Deck 38: Dentinal Hypersensitivity Management

Question 1

The transient,well-localized,sharp pain associated with dentinal hypersensitivity is most likely the result of the stimulation of which of the following nerve fibers near the pulp-dentin interface?

A) A-delta fibers
B) A-beta fibers
C) C-fibers
D) A-delta fibers,A-beta fibers,and C-fibers

Answer 1

A-delta fibers

Question 2

CASE STUDY
Client Profile
• 45-year-old woman
• Single mother of a 4-year-old girl
• Occupation: administrative assistant
Chief Complaint
• "My teeth are very sensitive when I eat or drink cold foods and beverages."
Health History
• No significant findings
Pharmacologic History
• Client taking Ortho Tri-Cyclen (norgestimate-ethinyl estradiol)
Dental History
• Regular 6-month continued-care appointments
• Brushes twice daily (uses a hard toothbrush)
Clinical Examination
• Light to moderate dental calculus
• Localized attrition along anterior incisal and canine tooth surfaces
• Localized recession and cervical abfraction evident on teeth 6,7,8,9,22,23,24,25,26,27,28,and 29
• Occlusal trauma on 6,7,8,9,22,23,24,25,26,27,28,and 29
Radiographic Findings
• Incipient enamel lesions (distal surface of 3,mesial surface of 15,distal surface of 19)
All of the following interventions except which one could be provided in the dental setting to treat this client's areas of dentinal hypersensitivity?

A) Use of a 5% sodium fluoride varnish
B) Placement of Class V restorations
C) Use of a desensitizing agent such as potassium nitrate
D) In-office oral irrigation with 0.12% chlorhexidine

Answer 2

In-office oral irrigation with 0.12% chlorhexidine

Question 3

CASE STUDY
Client Profile
• 45-year-old woman
• Single mother of a 4-year-old girl
• Occupation: administrative assistant
Chief Complaint
• "My teeth are very sensitive when I eat or drink cold foods and beverages."
Health History
• No significant findings
Pharmacologic History
• Client taking Ortho Tri-Cyclen (norgestimate-ethinyl estradiol)
Dental History
• Regular 6-month continued-care appointments
• Brushes twice daily (uses a hard toothbrush)
Clinical Examination
• Light to moderate dental calculus
• Localized attrition along anterior incisal and canine tooth surfaces
• Localized recession and cervical abfraction evident on teeth 6,7,8,9,22,23,24,25,26,27,28,and 29
• Occlusal trauma on 6,7,8,9,22,23,24,25,26,27,28,and 29
Radiographic Findings
• Incipient enamel lesions (distal surface of 3,mesial surface of 15,distal surface of 19)
All of the following factors from the client's assessment data might be the cause of gingival recession except which one?

A) Presence of carious lesions
B) Use of a hard toothbrush
C) Presence of abfraction
D) Presence of occlusal trauma

Answer 3

Presence of carious lesions

Question 4

What term is used to refer to sites of tooth structure wear commonly found on the incisal or occlusal surfaces of teeth as a result of masticatory forces?

A) Abrasion
B) Erosion
C) Attrition
D) Abfraction

Question 5

What teeth most commonly manifest gingival recession that in turn increases a client's risk of dentinal hypersensitivity?

A) Central and lateral incisors
B) Canines and first premolars
C) Incisors and second premolars
D) Molars

Question 6

CASE STUDY
Client Profile
• 45-year-old woman
• Single mother of a 4-year-old girl
• Occupation: administrative assistant
Chief Complaint
• "My teeth are very sensitive when I eat or drink cold foods and beverages."
Health History
• No significant findings
Pharmacologic History
• Client taking Ortho Tri-Cyclen (norgestimate-ethinyl estradiol)
Dental History
• Regular 6-month continued-care appointments
• Brushes twice daily (uses a hard toothbrush)
Clinical Examination
• Light to moderate dental calculus
• Localized attrition along anterior incisal and canine tooth surfaces
• Localized recession and cervical abfraction evident on teeth 6,7,8,9,22,23,24,25,26,27,28,and 29
• Occlusal trauma on 6,7,8,9,22,23,24,25,26,27,28,and 29
Radiographic Findings
• Incipient enamel lesions (distal surface of 3,mesial surface of 15,distal surface of 19)
All of the following would be good self-care recommendations for this client except which one?

A) Use a daily,self-applied fluoride mouth rinse.
B) Use a soft toothbrush.
C) Use a low-abrasive fluoride toothpaste for sensitive teeth.
D) Use an oral irrigation system.

Question 7

Behavior modification to decrease dentinal hypersensitivity would include all of the following except which one?

A) Use of a daily,self-applied fluoride mouth rinse or gel
B) Decreased intake of extreme hot and cold foods
C) Use of low-abrasive dentifrice
D) Periodontal surgery

Question 8

What term refers to the reduction of the dentinal tubule lumen as a result of the deposition of intratubular dentin?

A) Abfraction
B) Abrasion
C) Dentinal sclerosis
D) Attrition

Question 9

Mild dentinal hypersensitivity may be managed by using a sensitivity-protection toothpaste twice daily.Severe dentinal hypersensitivity with loss of tooth structure often requires restoration to control the hypersensitivity.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.

Question 10

Which of the following occurs most of the time with regard to the relationship between cementum and enamel?

A) Cementum overlaps enamel.
B) Cementum and enamel meet (no overlap).
C) Enamel overlaps cementum.
D) Enamel and cementum do not meet.

Question 11

What age range is considered the peak for dentinal hypersensitivity?

A) 10 to 20 years of age
B) 20 to 40 years of age
C) 40 to 60 years of age
D) 60 to 80 years of age

Question 12

Which one of the following is the best self-applied home product to help decrease dentinal hypersensitivity?

A) Fluoride mouth rinse or gel
B) Nonfluoride antibacterial mouth rinse
C) Oral irrigation system
D) Medium- to hard-bristled toothbrush

Question 13

For dentinal hypersensitivity to occur,all of the following conditions must exist except which one?

A) Dentin must be exposed.
B) A smear layer must cover the opening of the dentinal tubules.
C) Dentinal tubules must be open.
D) Vital pulp must be present.

Question 14

All of the following are characteristics of teeth observed to have dentinal hypersensitivity except which one?

A) Dentinal tubules open to the oral cavity
B) Large and numerous dentinal tubules
C) Ability of dentinal surface to communicate with vital pulp
D) Intact cementum

Question 15

Intrinsic erosion is a result of dietary factors that contribute to a highly acidic oral environment.The frequent consumption of acidic,carbonated,sports,or fruit drinks or frequent sugar consumption can cause intrinsic erosion.

A) Both statements are true.
B) Both statements are false.
C) The first statement is true;the second statement is false.
D) The first statement is false;the second statement is true.