Symptomatic treatment (enamel shielding) in a patient with dentin hypersensitivity followed by tooth bleaching: a case report

Abstract

Introduction: Hypersensitivity is a disease that affects a large part of the population who, very often, also seek to improve the esthetics of their teeth through tooth bleaching and fail to achieve their goal due to their symptomatic condition. Objective: To ascertain whether a patient with dentin hypersensitivity and cracked enamel would be pain-free after enamel shielding with neural and occlusive desensitizing agents in a single session, and whether she would continue to be pain-free after in-office tooth bleaching using 37% carbamide peroxide. Case report: A 31-year-old female patient who showcased high translucency in all dental elements, with many cracks and erosive tooth wear restricted to the cusp tips of elements 36 and 46. Following these findings and in association with the reported clinical history of high sensitivity, especially to cold diets, a diagnosis of dentin hypersensitivity was made. A single-session desensitizing procedure was carried out with neural and occlusive agents, and subsequently followed by in-office tooth bleaching. The patient reported the elimination of sensitivity with the desensitizing treatment (enamel shielding), which led to the patient agreeing to undergo teeth bleaching with a 37% carbamide peroxide-based product that guarantees no pain. Conclusions: The desensitizing protocol utilized fulfilled its role in terms of eliminating pain, with the patient returning to daily activities that had previously been impossible (such as drinking cold beverages) and allowing pain-free tooth bleaching to be carried out, but without much success in the color change achieved.