Post Periodontal Procedure Sensitivity Management

Indian Society of Periodontology conducted a nationwide survey which highlights evidence-based approaches for diagnosing and managing DH, particularly within the Indian context. This guideline emphasizes proactive care through early identification, regular screening, and personalized treatment

Nonsurgical periodontal therapy for the management of dentin hypersensitivity:

Prevalence and Association with Periodontitis:
	Higher Prevalence in Periodontitis Patients: DH prevalence in periodontitis patients ranges from 60% to 98%, much higher than the 45%-57% observed in the general population.
	Plaque and DH Association: The role of dental plaque in DH is controversial. Some studies suggest that plaque and microbial contamination of exposed dentinal tubules play a role, while others emphasize plaque control in DH patients.
	Plaque Control in DH Patients: Despite having good plaque control, patients with DH still experience sensitivity.

Key Observations and Considerations:
	Plaque and Sensitivity: High plaque and inflammation scores are observed at sites of gingival recession, and plaque may cause sensitivity by breaking down the smear layer and allowing bacteria to penetrate dentinal tubules.
	Transient Sensitivity: DH may increase transiently after periodontal treatments like scaling, root planing, or gingival surgery, necessitating special care during and after treatment.

Suggestions for Dentists/Caregivers:
	Avoid Over Instrumentation: Prevent over-instrumentation of root surfaces, especially in the cervical area during scaling.
	Avoid Over Polishing: Do not over-polish exposed dentin during stain removal.
	Gingival Tissue Care: Be cautious to avoid burning gingival tissues during in-office bleaching procedures.
	Home Bleaching: Advise patients to be careful during home bleaching to prevent sensitivity.
	Use Appropriate Tools: Avoid using harmful instruments and materials that can exacerbate sensitivity.

Supporting Evidence:

Meta-Analysis by de Oliveira et al. (2020):

•	A study showed that 46% of adults experienced DH, with a higher prevalence in patients with periodontal disease.
•	DH prevalence increased from 9% to 54% after nonsurgical periodontal management.

Desensitizers: Desensitizing agents (DAs) have been found effective in reducing DH pain, particularly under water and evaporative stimuli.

Effectiveness of DAs: DAs were more effective in reducing DH pain from evaporative and water stimuli compared to control groups, even though mechanical stimuli showed lesser effectiveness.

Conclusion

Nonsurgical periodontal therapy can temporarily increase DH, but desensitizing agents (DAs) are crucial for managing the pain and providing relief to patients. Proper care and the use of DAs are recommended for successful DH management post-treatment.

GGI-CO-A1-AQS-300032384-DVC-L24-0140
References:
Grover V, Kumar A, Jain A, et al. ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity. J Indian Soc Periodontol. 2022;26(4):307-333. doi:10.4103/jisp.jisp_233_22

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Dental & Oral Health

Dentinal Hypersensitivity

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Vantej, enriched with the Calcium Sodium Phosphosilicate (CSPS) molecule, is a highly effective occluding desensitizer. It provides relief from dentinal hypersensitivity caused by enamel damage due to attrition, abrasion, and erosion.

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Post Periodontal Procedure Sensitivity Management

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