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Dental root sensitivity — Clinical Guidelines

Overview

Dental root sensitivity occurs when dentin tubules are exposed, leading to painful responses to stimuli like cold, sweet, or acidic foods. It often results from gingival recession, tooth wear, or aggressive dental procedures. 4

Diagnosis

Presence of sharp, short-lived pain in response to stimuli.

History of gingival recession, tooth wear, or recent dental procedures.

Identification of exposed dentin tubules through clinical examination.

No specific diagnostic tests; clinical assessment is key. 4

Management

First-line treatments: Desensitizing toothpastes containing potassium nitrate or strontium chloride. 4

Adjunctive treatments: Fluoride varnishes or gels to occlude exposed tubules. 4

Professional interventions: Bonded tooth-colored restorations or gingival grafts to cover exposed roots. 4

Drug classes: No specific drug doses mentioned for root sensitivity management. 4

Special Populations

Pediatrics: Behavioral management strategies are crucial; consider sedation techniques like intranasal/intravenous midazolam for severely disabled patients requiring dental care. (Evidence: Moderate) 2

Disabled Patients: Neurosedation with midazolam, propofol, and remifentanil combinations can be effective, tailored to patient cooperation levels and medical status. (Evidence: Moderate) 3

Comorbidities: Sedation practices should be individualized based on patient cooperation, medical history, and procedural needs, with careful monitoring of vital signs. (Evidence: Expert opinion) 4

Key Recommendations

Utilize desensitizing toothpastes and fluoride treatments as initial management strategies for dental root sensitivity. (Evidence: Expert opinion) 4

For pediatric and disabled patients requiring dental procedures, consider intranasal/intravenous sedation techniques like midazolam for improved cooperation and safety. (Evidence: Moderate) 2 3

Ensure clinicians receive adequate training before employing sedation methods to minimize risks and enhance patient acceptability. (Evidence: Expert opinion) 4

References

1 Johnson C, Weber-Gasparoni K, Slayton RL, Qian F. Conscious sedation attitudes and perceptions: a survey of american academy of pediatric dentistry members. Pediatric dentistry 2012. link 2 Ransford NJ, Manley MC, Lewis DA, Thompson SA, Wray LJ, Boyle CA et al.. Intranasal/intravenous sedation for the dental care of adults with severe disabilities: a multicentre prospective audit. British dental journal 2010. link 3 Collini S, Pinto G, Lejeune L, Di Carlo S, Meloncelli S, Barraco G et al.. Neurosedation in dentistry of the disabled patient: the use of midazolam, propofol, and remifentanil. Minerva stomatologica 2006. link 4 Nathan JE. Behavioral management strategies for young pediatric dental patients with disabilities. ASDC journal of dentistry for children 2001. link 5 Primosch RE, Buzzi IM, Jerrell G. Monitoring pediatric dental patients with nasal mask capnography. Pediatric dentistry 2000. link

Dental root sensitivity