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Abstract

Tooth sensitivity during tooth whitening is a common concern among patients. This guide provides dentists with evidence-based strategies to address sensitivity according to each patient’s profile.

Understanding Sensitivity Types

Tooth sensitivity can be categorized into three main types:

  • Mild and Transient Sensitivity: Caused by thermal stimuli during treatment.
  • Pulsatile Sensitivity: Occurs post-treatment and is not stimulus-related.
  • Previous Dentin Hypersensitivity: A pre-existing condition requiring attention.

Identifying Sensitivity Profile

To identify the patient’s sensitivity profile, conduct a thorough assessment. Ask about:

  • Sensitivity to cold/hot water.
  • Sensitivity during toothbrushing.
  • Sensitivity with specific foods/beverages.
  • Sensitivity post-dental prophylaxis.
  • Occurrence of pain under specific circumstances.

Recommended Whitening Gels

Promote the use of whitening gels from the Whiteness line, offering a range of options to meet sensitivity profiles.

Whitening Gel Recommendations:

Advise the use of whitening gels containing:

  • Potassium Nitrate and Sodium Fluoride (e.g., Whiteness Perfect and White Class).
  • Calcium (e.g., White Class for at-home and Whiteness HP Blue and HP Automixx for in-office).
  • Discourage the use of exogenous light sources during whitening.

Strategies for Minimizing Sensitivity

Based on the sensitivity profile, employ these strategies & recommended gels:

Mild Sensitivity (e.g., thermal stimuli)

  • In-office session with appropriate whitening gel (e.g., Whiteness HP Blue or HP Automixx for 40-50 minutes ).
  • Tray use with Whiteness Perfect 10% (3-4 hours/day) or White Class 4-6% as per standard protocol.
  • Consider preceding the treatment with Desensibilize KF 0.2% for 10 minutes if you suspect mild discomfort to persist.
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Pulsatile/No Sensitivity

  • In-office session with appropriate whitening gel (e.g., Whiteness HP, HP Maxx, HP Blue, or HP Automixx).
  • Tray use with Whiteness Perfect (16% or 22%) or White Class (7.5% or 10%) based on preference.
  • Adjust gel concentrations if mild discomfort arises.

Combined Technique (In-Office and At-Home)

  • Suited for patients with specific preferences.
  • Assess patient collaboration and choose appropriate techniques and gel concentrations.

Previous Dentin Hypersensitivity

  • High-risk profile with thin enamel, biocorrosion, acidic diet etc.
  • Use lower gel concentrations and modify treatment protocols based on the patient’s risk factors and clinical signs.

Patient Collaboration

Emphasize the importance of patient collaboration for successful treatment outcomes. Remember that patients with sensitivity may require patience as progress can be slower. Patients with grayish teeth may exhibit a slower response to treatment. Patients with previous dentinal hypersensitivity should not be treated aggressively.

Conclusion

Understanding and addressing tooth sensitivity during tooth whitening is vital for patient comfort and successful outcomes. By identifying the patient’s sensitivity profile and applying evidence-based techniques and whitening gels, dentists can provide effective and tailored treatments while minimizing discomfort. Promote patient collaboration and consider individual factors, such as grayish teeth, to achieve the best results.

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