Increased sensitivity of the teeth (dental hyperesthesia). What to do with tooth sensitivity: treatment and prevention

Hyperesthesia - increased sensitivity of teeth to the effects of various irritating factors: sour and sweet, cold, hot or spicy. The pain occurs when the irritant hits the surface of the teeth and quickly passes. This distinguishes hyperesthesia from an acute inflammatory disease of the pulp (nerve), in which the pain does not go away for a long time (several minutes). A characteristic sign of hypersensitivity may be pain while brushing your teeth or when going outside and inhaling cold air. This problem occurs in both adults and children, especially during puberty, when the hormonal background of the child changes. Hyperesthesia can manifest itself as an independent syndrome, not associated with the development of another disease, or stand out as a sign of the underlying disease (periodontitis, periodontal disease, infectious diseases, endocrine disorders, etc.).

Causes of sensitive tooth reaction

Exposure to tooth enamel of fruit acids leads to an increase in its sensitivity.

Non-systemic factors:

the impact of acids (citrus juices, fruits, soda) on tooth enamel;
the use of whitening toothpaste and a hard brush (you can compare the time of pain with the start of using new items and hygiene products, sometimes manifestations occur after a few days);
pathological abrasion of dental tissues (initial manifestations of pain - along the cutting edges of the crowns of the teeth);
enamel erosion;
wedge-shaped defects (localized in the cervical areas of the teeth);
initial (softening of the surface layer of enamel);
periodontal disease (periodontitis);
after turning the teeth under the crown;
after removal of tartar (the enamel covered by it has a less dense structure and after removing deposits for several days remains susceptible to irritants);
after a chemical procedure (the outer layer of enamel is damaged);
microtraumas, enamel cracks, chipped corners of crowns (bad habits are important - chewing seeds, biting off wire or thread with teeth, etc.).

System factors:

lack of minerals (calcium, phosphorus, etc.);
toxicosis of pregnant women;
infections and viruses;
endocrine disorders;
mental illness, stress;
action of ionizing radiation;
taking hormonal contraceptives;
chemical production, occupational hazards.

Classification of hyperesthesia

Limited form (pain in the area of one or more teeth)
Systemic form (pain in the area of all teeth of one jaw or side)

According to clinical manifestations:

Grade 1 - pain reaction to cold, heat.
Grade 2 - pain from temperature stimuli plus from sweet, sour, salty, spicy.
Grade 3 - tooth tissues react to all types of stimuli.

Why do teeth become sensitive?

The main tissues are enamel, which protects the teeth from the outside, and dentin, located closer to the nerve (pulp). In structure, dentin is similar to bone tissue; it contains microscopic dentinal tubules with liquid. They stretch from the nerve cells lying in the pulp to the tooth enamel. In the tubules are the processes of nerve cells, they transmit a pain impulse under the action of stimuli. This happens when the enamel is thinning as a result of various reasons.

Treatment of tooth sensitivity

Treatment should begin with the observance of certain dietary rules. With an increase in the reaction of tooth enamel to sour, sweet, cold, such products should be avoided. Citrus fruits, freshly squeezed juices and sodas contain acids that are aggressive to the teeth. Avoid sudden changes in temperature, such as hot coffee with ice cream. Crackers, nuts, seeds can cause the appearance of microcracks and chips on the surface of the teeth. Foods rich in calcium, phosphorus, potassium, magnesium, iron (sea fish, seafood, milk, cheese, cottage cheese, liver) are very useful for strengthening teeth.

To reduce the sensitivity of enamel and dentin, various means are used. It can be special toothpastes, elixirs, gels and foams, varnishes, solutions and preparations for oral administration. Treatment of hypersensitivity should be complex, including not only local effects on dental tissues. It is necessary to find out the cause of the appearance of soreness, and if hyperesthesia is a symptom of another disease, it must first be treated.

Desensitizing toothpastes

A patient complaining of increased sensitivity of the teeth will probably be advised to clean the forelocks with a special paste.

Using pastes at home is convenient for the patient. Every day, while brushing your teeth, not only oral hygiene is carried out, but also a therapeutic effect on dental tissues. Examples of such pastes:

Oral-B Sensitive Original (contains 17% hydroxyapatite, similar in structure to the structural elements of enamel);
MEXIDOL dent Sensitive;
Sensodyne-F (contains a potassium compound whose ions block nerve impulse transmission);
"Rembrandt Sensitive" (forms a protective film on the teeth, you need to apply after each meal, it has an additional whitening effect).

Therapeutic pastes to reduce hyperesthesia contain alkalis (sodium bicarbonate, potassium and sodium carbonates), which, by binding to water in the dentinal tubules, cause their dehydration and, as a result, a decrease in susceptibility to irritation. It is necessary to apply such pastes in courses several times a year, the frequency of which depends on the degree of sensitivity of the teeth.

Therapeutic gels, varnishes, foams

Various companies have developed additional products to combat hyperesthesia. Gels, foams and mousses can be used with mouthguards by putting them on your teeth before going to bed. It is especially effective in systemic hyperesthesia. Solutions are used in the form of rinses several times a day or they are moistened with cotton turundas, balls, with which the agent is applied to the teeth. Varnishes form a protective film on the teeth after application, after which it is not recommended to eat for 30-40 minutes. All funds should be used regularly, only after a few days or even weeks their therapeutic effect becomes noticeable.

Bifluoride 12 (lacquer based on sodium and calcium fluoride);
Fluocal - gel or solution (the latter can be used in conjunction with electrophoresis);
Fluoride varnish (forms a yellow film on the teeth);
Remodent is a powder that is used as a 3% solution (for rinsing or leaving it for 15–20 minutes on cotton balls, a course of at least 10 applications). It contains elements such as zinc, iron, sodium, calcium, magnesium, phosphorus, manganese;
Strontium chloride paste 75% (for application to the teeth) or 25% aqueous solution (rinse);
10% calcium gluconate solution (apply for 15-20 minutes on the teeth);
Professional dental gel Tooth Mousse. Due to its special composition, it reacts with the saliva of the oral cavity to form a protective film. Apply the product to the teeth with cotton swabs or a finger, leave for 3 minutes. Can be used in children from 1 year;
MI Paste Plus (dental cream with fluoride, applied to teeth for 3 minutes, contraindicated in children under 12 years old).

Means for the treatment of hyperesthesia can be used in the prevention of caries in children with weak enamel.

Electrophoresis (iontophoresis)

This is a method of electrotherapy, in which the patient's body is affected by a constant galvanic or pulsed current along with a medicinal substance. The following agents are used to treat hyperesthesia:

5% solution (for children) or 10% solution of calcium gluconate (for adults) with a course of at least 10 procedures for 10-15 minutes;
1% sodium fluoride;
Vitamin B1 with trimekain;
Fluocal (solution).

Folk remedies for the treatment of increased sensitivity of the teeth

Tea tree oil (3 drops in a glass of warm water, rinse your mouth several times a day).
A decoction of oak bark (1 tablespoon of dry matter per glass of boiled water, keep on fire or leave for 5-10 minutes).
A decoction or infusion of chamomile and burdock (pour 1 teaspoon of dry herb with a glass of boiling water, leave for an hour and rinse your mouth).
Hold warm cow's milk in your mouth (for short-term relief of pain).

Treatment of hyperesthesia of the teeth should be carried out systematically and regularly. When the first symptoms appear, you should immediately start using pastes or other means, follow a diet. The presence of chronic diseases, against which the soreness of the enamel manifested itself, or medication makes it difficult to treat hyperesthesia. In such cases, it is possible to act on the tissues of the tooth with local preparations or remove the nerves in those teeth where the pain is very severe and local treatment does not help. One of the options is to cover the teeth with crowns.

Hyperesthesia of the teeth

What is Hyperesthesia of the teeth -

Hyperesthesia- increased sensitivity of tooth tissues to the action of mechanical, chemical and thermal stimuli. Most often this phenomenon is observed in the pathology of dental tissues of non-carious origin, as well as in caries and periodontal diseases.

Pathogenesis (what happens?) during Hyperesthesia of the teeth:

With caries, hypersensitivity can be in one area. Very often, hyperesthesia is observed during abrasion of tooth tissues, when the loss of enamel reaches the dentin-enamel junction. However, not all types of abrasion show increased sensitivity in the same way. So, with erosion of the enamel, hyperesthesia is often observed, while with a wedge-shaped defect, it almost never occurs. Sometimes a sharp sensitivity is observed even with a slight exposure of the necks of the teeth (by 1-3 mm).

In addition to the pain reaction of the teeth resulting from the action of local stimuli (the so-called non-systemic hyperesthesia), tooth pain can also occur in connection with some pathological conditions of the body (systemic, or generalized, hyperesthesia). The latter is observed in 63-65% of patients with increased pain reaction of the teeth. So, sometimes pain in the teeth is recorded with psychoneuroses, endocrinopathies, diseases of the gastrointestinal tract, menopause, metabolic disorders, infectious and other diseases.

Symptoms of hyperesthesia of the teeth:

Hyperesthesia manifests itself in a variety of ways. Usually, patients complain of intense, but quickly passing pain, caused by the action of temperature (cold, warm), chemical (sour, sweet, salty) or mechanical stimuli. The patients say that they cannot inhale cold air, eat sour, sweet, salty, fruits, take only slightly warmed food. As a rule, these phenomena are constant, but sometimes there may be a temporary decrease or cessation of pain (remission).

In some cases, it is difficult to identify a diseased tooth, as the pain radiates to adjacent teeth.

On examination, as a rule, changes in the structure of the hard tissues of the tooth or the state of the periodontium are revealed. Most often, there is a decrease in hard tissues on the chewing surface or at the cutting edge, but often it is noted on the vestibular surface of incisors, canines and small molars.

In all cases, the exposed dentin is hard, smooth, shiny, sometimes slightly pigmented. When probing the area of exposed dentin, pain occurs, sometimes very intense, but quickly passing. Exposure to cold air, as well as sour or sweet causes a pain reaction.

Sometimes there is a slight exposure of the neck of the teeth only from the vestibular surface, but the pain is pronounced. However, there may be significant root exposure, but the sensitivity is usually seen in only one area. Sometimes hyperesthesia is observed at the bifurcation of the roots.

There are several classifications of hyperesthesia. A more detailed classification of hyperesthesia was developed by Yu.A. Fedorov et al. (1981).

By prevalence
- The limited form usually appears in the area of individual or several teeth, more often in the presence of single carious cavities and wedge-shaped defects, as well as after the preparation of teeth for artificial crowns and inlays.
- The generalized form manifests itself in the region of most or all teeth, more often in the case of exposure of the necks and roots of the teeth in periodontal diseases, pathological tooth abrasion, multiple dental caries, as well as in the multiple and progressive form of dental erosion.
Origin
- Dentin hyperesthesia associated with the loss of hard tooth tissues:
  - in the area of carious cavities;
  - arising after the preparation of tooth tissues for artificial crowns, inlays, etc.;
  - concomitant pathological abrasion of hard tissues of the tooth and wedge-shaped defects;
  - with erosion of hard tissues of teeth
Hyperesthesia of dentin, not associated with the loss of hard tooth tissues:
- hyperesthesia of the dentin of the exposed necks and roots of the teeth in periodontal disease and other periodontal diseases;
- dentine hyperesthesia of intact teeth (functional), accompanying general disorders in the body.
By clinical course

Grade I- tooth tissues react to temperature (cold, heat) irritant; the electrical excitability threshold of dentin is 5-8 μA.

Grade II- tooth tissues react to temperature and chemical (salty, sweet, sour, bitter) irritants; the threshold of electrical excitability of dentin is 3-5 μA.

Grade III- tooth tissues react to all types of stimuli (including tactile); the threshold of electrical excitability of dentin reaches 1.5-3.5 μA.

Using this classification, it is possible to facilitate differential diagnosis and determine the choice of the most rational methods for eliminating hyperesthesia of hard dental tissues.

Diagnosis of Hyperesthesia of the teeth:

Hyperesthesia of hard tissues must first of all be differentiated from acute pulpitis, since the similarity lies in the presence of acute pain and difficulty in identifying a diseased tooth. The diagnosis is made taking into account the duration of pain (with pulpitis it is long, occurs at night) and the condition of the pulp (with pulpitis, the tooth reacts to currents of more than 20 μA, and with hyperesthesia, the reaction of the pulp to the current is not changed - 2-6 μA).

Treatment of Hyperesthesia of the teeth:

Therapy for hyperesthesia of hard tissues of the tooth has its own history. Proposals for the use of many medicinal substances in order to eliminate hyperesthesia indicate its lack of effectiveness. Used substances that destroy the organic substance of the hard tissues of the tooth. This group includes solutions of silver nitrate and zinc chloride. In case of hyperesthesia of hard tissues, pastes were widely used, which include alkalis: sodium bicarbonate, sodium, potassium, magnesium carbonates, as well as substances that can rebuild the structure of hard tissues of the tooth: sodium fluoride, strontium chloride, calcium preparations, etc. According to modern concepts, the fluorine ion is able to replace the hydroxyl group in hydroxyapatite, turning it into a more stable compound - fluorapatite. Indeed, after applying 75% fluoride paste to the dried area of sensitive dentin, pain relief occurs, and after 5-7 procedures the pain may disappear. However, after a short period of time, pain reappears, which is a significant drawback of the method.

In order to relieve pain sensitivity, dicaine liquid, proposed by E.E. Platonov, was used. 1-2 minutes after applying the liquid, tissue preparation becomes possible. However, the analgesic effect is short-lived.

A more effective method for removing hyperesthesia was proposed later by Yu.A. Fedorov and V.V. Volodkina. For local action, they used a paste of calcium glycerophosphate on glycerin (6-7 procedures), along with ingestion of glycerophosphate or calcium gluconate 0.5 g 3 times a day for a month, multivitamins (3-4 tablets per day), phytoferolactol (1 g per day) for a month. The authors propose to use the proposed scheme 3 times a year.

Therapeutic effect has a systematic use of remineralizing paste "Pearl".

At present, with hyperesthesia of tooth tissues, re-mineralizing therapy is widely used. The theoretical substantiation of the method is that with some types of hypersensitivity, in particular with erosion of hard tissues, surface demineralization was found. In the case of this procedure, the teeth are isolated from saliva, thoroughly dried with a cotton swab and plaque is removed from the enamel surface. Then 10% calcium gluconate solution or remodent solution is applied for 5-7 minutes. During every third visit, after two applications of the remineralizing liquid, the surface is treated with 1-2% sodium fluoride solution. Fluoride varnish can be used instead of this solution. Inside prescribe calcium gluconate 0.5 g 3 times a day for a month. Along with this, it is recommended, if possible, to exclude juices, acidic foods from the diet, and use fluoride-containing pastes for brushing your teeth. As a rule, improvement occurs after 5-7 procedures, and hyperesthesia disappears after 12-15 procedures. It should be borne in mind that after 6-12 months it may occur again. In such cases, it is recommended to repeat the course of treatment.

Which doctors should be contacted if you have Hyperesthesia of the teeth:

Dentist

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Other diseases from the group Diseases of the teeth and oral cavity:

Abrasive precancerous cheilitis of Manganotti

Abscess in the face

Adenophlegmon

Adentia partial or complete

Actinic and meteorological cheilitis

Actinomycosis of the maxillofacial region

Allergic diseases of the oral cavity

Allergic stomatitis

Alveolitis

Anaphylactic shock

angioedema angioedema

Anomalies of development, teething, discoloration

Anomalies in the size and shape of the teeth (macrodentia and microdentia)

Arthrosis of the temporomandibular joint

Atopic cheilitis

Behçet's disease of the mouth

Bowen's disease

Warty precancer

HIV infection in the mouth

Impact of acute respiratory viral infections on the oral cavity

Inflammation of the dental pulp

Inflammatory infiltrate

Dislocations of the lower jaw

Galvanosis

Hematogenous osteomyelitis

Duhring's dermatitis herpetiformis

Herpangina

Gingivitis

Gynerodontia (Crowding. Persistent baby teeth)

Hyperplastic osteomyelitis

Hypovitaminosis of the oral cavity

hypoplasia

Glandular cheilitis

Deep incisal overlap, deep bite, deep traumatic bite

Desquamative glossitis

Defects of the upper jaw and palate

Defects and deformities of the lips and chin

Facial defects

Mandibular defects

Diastema

Distal bite (upper macrognathia, prognathia)

periodontal disease

Diseases of the hard tissues of the teeth

Malignant tumors of the upper jaw

Malignant tumors of the lower jaw

Malignant tumors of the mucous membrane and organs of the oral cavity

Plaque

Dental deposits

Changes in the oral mucosa in diffuse diseases of the connective tissue

Changes in the oral mucosa in diseases of the gastrointestinal tract

Changes in the oral mucosa in diseases of the hematopoietic system

Changes in the oral mucosa in diseases of the nervous system

Changes in the oral mucosa in cardiovascular diseases

Changes in the oral mucosa in endocrine diseases

Calculous sialadenitis (salivary stone disease)

Candidiasis

oral candidiasis

Dental caries

Keratoacanthoma of the lip and oral mucosa

acid necrosis of the teeth

Wedge-shaped defect (abrasion)

Cutaneous horn of the lip

computer necrosis

Contact allergic cheilitis

lupus erythematosus

Lichen planus

drug allergy

Macrocheilitis

Drug and toxic disorders of the development of hard tissues of the tooth

Mesial occlusion (true and false progeny, progenic ratio of the anterior teeth)

Multiform exudative erythema of the oral cavity

Taste disorder (dysgeusia)

salivation disorder (salivation)

Necrosis of hard tissues of teeth

Limited precancerous hyperkeratosis of the red border of the lips

Odontogenic sinusitis in children

Shingles

Tumors of the salivary glands

Acute periostitis

Acute purulent (abscessing) lymphadenitis

Acute nonspecific sialadenitis

Acute osteomyelitis

Acute osteitis

Acute serous lymphadenitis

Open bite

Focal-caused diseases of the oral cavity

Hyperesthesia is called hypersensitivity of the teeth. Surely many have experienced manifestations of hyperesthesia.

It's a rather unpleasant sensation when you bite off a piece of ice cream in the heat of summer, or try to warm yourself by taking a sip of hot tea in winter. According to the statistics of dentists, practically half of the population suffers from this phenomenon to some extent.

Most people are used to completely ignoring such sensations, as they consider it a temporary and individual phenomenon. This approach is fundamentally wrong.

The fact is that hyperesthesia can be an independent problem, or it can signal the development of other dental diseases, for example, caries. Today we will try to tell you more about what hyperesthesia is and how you can get rid of it.

Hypersensitivity from the point of view of science

So, hyperesthesia is defined as an increased sensitivity of the hard layers covering the tooth. Beneath the hardest layer, the enamel, is the dentin, which is made up of bone tissue and forms the bulk of the tooth.

Since teeth are a full-fledged part of our body, they are also alive - they receive nutrition, develop, and have nerve endings.

The dentin throughout the entire volume is permeated with thin small tubules, which resemble tubules in shape. With the help of these tubules, the bone tissue is connected to the inner part - the pulp.

This occurs through thin processes of nerve endings passing from the dentin through the tubules. They are also filled with a special fluid that is constantly in motion.

It is the change in the speed of movement of this fluid that contributes to the occurrence of pain and sharp discomfort. Usually external irritants - hot or cold - cannot penetrate the tooth enamel.

However, when it is too thin, the tubules in the dentin are exposed. Therefore, temperature change and other factors cause change in the velocity of dentinal fluid. Then patients complain of pain and greater sensitivity.

What dentists say about tooth sensitivity - watch the video:

Causes

The reasons for this extremely unpleasant phenomenon are completely individual and so diverse that it is unlikely that it will be possible to list them all. Therefore, we give only the most common and main causes of hyperesthesia.

Even severe nervous exhaustion can cause hyperesthesia, as well as prolonged depression and exposure to radiation. In addition, bad habits that weaken the entire body also have a negative effect on tooth enamel.

Kinds

At the moment, several types of classification of this disease have been developed. Each is associated with one of the determining factors - the prevalence, origin, severity of the disease.

According to the prevalence of the phenomenon

Limited hyperesthesia- Hypersensitivity is observed only for a few teeth. This is usually associated with the formed carious cavities, the presence of a wedge-shaped defect (gingival enamel lesion), as well as mechanical damage, for example, preparation and filing of teeth for the installation of orthopedic structures.
Generalized- observe an increase in sensitivity for all teeth or their main mass. Most often, this phenomenon occurs together with extensive caries, inflammatory diseases of the periodontal tissues or widespread erosion of the enamel, in addition, with the so-called aging of the teeth.

According to the origin of the phenomenon

Disease not associated with the destruction (or loss) of hard tissues:

with various diseases and inflammations of the gums, it is possible to expose the lower part of the teeth - the cervical region and even the roots;
common diseases can cause sensitivity in perfectly healthy (intact) teeth.

Loss or destruction of hard tissues:

where there is caries;
preparation of enamel and dentin for the installation of various designs;
erosion development;
the appearance of a wedge-shaped defect or severe aging.

Degree of hyperesthesia or clinical course

First degree- pain reaction occurs after exposure to thermal stimuli. At this stage, the electrical excitability of dentin appears at 5-8 μA.
Second degree- the threshold of electrical excitability is reduced to 3-5 μA, and additional stimuli are also chemical factors, that is, bitter, sour, salty, sweet.
Third degree- here the dentin already reacts to an electric current of 1.5-3 μA. In addition to the previously listed temperature and chemical stimuli, there is also pain on tactile contact.

Diagnostics

The difficulty in diagnosing hyperesthesia is to separate it from other diseases. First of all, this. The fact is that with pulpitis there are also strong and sharp pain sensations, and there is also no way to determine exactly which tooth is their source.

To make a correct diagnosis, the duration of pain should be taken into account.. If, with hyperesthesia, pain attacks are short-term, then pulpitis gives long-term pain. And it occurs mostly at night.

They also use the fact that during pulpitis, the reaction to an electric current occurs in discharges of more than 20 μA.

Treatment

Treatment of this disease is a rather complicated process. The choice of technique usually depends on what exactly the disease was caused by.

Remineralization and fluoridation. There are procedures that will help saturate the enamel with the necessary substances to strengthen it. First of all, it is calcium and fluorine.
With a strong thinning of the enamel (second and third severity), it can be increased in volume with the help of modern filling materials.
If hyperesthesia was caused by caries, then it is necessary to completely remove all foci of its occurrence and close the resulting cavities.
Bare roots and cervical areas can be closed with surgery.
If the enamel is subject to abrasion, then in most cases there is a need for preliminary orthodontic treatment, that is, bite correction.
An extensive form of hyperesthesia, which is called generalized, is not subject to conventional dental treatment. In this case, it is mandatory to take drugs that can restore the exchange of phosphorus and calcium. Basically, these are various mineral supplements and vitamin complexes.
Most often, during treatment, experts recommend that the patient use special pastes and gels that will help restore enamel - containing fluoride and calcium.
Electrophoresis is used in combination with special compounds (fluorine and calcium compounds), which serve to saturate the enamel with the necessary elements.
Folk remedies should also not be overlooked. Usually these are rinses using tea tree oil, oak bark, burdock and chamomile.

Prevention

In order to avoid the appearance of hyperesthesia, you should follow some rules. They will be preventive measures.

Primarily - proper and balanced nutrition. The diet should contain enough foods containing vitamins and minerals that are necessary to strengthen enamel and gum health. Among the main vitamins - C, D, A, group B. Particular attention should be paid to minerals - calcium, fluorine, potassium, phosphorus.
The right approach to hygiene. Firstly, all procedures must be of high quality (correct brush movements), timely (after meals) and regular (daily, at least in the morning and evening). Secondly, you need to choose the right care products - brush, paste, floss, and so on. It is advisable not to use products that have a high rate of abrasiveness.
Mandatory preventive examinations every six months in the dental office. Also here you need to add professional hygiene.
Timely and high-quality treatment of general and other dental diseases It will also help prevent hypersensitivity.

At the slightest sign of teeth reacting to any irritants, you should contact a specialist as soon as possible. This will help to identify hyperesthesia at an early stage and avoid big problems.

And in conclusion, a video that will tell you how to reduce hyperesthesia:

If you find an error, please highlight a piece of text and click Ctrl+Enter.

Hyperesthesia of the teeth is an increased sensitivity to various kinds of stimuli. Let's look at the types of hyperesthesia, the causes of the disease, methods of treatment and prevention.

Hyperesthesia or heightened sensitivity is manifested due to exposure to temperature, mechanical and other stimuli. The disease manifests itself in the form of intense, sharp pains that occur when exposed to irritants. Sometimes unpleasant symptoms appear when brushing your teeth, causing aching pain.

Hyperesthesia causes a lot of trouble. Despite the fact that outwardly the teeth look absolutely healthy, they react sharply to any stimuli, both physical and mechanical. A sip of cold water or a spoonful of hot soup causes severe toothache.
Most often, patients complain of hyperesthesia of tooth enamel, while hyperesthesia of the hard tissues of the tooth is diagnosed in every second patient of dentistry.

The degree of pain is varied, the pain can be fast-passing or acute, intense, prolonged, pulsating. Particular sensitivity is manifested to sour food, sweet, hot and cold, while pain occurs near the gum at the base of the tooth.

ICD-10 code

K03.8 Other specified diseases of hard tissues of teeth

Causes of hyperesthesia of the teeth

The causes of hyperesthesia of the teeth are varied. The disease can occur due to damage to the enamel of the teeth, lesions, and even due to disturbances in the functioning of the body. The most common causes of hyperesthesia of the teeth:

Damage to tooth enamel due to exposure to mineral or organic acids.
Pregnancy, menopause, hormonal disorders and malfunctions of the endocrine system, suffered nervous and psychological diseases.
Frequent consumption of sour fruits and juices.
Negative effects of ionizing radiation on the body.
Open dentinal canals due to tooth lesions (carious and non-carious).

Hyperesthesia occurs due to exposure of the dentinal canals or exposure to irritants on the pulp of the tooth. In this case, pain can occur even during breathing and brushing your teeth.

Let's look at the mechanism of the disease. Dentin is a dental tissue that determines its shape and appearance, penetrated by thin channels in which nerve cells are located, connected to the tooth pulp. Dentinal channels are always filled with fluid that moves. Changing the speed of its movement causes pain. If the tooth enamel is damaged or thinned, then this causes increased sensitivity, constant discomfort and pain.

Hyperesthesia of tooth enamel

Hyperesthesia of tooth enamel is a defeat of the thin tissue that protects the tooth from external damage. Tooth enamel is very sensitive. Lack of vitamins and minerals, resulting from improper nutrition, disrupts the pH balance and destroys the protective layer of enamel.

Excessive consumption of harmful foods: soda, sour foods and sweets is one of the causes of hyperesthesia of tooth enamel.
The use of hard toothbrushes and toothpastes with abrasive elements is another cause of the disease.
Very often, enamel disease is accompanied by bleeding and atrophy of gum tissue.
Failure to follow the rules of oral hygiene, refusal to treat dental problems and visit the dentist.
Bad habits also have a negative impact, which lead to the formation of cracks and violate the integrity of the enamel (clenching teeth, grinding teeth, biting nails, etc.).

In the absence of proper treatment, hyperesthesia of tooth enamel can provoke inflammation of the nerve and tooth pulp. Due to increased sensitivity, swelling of the gums occurs, which indicates an inflammatory process that requires medical treatment.

Hyperesthesia of dental hard tissues

Hyperesthesia of hard tissues of the tooth is a common dental disease. Hyperesthesia is classified in several ways. There is a generalized and local form of the disease, as well as several degrees of development. Let's take a closer look at the features of hyperesthesia of hard tissues of the tooth.

Hyperesthesia by distribution

Painful sensitivity is manifested both in the whole dentition and in a single tooth. Depending on the degree of spread of painful sensations, there is a local, that is, a limited form of hyperesthesia and generalized.

Local - occurs in one or more teeth at the same time. Very often, the pain is associated with caries, non-carious lesions and other dental diseases of the hard tissues of the tooth. Hypersensitivity may occur due to treatment, extraction or filling of teeth.
Generalized form - the pain affects all the teeth at the same time. As a rule, this form develops due to the exposure of the necks of the tooth due to periodontal disease, tooth erosion, increased wear and other diseases.

Origin

I distinguish two types of hyperesthesia, the first is associated, and the second is not associated with the loss of hard tooth tissues. If hypersensitivity arises from a violation and loss of hard tissues of the tooth, then this is due to the presence of carious cavities, increased abrasion of enamel and hard tissues of the tooth. If the disease is not associated with the loss of hard tissues of the tooth, then the appearance of hypersensitivity is provoked by periodontal disease, metabolic disorders of the body or gum recession.

Clinical course

This category of the disease has three stages. At the first stage, the tooth reacts to temperature stimuli, at the second stage, pain occurs due to temperature and chemical stimuli, and at the third stage, pain occurs when exposed to temperature, chemical and tactile stimuli. That is, painful sensations appear even from a light touch to the teeth.

This classification of hyperesthesia of the teeth allows the dentist to conduct a differential diagnosis and select the most effective treatment.

Symptoms of hyperesthesia of the teeth

Symptoms of hyperesthesia of the teeth are manifested as short-term pain in the oral cavity, in the area of the teeth and gums. Patients complain of discomfort after sour, hot, cold and sweet foods and drinks. Unpleasant sensations arise for a couple of minutes and subside. But the pain grows over time and becomes intense, pulsating, not passing.

Sometimes even a breath of cold air causes a terrible pain in the teeth. Pain in hyperesthesia is a constant and surest symptom of the disease. Sometimes, with hyperesthesia, there are periods of remission, when stimuli do not cause pain, and the intensity of discomfort is significantly reduced. But, after such a remission, hyperesthesia of the teeth returns with renewed vigor, causing severe pain and discomfort.

Diagnosis of hyperesthesia of the teeth

Diagnosis of hyperesthesia of the teeth begins with a visual and instrumental examination by a dentist. The doctor examines the teeth for cracks, chips of enamel and other changes. Only after the examination, the dentist can determine the degree of sensitivity of the enamel and hard tissue of the tooth to various irritants. In addition to the examination, the dentist conducts a conversation with the patient and finds out when pain occurs. So, if the patient complains of pain after cold, sour or hot, then the dentist may suspect increased sensitivity of the teeth, that is, hyperesthesia.

During a visual examination, the dentist can see significant changes in the structure of the hard tissues of the tooth, enamel chips on the front and side teeth and on the chewing surface, that is, on the back teeth. The dentist conducts a differential diagnosis to determine hyperesthesia. The main task of the doctor is to distinguish hypersensitivity from the symptoms of acute pulpitis.

If the disease is provoked by damage, then a correction is carried out, which will help get rid of the painful symptoms. Mandatory is the treatment of carious lesions and professional oral hygiene.

Treatment of hyperesthesia of the teeth

Treatment of hyperesthesia of the teeth is a complex process. Treatment depends on the cause of hypersensitivity and the degree of development of hyperesthesia. Today, in modern dentistry, there are many different methods that can cure the increased sensitivity of tooth enamel and hard tissues of the tooth. As a rule, therapeutic treatment is used, less often they resort to the surgical method.

Teeth fluoridation helps in the treatment of hyperesthesia. The fluoridation procedure is the application of cotton swabs of fluorine and calcium salts to diseased teeth. For a complete treatment of sensitivity, 10-15 procedures are enough.
If teeth with 2 or 3 degrees of hyperesthesia are to be treated, then modern filling materials are used for treatment, which are used to cover the enamel.
In case of a disease caused by a carious process, they resort to tooth preparation, cleaning the cavity from affected tissues and installing a filling.
If the disease has arisen due to the lowering of the gums at the time of inflammation of the periodontium and the opening of the cervical zone, then surgical treatment is performed. During the operation, the dentist covers the neck of the tooth and raises the gum.
With hyperesthesia due to increased abrasion of teeth, orthodontic treatment is performed. Therapeutic methods in this case are not effective, since bite correction is required.
The generalized form is treated only with medication. The patient is prescribed drugs that restore phosphorus-calcium metabolism. For treatment, multivitamin complexes and calcium preparations of glycerophosphate are used.
Sometimes improperly performed dental filling causes hyperesthesia. Hypersensitivity occurs in patients who have received a filling incorrectly, if the filling does not fit snugly against the tooth, or if there is a small gap between the filling and the tooth. In this case, food debris can get to the tooth and cause pain. For treatment, a second filling is carried out, but before that, the old filling is removed and the tooth is cleaned, and if necessary, the canals.
If hypersensitivity arose after the treatment of caries, then this indicates an inflammatory process in the pulp. To do this, the tooth is opened, the canals are cleaned and sealed.
Hyperesthesia after whitening or brushing teeth indicates thinned tooth enamel. For treatment, electrophoresis and a solution of calcium glycerophosphate are used. A more modern method of treatment is also used - enamel coating with sodium and calcium fluoride varnish.
Hypersensitivity can also occur due to wearing braces. In this case, for the treatment of hyperesthesia, a course of applications of fluorine and calcium salts or coating of tooth enamel with varnish of sodium and potassium fluorides is prescribed.

For the treatment of hyperesthesia, special preparations are used that contain minerals (calcium and fluorine), special gels, as well as traditional medicine. Let's look at ways to treat tooth sensitivity.

Desensitizing pastes

Treatment of this type is very convenient to carry out at home. To do this, use special toothpastes that have a healing effect on dental tissue. Pastes that reduce hyperesthesia contain alkalis, which, when cleaned and interact with water, enter the dentinal tubules, cause their dehydration and reduce sensitivity. It is necessary to use such toothpastes with treatment courses, 2-3 times a year. Healing pastes:

MEXIDOL dent Sensitive is a therapeutic toothpaste designed to prevent and treat hyperesthesia of teeth, periodontitis and bleeding gums. The paste eliminates the causes of many dental diseases - microbial flora and oxidative reactions in the cells of the oral cavity. The active substance of Mexidol toothpaste is a powerful antihypoxant and antioxidant. The paste has an antibacterial effect and accelerates the regeneration processes. Toothpaste increases local immunity, accelerates the healing of purulent wounds and reduces bleeding.
Oral-B Sensitive Original is an effective toothpaste for the treatment of hyperesthesia caused by hypersensitivity of tooth enamel. The composition of the toothpaste includes a substance that is similar in structure to tooth enamel - 17% hydroxyapatite.
Rembrandt Sensitive is a low-grade toothpaste with a whitening and anti-caries effect. The peculiarity of this toothpaste is that it forms a protective film on the teeth, which protects tooth enamel from irritants.

Therapeutic gels and foams

Such funds are designed specifically for the treatment of hyperesthesia of the teeth. Means are used for rinsing or applied to cotton turundas and wipe the teeth with them. Therapeutic varnishes form a protective film on the teeth, and gels and foams prevent inflammatory processes. This kind of funds can be used to treat hypersensitivity of tooth enamel in children from one year old. The most popular medicinal preparations from this series:

Bifluoride 12 is a fluorine-containing varnish with sodium and calcium. After application to the teeth, it forms a film on the enamel, which protects against the action of temperature irritants.
Tooth Mousse is a healing gel that reacts with saliva and forms a protective film on the teeth. The drug is applied to the teeth with cotton swabs. The gel belongs to professional dental products.
Remodent - medicinal powder for rinsing. The main indication for the use of the drug is the prevention of carious lesions. Remodent is effective in the treatment of hyperesthesia of the teeth. The composition of the drug includes elements such as: sodium, phosphorus, calcium, manganese, iron.

Electrophoresis (iontophoresis) in the treatment of dental hyperesthesia

A therapeutic method that involves the use of impulsive or galvanic current along with medicinal substances. A similar effect on the body is used to treat hyperesthesia of the teeth. The main drugs used in electrophoresis:

Calcium gluconate solution - for the treatment of increased tooth sensitivity in children, a 5% solution is used, and for adults 10%. The treatment course should consist of at least 10-12 procedures of 15-20 minutes each.
Fluocal solution - the active substance of the drug is sodium fluoride. Before using the solution, the tooth must be dried and protected from saliva. A cotton swab soaked in the solution is applied to the affected surface of the tooth and held for 1-3 minutes.
Belak-F is a fluorinating varnish with an analgesic effect. The tool is used for the treatment and prevention of hyperesthesia of the teeth and caries. The composition of the drug includes fluorine ions, chloroform, potassium fluoride and other substances that strengthen the enamel and hard tissues of the tooth and reduce their permeability. Belak-F is effective for wedge-shaped defects, non-carious and traumatic lesions of the teeth, causing hypersensitivity.

Folk remedies for the treatment of increased sensitivity of the teeth

Most often, traditional medicine is used to treat hyperesthesia. Such treatment involves the use of only herbal medicines. Folk remedies can be used not only for treatment, but also for the prevention of a number of dental diseases. Let's look at the most effective traditional medicine recipes:

For the treatment of any dental problems, and especially hyperesthesia, it is recommended to use a decoction of oak bark. Pour boiling water over a spoonful of dry oak bark, boil in a steam bath for 10-15 minutes, cool and strain. Rinse your mouth with decoction 2-3 times a day. The course of treatment should be from 7 to 14 days.
If the pain occurs suddenly, dilute a couple of drops of tea tree oil in a glass of warm water and rinse your mouth. To consolidate the therapeutic effect, the procedure should be carried out 3-4 times a day, preferably after each meal.
Pour a glass of boiling water over a spoonful of chamomile and burdock. It is recommended to infuse the decoction for 20-30 minutes, then strain and rinse the tooth 2-3 times a day. Therapeutic and prophylactic course takes from 5 to 10 days.

Treatment of hyperesthesia of the teeth is a long process that must be carried out systematically. All of the above remedies can be used only after consultation and examination by a dentist. The doctor will determine the cause of the increased sensitivity of the teeth and select the most effective remedy. In addition to therapeutic agents, it is important to follow a diet, that is, eating food rich in vitamins, minerals and trace elements. Of particular difficulty are chronic and acute forms of hyperesthesia, in the treatment of which surgical methods of treatment can be used. In especially severe cases, the patient is given dental crowns or prosthetics of the affected teeth.

Follow the rules of oral hygiene. Regularly brush your teeth using toothpastes that do not contain abrasive elements that destroy tooth enamel.
Adhere to proper brushing technique. To do this, you must use a medium-hard toothbrush that will not injure the gums and teeth.
Refuse to use whitening toothpastes, as they contain chemical elements and abrasive particles. These particles cause damage to tooth enamel and leach calcium from the teeth.
Eat right, eat foods that contain minerals (calcium and phosphorus). Cut down on sour and sugary foods.
Do not forget about systematic preventive visits to the dentist. You need to go to the doctor two or three times a year.

For the prevention of hyperesthesia, it is recommended to use decoctions of herbs. Particularly effective are rinses for inflammation of the gums, which provoke hypersensitivity. Medicinal decoctions involve long-term use in order to achieve an effective therapeutic effect.

Prognosis of tooth hyperesthesia

The prognosis of hyperesthesia of the teeth depends on the cause of the disease and its stage. As a rule, if a patient in the early stages of the disease turned to the dentist and the doctor began to treat hypersensitivity, then the prognosis is favorable. The most important rule for a favorable prognosis is prevention and rational dental care.

Hyperesthesia of the teeth is an unpleasant disease that can occur at any age. Hyperesthesia or hypersensitivity occurs due to dental diseases or due to damage to the enamel. To prevent disease, there are many preventive methods that allow you to keep your teeth healthy.

Despite the fact that hyperesthesia is not an independent disease, its external manifestations are quite dangerous and unpleasant. An increased mental reaction to external stimuli, excessive sensitivity of the teeth or skin is not only unpleasant, but also dangerous to the body. The difficulty of dealing with the disease lies in the fact that in order to eliminate its symptoms, it is imperative to find out the cause of their appearance.

Psychological reasons for the appearance

Hyperesthesia, that is, a pathological increase in the threshold of sensitivity, is often caused by psychological reasons. A person feels an excessive increase in the sharpness of perception of reality and reacts too violently to external stimuli (for example, the rustle of leaves or the chirping of a cricket).

In most cases, the described symptoms manifest themselves in the initial stages of certain types of clouding of consciousness (for example, sleepwalking), as well as other acute mental disorders.

Another reason for increased mental sensitivity is an abnormal reaction of the body or poisoning with drugs used in the treatment of mental illness and having a psychoactive effect.

Symptoms

Mental hyperesthesia is characterized by such manifestations as increased irritability and emotional instability. The patient inadequately and overreacts to certain external factors. It does not matter which sense organs or receptors are irritated: auditory (clock ticking, rustle), olfactory (slight smell), tactile (light touch, prick).

A person becomes emotionally unstable, easily excitable, cannot adequately control his emotions. Sometimes patients complain of a lot of pointless discomfort that occurs in various parts of the body and is not amenable to localization.

Too frequent manifestation of symptoms of hyperesthesia indicates additional pathologies that the patient has. Therefore, before starting treatment, it is necessary to confirm or deny their presence.

Diagnostics

As in any other case, establishing the causes of the appearance of a pathology begins with an analysis of the patient's complaints and the collection of anamnesis, that is, information about the history of the course of the disorder, living conditions, previous illnesses, and so on.

Then a neurological examination is performed. The reaction of the skin is evaluated, the vision and olfactory functions of a person are checked. A visit to a psychologist or psychiatrist, who can assess the psycho-emotional state of the patient, will help diagnose the disease and establish the causes of its occurrence.

As for the tools, the most effective among them is electroneuromyography. Using this procedure, the speed of passage of a nerve impulse from external receptors to the brain is measured, and the degree of damage to the nervous tissue is determined.

Hyperesthesia can be caused by a high content of glucose, the presence of toxic substances and products of protein metabolism. Therefore, a general laboratory analysis of urine and blood is also necessary.

Treatment

Most often, the appearance or exacerbation of hyperesthesia is associated with a person receiving a physical injury or getting into situations that are stressful for him. The “trigger” factor may not even be the pain itself, but its expectation or an acute feeling about the suffering of other people.

Treatment is carried out with several medications at once. First of all, painkillers. Anesthetics stop the pain syndrome, which is the cause of the appearance of signs of hyperesthesia. Medical equipment may be used. Sedative drugs are used to normalize the mental state of the victim.

Increased tooth sensitivity

As in the previous case, hyperesthesia of the hard tissues of the tooth is not an independent pathology, but a consequence or reaction to other painful conditions, such as carious lesions or external physical influences.

In most cases, the pain does not have a prolonged character, and varies in intensity from barely noticeable to almost unbearable. Sometimes hyperesthesia of the teeth prevents even eating or brushing.

The exact mechanism of the occurrence of pathology is still unknown. However, all experts agree that hyperesthesia of the teeth appears due to:

intensive carious processes in the dental cavity;
increased fragility of tooth enamel;
chips and other damage to the surfaces of the teeth;
other processes that are not classified as carious by dentists;
damage to the enamel located in the area of the neck of the tooth;
necrosis and erosion of teeth.

Symptoms

The main sign by which hyperesthesia of the teeth is diagnosed is the appearance of short-term, but very intense pain. The duration of the pain syndrome is from 10 to 30 seconds. The area of manifestation can be clearly defined or have a global character.

All symptoms of pathology are classified according to the following criteria:

sign	Characteristic
Localization	clearly defined - discomfort occurs in one or more specific teeth; systemic - pain appears in the mouth and the patient cannot specifically point to its source.
Origin	associated with the loss of hard tooth tissues - often this type of hyperesthesia appears when enamel is removed during the treatment of carious processes or necrosis; not associated with the loss of a layer of enamel.
Clinical picture	the appearance of pain when exposed to temperature (cold or heat); the presence of unpleasant sensations is associated not only with the effects of temperature, but also with chemicals (acid, sweetness); irritation is caused by all influences, including physical ones.

Treatment

The method of getting rid of the disease depends on the cause of the pathology. Most often, it is enough to use prophylactic agents, but in some cases, for example, exposure of the neck of the tooth or pathological lowering of the gums, surgical intervention is indispensable.

If hyperesthesia of the teeth is recurrent due to fragility or increased abrasion of the enamel, orthodontic procedures may be prescribed.

Hypersensitivity of the skin

Another fairly common type of hypersensitivity is skin hyperesthesia. This condition is a consequence of a violation of the functioning of special nerve fibers passing through the thickness of the skin. As a result, nerve receptors interact incorrectly with internal organs, including the brain.

The causes of this pathology can be both significant external influences (burns, injuries, lichen, wounds) and internal factors. The latter include increased excitability of neurons in the brain. Skin hyperesthesia is often diagnosed in patients suffering from neurosis, mental disorders and other similar ailments.

Symptoms

The violation in question is characterized by unpleasant sensations of a pressing nature, as well as burning pains, similar to burns. Moreover, the nature of their manifestation differs from the place of localization. An attempt to lift part of the skin causes almost unbearable pain.

An additional sign of hyperesthesia is dermographism. If you run a fingernail or spatula over the skin of a healthy person, it leaves an inconspicuous pale pink mark that quickly disappears. The presence of pathology is evidenced by a pronounced dark red line, which does not disappear for a rather long period of time.

But with this method of diagnosing pathology, one should be careful. Dermographism may also indicate dysfunction of the endocrine and nervous systems, inflammation of the membranes of the brain and spinal cord, and so on. Therefore, to clarify the diagnosis, it is necessary to contact a medical institution.