Hi.. I'm a dental gp .. I have a 21 years old female patient present to my clinic complaining of pain in the posterior upper teeth ( some times she localized them at 15,14,24,26 ) and its less painful in the lower posteriors .. Pain initiated with thermal,sweets and mastication. Duration of pain half a minute to 2 minutes . Patient complaining for more than 5 years .. Diagnosed as hypersensitivity before 4 years and she used sensodyne for 2 years with improvement up to 60% .. Clinical examination shows a skeletal class III , scissor bite , no recession or exposed dentin and a small fissure caries in 47,26,16 .. Now I put the patient on sensodyne todays is the 5th day and she say there is improvement more than 80% at the first 3 hours after brushing .. I'm asking what could be the cause of the pain ? Is it the hypersensitivity or there is no hypersensitivity its the small fissure caries ..? And could it be a very small fissure caries for more than 5 years causing the same complain ? Thanks :)

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  • Dr.Ritz

    Dr.Ritz 30 - January - 2012, at 02:02 AM

  • Pain in relation to back upper teeth can be there because of decay present or can be there because of some gum infection present. Pain can also be there because of tooth wear or can be a referred pain. Traumatic bite if present can also lead to pain. Tooth wear and decay causes teeth sensitivity which becomes better by use of a desensitizing tooth paste (Sensodyne). If there are small fissure caries present, then they can be restored. If demineralization of tooth structure has occurred, then tooth can be remineralized with fluoride application or by fluoride rinses. You can restore the fissure caries which are present and can tell the patient to continue with use of desensitizing tooth paste. For more info on tooth hypersensitivity, refer to…..   http://www.identalhub.com/article_understanding-hypersenstivity-216.aspx

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