Alleviating Dentin Hypersensitivity
Shield Force® Plus seals dentinal tubules for permanent relief
Gerard Kugel, DDS, MS, PhD
Figure 1 | Dentin hypersensitivity (DH) causes discomfort in 15% to 74% of all dental patients. It usually lasts no longer than 10 seconds and is induced by thermal, air, tactile, osmotic, or chemical stimulation of exposed dentin. This induces fluid flow in the dentinal tubules, stimulating free nerve endings and causing pain.
Hypersensitivity often occurs after excessive scaling and root planing, particularly after removing subgingival calculus or smoothing root surfaces. It also occurs after periodontal surgery that exposes dentin on root surfaces previously protected by periodontal tissue. Inappropriate brushing methods or selection of toothbrushes (eg, hard toothbrushes) can lead to problems such as gingival recession and wedge-shaped defects. Occlusal trauma, excessive bruxism, and clenching can also be sources of trouble, along with abfractions caused by malocclusion. Hypersensitivity often occurs after cavity preparations for a vital tooth. Tooth preparation typically exposes one to two million dentinal tubules, eventually inducing hypersensitivity. Hypersensitivity that persists after the final restoration is in place could have many etiologies, including improperly sealed dentinal tubules.
Materials that have been used to suppress hypersensitivity share the general approach of sealing open dentinal tubules. To this end, Tokuyama developed Shield Force® Plus (SFP) desensitizer for treatment of hypersensitive dentin, which I have recently started using in my practice. Its thin, even, durable coating and resin tags block external stimulation. When SFP is applied to the affected area, the adhesive monomer reacts with the calcium in the tooth substance, and the reaction product accumulates in the dentinal tubules and on the coated surface. When the solvent component and water are removed with a stream of air, a thin film forms on the surface affected by hypersensitivity. At this stage, the dentinal tubules are sealed, and the treatment effect (pain relief) appears. Exposure to light cures the reaction product in the dentinal tubules and the thin film on the coated surface, forming a coating. Hypersensitivity is suppressed when the dentinal tubules are sealed, and SFP has been shown to relieve pain for up to 3 years.
Indications for use include treatment of hypersensitive dentin, reduction of abrasion and erosion of exposed cervical dentin, and alleviation and/or prevention of tooth sensitivity after tooth preparation for direct and indirect restorations.
About the Author
Gerard Kugel, DDS, MS, PhD, is the associate dean for research and professor of prosthodontics and operative dentistry at Tufts University School of Dental Medicine. He is editor-in-chief of Inside Dentistry and part of a group practice in Boston, Massachusetts. He received no compensation for this article.
For more information, contact:
Tokuyama Dental America
877-378-3548
www.tokuyama-us.com
