Following up on what I wrote about the causes of sensitive teeth,there need to be an awareness that individuals with sensitive teeth actually can do something about their condition.

A very comprehensive asessment is necessary to determine the actual cause of the sensitivity.A normal routine history taking would include the chronology,nature,location,aggravating and alleviating factors that influence the sensitivity.The teeth and the soft tissue surrounding should be examined.Our diet should be discussed,because fruit juices and fizzy beverages not only have high sugar content,but also contain a considerable amount of titratable acid,which can be errosive in nature.

Once your dentist has determined the cause of your teeth sensitivity,and the diagnosis arrived is dentin hypersensitivity(ie,it is not due to decay,broken fillings,cracked tooth etc etc),then there are some self care products that can be used at home.

One of the commonest things that is presribed is a professionally endorsed desensitizing tooth paste containing active agents like potassium salts,strontium salts and various flouride compounds.

Typical examples of such toothpaste would be SensodyneF,which contains 5%potassium nitrate and 0.32% sodium fluoride.(potassiums salts work by interfering with the transmission of the stimuli to the nerve ends and the fluoride acts as a barrier to the dentinal tubules)

Another toothpaste that can be used is Colgate Sensitive which contains 5.53% Potassium Citrate and 1500 ppm fluoride.

Other products that can be used are tooth-coating creme containing Casein Phosphopeptide-Amorphous Calcium Phosphate(CPP-ACP).One such product is the Tooth Mousse,which can be purchased from your dentist.

This is a calcium compound that works by occluding the dentinal tubiules with its calcuim and phosphate salts.It also contains a safe pH where tooth errosion does not occur.The casein in the product acts by binding the calcium and phosphate to the enamel layer and the gums.Excellent product,highly recommended.

Other considerations would include changing wrong tooth brushing techniques to prevent tooth abrasion,better brushing and flossing to reduce plaque,change of diet to reduce intake of food and drinks high in sugar and acid.

Tooth sensitivity is usually presented as a short and sharp temporary discomfort or pain on taking cold food or beverage;or upon sucking on air into the mouth.Anything more intense or prolonged would mean that there is some damage to the tooth nerve and you would need to see a dentist as soon as possible.

Dentin hypersensitivity,which is the proper term to describe sensitive teeth, is actually a very common problem.A prerequisite for hypersensitivity is gum recession and subsequent exposure of dentin due to loss of enamel or cementum( a thin layer of tooth structure covering dentin below gum level).

 

The common causes of gum recession include the normal aging process,chronic gum/periodontal disease,incorrect toothbrushing habits,to name a few.When the gums are receded,the exposed root surface is prone to abrasion from aggressive tooth brushing and erosion from acidic substances in our diet.The exposed dentin layer consists of tubules through which stimuli from the oral cavity gains excess to the nervs in the pulp.Basically external stimuli will result in hydrodyanamic changes in the dentinal tubules and will be perceived as pain/sensitivity.(Too much of this information is going to bore everyone to tears!)

However,to establish that one actually has this problem of dentin hypersensitivity,there are a few other factors to be considered.You would need to rule out these causes(of tooth sensitivity).

1.Caries or tooth decay-  Decay would mean that the enamel layer of the tooth is breached and therefore dentin is exposed.You would need to see your dentist for a filling.

2.Marginal leakage of exisitng tooth filling- Old restorations or fillings may leak over time,usually from wear and tear.Again,see your dentist to have the old filling replaced.

3.Broken filling- Fillings whether new or old can fracture due to accidentally biting on hard food.In our Asian context,especially in the gloriously food-filled Malaysia,these accidents can happen quite frequently.The common culprits are crabs,chicken bones,nuts etc.

4.Cracked tooth- This is usually preceded by exisiting fine fracture lines on the tooth surface.These crack lines propagate over time and use.Once the fracture gets into the dentin layer,there will be sensitivity.This is most common amongst those who tend to chew on one particular side.It could also present in individuals who grind their teeth habitually,especially in their sleep.Usually,before the fracture propagates to a point of no return where the pulp is involved,the tooth would need to be crowned,or an onlay placed over it.

5.Other factors like post-operative sensitivity,sinusitis,other parafunctions of the jaw.

The people with high risk of tooth sensitivity/dentin hypersensitivity are those with

1.Periodontal disease,where the bacterial toxins are causing and inflamation within the dentinal tubules

2.Gum recession with root exposure

3.Parafunction habits like bruxism

4.Xerostomia or reduced salivary flow

5.Individuals with highly acidic diet,where there is a lot of enamel erosion

6.Long term use of tooth-bleaching products

Tooth sensitivity is a chronic condition which is often under diagnosed.Therefore it is essential that a comprehensive assesment is done and the appropriate treatment is prescribed to relieve the discomfort.

More about the treatment options in my next post.

I have a friend,who is my patient at iSmile.Steven had been avoiding the dentist’s clinic for years.When he finally made it to see me,I had to give him plenty of credit for that.Unfortunately,I couldn’t do the same for him oral health at that time.

I took some pictures,encouraged him to beef up his oral hygiene and did quite a thorough cleaning for his teeth.I also taught him to floss his teeth correctly.

Well,when I reviewed him a month later,there was tremendous improvement.This time,he really deserved much credit!

  

When Steven first came to see me………….and a month after.

I must say that there is so much more motivation on Steven’s part to keep his teeth clean and more importantly,his gums healthy.Gum disease,also known as periodontitis,is increasingly becoming a rampant disease and widely linked to many systemic diseases ie heart disease and diabetes,to mention a few.More about that later.

Steven has also written a very animated testimonial for me which I am putting on this blog,with his permission.It brought a huge smile to my face when I first read it.Here it is.

The question about which part of the body is more important; the ear shall not tell the mouth that I am more important; in the same way the eye shall not tell the nose that you are not important, each part depends on one another for a integrated effort to keep the body alive and healthier.

How about my teeth?
I must confess that, I did not understand the basic principle on what I need do.
In the past I was always skeptical about making an appointment with the dentist.I still remember the pain, blood and the sound from the grinding and polishing …

Definitely  not a good idea to go to a dentist, what you get is a lot of pain, complaints about my teeth being in a very bad condition etc, and after which I still need to pay the dentist for making me feel bad and telling me all the bad news…….

In the past I mistreated my teeth without love and used them like a slave worker, with my command each of them cannot refuse to work for my eating; I did not take good care of them until I was introduced by a church friend to Dr. Jean. As usual, I missed my first appointment with her and I had to reschedule another appointment.I could recall my last time seeing a dentist was more then 5 years ago, and I choose not to remember them…..
Thank God I finally repented.
I discover that Dr.Jean is different .She is most passionate about what she does and would go to great length to take away my fears.With her gentle encouragement, I began to fall in love with my teeth again, and learning all the techniques to brush and floss my teeth…still trying very hard to change and to appreciate my teeth everyday.
I am very thankful to Dr.Jean for her gentleness, In fact I do enjoy the visits to the dental clinic now compared to the past. She provides me the best music and brings a smile to my face every time I visit  “i-Smile” dental clinic… 
 
Prepared by Steven
 
 

I had some ladies over for tea last Sunday the 14th,to chat and to just to catch up with one another after quite a while,at the same trying NOT to gossip(it’s one of the inevitable hazards when you put a bunch of ladies together!)

I baked some wholemeal buns to go with our English tea.The highlight was actually my new fine bone china tea set,given to me by a group of good friends for the occasion of the opening ceremony of my clinic last year.It took me THAT long to get the lovely set out of the box!

I had to wash them first,of course,and for a few moments there,was quite paranoid that they will slip out of my hands and shatter to smithereens on my kitchen floor.Well,I am definitely not a regular fine bone china user!!

   

Piping hot and coming out from the oven and Tada!

   

The way to drink tea from such fine crockeries,with the little finger lifted up!

Now,this weekend,the 20th and 21st,I spent the 2 days from 8.30am till 5.30pm attending lectures on Updates in Dentistry and visiting exhibition booths at the FDI-MDA Convention at the Sunway Convention Centre.It was a working weekend indeed!The hours are even longer than my clinic hours!!

     

I couldn’t resist posing at one of the booths!

Apart from the fact that I had frost bitten ears and nose(my fingers were spared as they were securedly tucked under my shawl) due to the icelandic temperature in the convention hall,I am very glad that I attended the lectures.I learnt so much from the 2 days.There is so much going on that is constantly changing in the field of Dentistry.It’s a humbling experience for me and I believe,for many others who were there.As dental practitioner,it is my responsibility to learn as much as I can.

The children who come to iSmile for their dental treatment are usually given some colouring pages to colour on while waiting for their turn at the reception area.It keeps them occupied and entertained and at the same time,we discover the many talents in these children.

I had meant to choose a winner for each of the 2 categories;8 to 12 years old and 7 years old and below,on a quarterly basis.Well,I finally got around doing it after 2 quarters.Sigh!I must make sure I do the quarterly judging from January 2007(one of the zillions of new year resolutions that I have!)

For the 7 years and below,the winner is……..

Rosanna Wong,7 years old

And for the 8 to 12 year old category,the winner is…

Ling Qiu Lin,11 years old

We have prepared a little gift for each of the winners.I hope they will like it!

Britesmile Malaysia – FAQ Teeth Whitening

There are some commonly asked questions when it comes to professional whitening,apart from the question of cost.