This problem is driving my dentist to distraction. And me, too.

I'm 67 years old. Appx. three years ago, i began experiencing sugar
(only) sensitivity in the area of #22 lingual. There was no
sensitivity to hot, cold or percussion. An immediate application of
Sensodyne to the affect area always stops the minor pain that ensues.

My dentist put an acrylic restoration on #22, but it didn't solve the
sensitivity problem. He subsequently tried and succeeded by applying a
bonding agent to the area around the gum line. The application last
for appx. six months and then needed to be applied again because the
sensitivity returned.

We followed this pattern for almost three years with success.

When the sensitivity returned a month ago, I saw my dentist and he
again applied the bonding agent. This time, no results. He tried a
second application a few days ago and applied it to a larger area.
This time, there was a 50 percent improvement, but no gold ring.

My dentist next sent me to see a specialist, an endodontist who has all
the newest equipment including digital x-ray machine.

Today, I saw the expert and looked at the digital x-rays with him.
Unfortunately, there was no smoking gun. No decay to be seen, no
anything else that could be discerned as needed treatment.

The expert suggested the following course of action:

1. Try doing the bonding agent treatment again, this time taking time
to cover every possible entry point for the sugar. Also, perhaps
cover a larger area. If not, successful, try same again.

2. If still unsuccessful, considering prepping the tooth for a crown
that comes down low enough to offer the tooth more protection,
particularly close to the gum line.

3. If that fails, perform a root canal prior to permanent cementing of
the crown to improve probability of root canal success.

I'd like to receive some other input from readers. Such as does there
exist alternate materials that could be used to protect the area near
the gum line and root from intrusion by the sugar?

Any other suggestions that could be tried short of crowning the tooth
or doing root canal therapy?

All would be appreciated.

P.S. I would not carry a printout of any suggestions to my dentist. I
would only tell him that "I heard about such and such and might it be
an idea to be tried.

Thanks very much.

Rob wrote:

This problem is driving my dentist to distraction. And me, too.

I'm 67 years old. Appx. three years ago, i began experiencing sugar
(only) sensitivity in the area of #22 lingual. There was no
sensitivity to hot, cold or percussion. An immediate application of
Sensodyne to the affect area always stops the minor pain that ensues.

My dentist put an acrylic restoration on #22, but it didn't solve the
sensitivity problem. He subsequently tried and succeeded by applying a
bonding agent to the area around the gum line. The application last
for appx. six months and then needed to be applied again because the
sensitivity returned.

We followed this pattern for almost three years with success.

When the sensitivity returned a month ago, I saw my dentist and he
again applied the bonding agent. This time, no results. He tried a
second application a few days ago and applied it to a larger area.
This time, there was a 50 percent improvement, but no gold ring.

My dentist next sent me to see a specialist, an endodontist who has all
the newest equipment including digital x-ray machine.

Today, I saw the expert and looked at the digital x-rays with him.
Unfortunately, there was no smoking gun. No decay to be seen, no
anything else that could be discerned as needed treatment.

The expert suggested the following course of action:

1. Try doing the bonding agent treatment again, this time taking time
to cover every possible entry point for the sugar. Also, perhaps
cover a larger area. If not, successful, try same again.

2. If still unsuccessful, considering prepping the tooth for a crown
that comes down low enough to offer the tooth more protection,
particularly close to the gum line.

3. If that fails, perform a root canal prior to permanent cementing of
the crown to improve probability of root canal success.

I'd like to receive some other input from readers. Such as does there
exist alternate materials that could be used to protect the area near
the gum line and root from intrusion by the sugar?

Any other suggestions that could be tried short of crowning the tooth
or doing root canal therapy?

All would be appreciated.

P.S. I would not carry a printout of any suggestions to my dentist. I
would only tell him that "I heard about such and such and might it be
an idea to be tried.

Thanks very much.



Sometimes managing root senstitivity is difficult. When I went to
dental school in the '70s, we wouldn't even place non-bonded composite
resin on the dentine without a calcium hydroxide liner. Now everyone
"knows" that placing phosphoric acid on dentin is innocuous, as long as
a good saturation of bonding agent follows, and all the solvent driven
off.
I'm not so sure. There are a variety of desensitizing agents such as
fluoride varnishes that can be useful (usually multiple applications are
necessary) but if the sensitivity can't be managed with desensitizing
agents, I would try to place a glass ionomer on the sensitive area. I
do this with discretion, because done thickly or sloppily these can be a
plaque trap. But glass ionomer bonds to tooth structure without the
need to etch a sensitive tooth with acid.
I agree that considering endodontic treatment and/or crowning the tooth
for dentinal hypersensitivity (if that indeed is all it is) is rather
extreme.

Steve

This is a puzzling case but isn't it possible that we are dealing
with an incomplete fracture somewhere ?

Ya'll know me, if it doesn't stop hurting, --> endo !

This is a puzzling case but isn't it possible that we are dealing
with an incomplete fracture somewhere ?

Ya'll know me, if it doesn't stop hurting, --> endo !