Periodic 6-monthly preventive visits to the dentist go a long way in preventive pain management. Dentine hypersensitivity is treated by in-office application of unfilled resin and photopolymerization and fluoride application with 2% sodium fluoride. Commercially available fluoride varnishes such as Duraphat® can be used in the office. Over-the-counter pastes such as Sensoform® and Sensodyne® are available. Trowbridge and Silver (1990) have recommended the use of cavity varnishes, calcium hydroxide, potassium oxalate, fluoride compounds, and restorative resins for desensitization among other agents.
Avoiding cross-brushing will prevent gingival recession and protect the thin cementum at the neck of the teeth. Acute toothache can be treated with local anesthetic block injections for temporary relief. Local anesthesia can be administered with 2% lidocaine hydrochloride with 1:80,000 epinephrine. Non-steroidal anti-inflammatory agents such as ibuprofen and ketorolac can be used to control pain. Standard dosages should be reduced when used in children and the geriatric population. It is important to take timely medication for pain control to maintain the therapeutic blood level.
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