Dentin hypersensitivity (Tooth Sensitivity) is pain or discomfort in one or more teeth as a response hot or cold temperatures. The pain is usually sudden, sharp and shooting. It occurs when the dentin or cementum is exposed. Pain trigerred when exposed areas respond to hot and cold, and occasioanlly to very sweet and spicy foods. The condition may be temporary or a chronic and it may affect single tooth, several teeth, or all the teeth together. Though the causes are different, in most cases it can be treated or prevented by changes in oral hygiene regimen of the patient. Good oral habits and regular dental visits help patient to treat the condition. Treatment line depend on factors causing the sensitivity.
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Causes and Symptoms
When dentinal tubules are exposed due to receding gum tissue or enamel loss, nerves are triggered by stimuli causing tooth sensitivity. In certain cases. Other factors like hard brushing, cavities, gum diseases, exposed tooth root, worn tooth enamel and fractured teeth. Patient experience pain or discomfort as a response to triggers at the roots of the affected teeth. Symptoms may come and go over time for no reason and may be from mild to intense. Common triggers include – hot / sweet/acidic foods and beverages, cold water, brushing or flossing teeth and alcohol-based mouth rinses.
Diagnosis of tooth sensitivity begin with a dental examination for loose fillings, or recessed gums that causing the sensitivity. Mild cases of tooth sensitivity treated with over-the-counter dental treatments.
Proper diagnosis of the cause for the sensitivity is very essential for treatment. Some of the In-office treatment procedures are mentioned here in below:
Surgical Gum Graft :
Gum graft is performed when gum recession occurs exposing more of the tooth at the root. Gum graft is simple procedure where periodontist removes a piece of tissue from the roof of the mouth or from healthy gum tissue, and it is grafted to the area where the gums worn away. This protect exposed roots and reduce sensitivity. There are different types of gum grafts, and the type of surgery suggested by dentist depend on the extent and severity of gum recession
CDT codes for gum graft procedure:
D4270 - Pedicle soft tissue graft
D4273 – Autogenous connective tissue graft procedure (including donor and recipient surgical sites) first tooth, implant, or edentulous tooth position in graft
D4275 - Soft tissue allograft
D4276 - Combined connective tissue and double pedicle graft, per tooth
D4283 - Autogenous connective tissue graft procedure (including donor and recipient surgical sites)-each additional contiguous tooth, implant or edentulous tooth position in same graft site
D4285 - Non‐Autogenous connective tissue graft procedure (including recipient surgical site and donor material) – each additional contiguous tooth, implant or edentulous tooth position in same graft site
If there is severe pain, dentists may suggest root canal procedure for repair a badly damaged or infected tooth instead of removing it. It is done by removal of the soft center of the tooth, which is made up of nerves, connective tissue, and blood vessels. Removing injured or infected pulp is the best way to preserve the structure of the tooth.
CDT codes for root canal procedure:
D3331 Treatment of root canal obstruction; non-surgical access
D3346 Retreatment of previous root canal therapy – anterior
D3347 Retreatment of previous root canal therapy – bicuspid
D3348 Retreatment of previous root canal therapy – molar
Fluoride Varnish and Coatings
Application of fluoride varnish to the sensitive teeth can reduce pain. The fluoride varnish fills tiny holes of tooth enamel. Other bonding agents and plastic sealant coatings may be applied to strengthen enamel and dentin.
Desensitizing or Bonding Agents
Exposed tooth root surfaces are treated by bonding resin to the sensitive root surfaces. It will seal the dentin and provide a barrier to sensitivity. Bonding agents are not used if patient has tooth decay, infections, and plaque.
Desensitizing toothpastes temporarily fill the holes within tooth enamel and dentin and reduces exposure of sensitive nerves. Desensitizing toothpastes are available over-the-counter.
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