牙龈退缩是DS的一个重要诱发因素[15]。一般认为,SRP术后随着牙龈肿胀的消退,牙根进一步暴露,加重了DS的症状。在本研究中,牙龈退缩在3 mm以内的DS牙数占77.4%,4 mm以上仅占6.4%,其结果未能反映出牙龈退缩与DS之间的相关性。Vaitkeviciene等[16]认为,当牙齿因长期的慢性牙周感染导致附着丧失和牙龈严重退缩时,侵入牙本质小管内的细菌及其分泌物会引起牙髓神经末梢发生明显的退行性变,牙齿的敏感程度反而可能降低。
年龄和性别也是与DS有关的生理因素。本研究发现,40~49岁和60岁以上年龄段发生DS的比例略高于其他年龄段,DS患者中女性的比例显著高于未发生DS的女性患者。本研究因样本量相对较少以及患者来源等因素,因此年龄和性别指标仅从一个侧面反映了牙周治疗后DS的分布特征,尚需扩大样本量以加强研究结果的说服力。
问卷调查显示,牙周治疗后DS患者对冷、酸刺激较敏感,热、甜和刷牙等刺激则无明显差异。Banfield等[17]发现,橙汁能够去除牙表面的涂层并导致牙本质小管开放,酸性食物特别是碳酸饮料与DS有一定的相关性。鉴于上述原因,笔者认为SRP术后,临床医生应当建议患者适当控制酸性食物的摄入量以减轻DS的症状。
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