin hypersensitivity in various populations. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
The purpose of this study was to estimate the prevalence of dentin hypersensitivity in various populations.
SOURCES
Four electronic databases (Medline via PubMed, Cochrane Library, Wiley Online Library and Web of Science) were searched until June 2018.
STUDY SELECTION
Cross-sectional studies on the prevalence of dentin hypersensitivity were included. Meta-analysis were conducted and meta-regression models were used to explain the variation of the prevalence measures. Data were extracted, and the studies were assessed for quality.
DATA
A total of 65 papers (reporting on 77 studies) met the inclusion criteria and were included in the meta-analysis. The prevalence range was observed to be as low as 1.3% and as high as 92.1%. Effect modifiers for dentin hypersensitivity prevalences were the type of participants included in the study, age range, recruitment strategy and number of study sites. Higher prevalences were observed in studies involving specialty practice patients, younger adults, convenience sample and those characterized as single-site.
CONCLUSION
The best estimate of dentin hypersensitivity was 11.5% (95%CI:11.3%-11.7%) and the average from all studies was 33.5% (95%CI: 30.2%-36.7%). The extremely high degree of heterogeneity among studies can only be partially explained by characteristics of the studies.
CLINICAL SIGNIFICANCE
Dentin hypersensitivity is a persistent clinical problem that poses significant challenge for clinicians and affects patients' quality of life. Better understanding of the dentin hypersensitivity burden and its associated factors can assist on resource planning for reducing/preventing any discomfort arising from this condition and will aid in the decision-making process.
Topics: Cross-Sectional Studies; Databases, Factual; Dentin Sensitivity; Humans; Prevalence; Quality of Life
PubMed: 30639724
DOI: 10.1016/j.jdent.2018.12.015 -
Dental and Medical Problems 2022The prevalence of dentin hypersensitivity (DH) is increasing around the world. At least one in 10 individuals in the general population has been diagnosed with DH. It is... (Review)
Review
The prevalence of dentin hypersensitivity (DH) is increasing around the world. At least one in 10 individuals in the general population has been diagnosed with DH. It is a diagnosis that has significant negative effects on a person's oral health-related quality of life. This condition, which is characterized by sharp, short tooth pain in response to thermal, chemical, tactile, and evaporative stimuli, is more commonly seen in adults. DH has a tremendous impact on the social and financial aspects of patients and society at large. It is essential to recognize the factors that can contribute to a successful treatment outcome to guarantee the overall well-being of DH patients. The aim of this narrative review was to highlight strategies that can lead to successful DH treatment outcomes, along with current updates on DH mechanisms, treatment options, and the latest management approaches. A positive treatment outcome for DH requires a concerted effort from both the patient and the dental practitioner. Highly motivated patients and dental practitioners with sound knowledge of DH diagnosis and available treatment options will ensure successful long-term improvement of DH symptoms.
Topics: Adult; Dentin Sensitivity; Dentists; Humans; Professional Role; Quality of Life; Treatment Outcome
PubMed: 36206495
DOI: 10.17219/dmp/143354 -
Cureus Apr 2022Bleaching agents can cause certain surface alterations on the enamel, such as depressions, surface porosity, and surface irregularities; this makes the dentin more... (Review)
Review
Bleaching agents can cause certain surface alterations on the enamel, such as depressions, surface porosity, and surface irregularities; this makes the dentin more susceptible to post-operative tooth sensitivity (PoS). In addition, the presence of flawed or leaky restorations, gingival recession, or defects in the cementoenamel junction can also cause severe tooth sensitivity post tooth bleaching.Hence, the current study aimed to perform a systematic review to determine the efficacy of various desensitizing agents (DA) in managing post-operative tooth sensitivity and color alteration when applied before in-office bleaching procedures. Randomized clinical trials were searched to conduct an SR where the post-operative tooth sensitivity was evaluated after in-office bleaching with various desensitizing agents used before the procedure. Post-operative pain assessment was measured using the Visual Analogue Scale (VAS). Outcomes were evaluated up to an hour and 24 hours post the procedure. Out of 163 articles, only 13 titles were selected that met the eligibility criteria. Eight hundred and forty-one adult patients with vital pulp status were included. The participants receiving prior desensitizing agent applications reported significantly lower pain scores in the VAS reports. The most significant reduction of post-operative sensitivity was observed in the immediate (up to an hour) and 24 hours after the in-office bleaching. The popular desensitizing agent that could manage post-operative tooth sensitivity (TS) is 5% potassium nitrate and 2% sodium fluoride used before the in-office bleaching procedure.
PubMed: 35547454
DOI: 10.7759/cureus.24028 -
Journal of Esthetic and Restorative... Jan 2022This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
This study comprehensively reviewed clinical trials that investigated the effect of immediate dentin sealing (IDS) technique on postoperative sensitivity (POS) and clinical performance of indirect restorations.
MATERIALS AND METHODS
The systematic review was conducted according to the preferred reporting items for systematic reviews and meta-analyses statement, and was guided by the PICOS strategy. Clinical trials in which adult patients received at least one indirect restoration cemented with IDS approach and one restoration cemented following the delayed dentin sealing (DDS) were considered.
RESULTS
Following title screening and full-text reading, four studies met the inclusion criteria and were included for qualitative synthesis, while two studies were selected for quantitative synthesis. According to Risk of bias-2 tool, two studies were classified as "some concerns" for the outcome POS. No statistically significant differences were found between teeth restored with indirect restorations using the IDS and DDS approach for POS (p > 0.05), neither at the baseline (very low certainty of evidence according to GRADE) nor after 2 years of follow-up (low certainty of evidence according to GRADE).
CONCLUSION
There is low-certainty evidence that IDS does not reduce POS in teeth restored with indirect restorations.
CLINICAL SIGNIFICANCE
There is no clinical evidence to favor IDS over DDS when restoring teeth with indirect restorations.
Topics: Adult; Composite Resins; Dentin; Humans; Molar
PubMed: 34859939
DOI: 10.1111/jerd.12841 -
Dental and Medical Problems 2023Laser protocols for the treatment of dentin hypersensitivity (DH) have not yet been studied systematically. (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Laser protocols for the treatment of dentin hypersensitivity (DH) have not yet been studied systematically.
OBJECTIVES
The present study aimed to review clinical trials on the treatment of DH with laser therapy through a systematic review and meta-analysis.
MATERIAL AND METHODS
The search of electronic databases resulted in 562 publications up to April 2020. The inclusion criteria were studies carried out on humans and reporting on the treatment of DH with laser therapy. Case reports, literature reviews and systematic reviews were excluded. Selected by abstract, potentially eligible papers were read in full (n = 160). Independent examiners performed data extraction and the assessment of the risk of bias.
RESULTS
A total of 34 studies were included in the analysis, and 11 in the quantitative analysis. It was observed that most studies followed up patients for a maximum of 6 months (55%). Through the meta-analysis, we observed statistically significant differences between the average pain before and after 3 months of treatment with highand low-power lasers. However, through indirect comparisons, it was observed that the high-power laser showed a greater tendency to reduce the pain levels after 3 months of treatment as compared to the low-power laser, but without a statistically significant difference.
CONCLUSIONS
It was possible to conclude that regardless of the type of laser used in the treatment of DH, this treatment is an effective option for the control of pain symptoms. However, it was not possible to establish a defined treatment protocol, since the evaluation methods are very different from each other. Text for Rewiew and clinical cases.
Topics: Humans; Dentin Sensitivity; Laser Therapy; Low-Level Light Therapy; Treatment Outcome; Lasers
PubMed: 37023343
DOI: 10.17219/dmp/151482 -
Australian Dental Journal Jun 2014Abnormalities of enamel and dentine are caused by a variety of interacting factors ranging from genetic defects to environmental insults. The genetic changes associated... (Review)
Review
Abnormalities of enamel and dentine are caused by a variety of interacting factors ranging from genetic defects to environmental insults. The genetic changes associated with some types of enamel and dentine defects have been mapped, and many environmental influences, including medical illnesses that can damage enamel and dentine have been identified. Developmental enamel defects may present as enamel hypoplasia or hypomineralization while dentine defects frequently demonstrate aberrant calcifications and abnormalities of the dentine-pulp complex. Clinically, developmental enamel defects often present with problems of discolouration and aesthetics, tooth sensitivity, and susceptibility to caries, wear and erosion. In contrast, dentine defects are a risk for endodontic complications resulting from dentine hypomineralization and pulpal abnormalities. The main goals of managing developmental abnormalities of enamel and dentine are early diagnosis and improvement of appearance and function by preserving the dentition and preventing complications. However, despite major advances in scientific knowledge regarding the causes of enamel and dentine defects, further research is required in order to translate the knowledge gained in the basic sciences research to accurate clinical diagnosis and successful treatment of the defects.
Topics: Amelogenesis Imperfecta; Dental Caries; Dental Enamel; Dental Enamel Hypoplasia; Dental Research; Dentin; Dentin Sensitivity; Dentinogenesis Imperfecta; Humans; Tooth Demineralization
PubMed: 24164394
DOI: 10.1111/adj.12104