Teeth are made up of three components with individual and complex roles in the oral cavity.
Thus, the dental pulp, the deepest layer, is the center of the tooth, where vitality and nutrition are provided by the blood vessels that run through it and communicate with the underlying structures. Dentin borders the dental pulp and has the capacity to be secreted as long as the tooth is vital.
There are several types of dentins:
Primary – which forms as the tooth develops.
Secondary – which is secreted after the tooth has erupted and taken its place on the arch, becoming functional.
Tertiary – this is the dentine that is deposited when factors that can damage the pulp appear in the oral cavity. This type of dentine has the role of increasing the distance to the pulp chamber, being a protective element, slowing down the pathological process.
Enamel is the third layer of the tooth, the one that comes into contact with the multitude of stimuli present in the oral cavity. It is the outer, well-mineralized layer, consisting mostly of inorganic substances.
Dentin sensitivity can occur when the enamel layer gradually thins due to pathological processes that may be occurring more rapidly or more slowly. Acidic substances that can lower the pH of the oral cavity have the ability to remove calcium ions from the enamel, demineralizing it.
To prevent and reduce dentine senescence, patients can follow their dentist’s advice to improve their quality of life. In advanced cases, when pain persists, treatment may be with medication or, in severe cases, the tooth pulp may be removed, with loss of vitality.
Patient care of teeth includes the following aspects:
Tooth brushing – tooth brushing is instituted two or three times a day at the end of meals. The movements should be gentle as any increased pressure applied to the teeth can destroy the surface layers of enamel, with the development of dentine sensitivity over time. The toothbrush used to clean the tooth surfaces should have soft, fine, synthetic or natural bristles.
The type of toothpaste used shall be taken into account. It should be fine-grained, as large particles can lead to thinning of the enamel. Also, the popular idea of brushing teeth with salt or rubbing the tooth surfaces with astringent fruit peels (lemons, oranges) should be abandoned. The acids in the fruit will destabilize the oral pH whereas salt is hygroscopic, having the property of drawing out water and leading to excessive dehydration of tooth surfaces.
Desensitizing toothpastes can be applied to exposed tooth roots following gum recession to reduce discomfort.
The dentist will first treat the lesions or malfunctions that have led to the installation of tooth wear or receding gums. Thus, bruxism will be treated by applying mouth guards and the erosive lesions will be filled, the patient will be instructed to eat in order to prevent chemical wear of other surfaces not yet affected.
