By: Lee Ann Brady DMD
Topic Originally Appeared on PankeyGram.Org. Dr. Brady granted permission for igniteDDS to share with our readers.
One of the most common questions I get is about the use of a category of materials we refer to as desensitizers, prep scrubs, or prep wetting agents.
The question is usually do they actually make a difference, and are they worth the cost? The answer is “yes” and “yes”.
Benefits of Using Desensitizers Before Tooth Prep
When incorporating prep scrubs, we aim to achieve four key benefits:
- Prevent sensitivity
- Antimicrobial activity
- Reduce bond degradation over time
- Moisten dentin for bonding
1. Prevent Sensitivity
The prevention of sensitivity is caused in two ways. First, products like Gluma from Kulzer contain HEMA, which occludes dentinal tubules, stopping fluid movement that could otherwise trigger a pulpal response.
2. Antimicrobial Activity
Second, the antimicrobial action of either glutaraldehyde (found in Gluma) or chlorhexidine (found in Consepsis by Ultradent) significantly reduces bacteria in the dentin, thereby lowering the risk of pulpitis and the subsequent need for a root canal.
3. Reduce Bond Degradation Over Time
Both chlorhexidine and glutaraldehyde also minimize the production of MMP’s (Matrix Metal Proteinases) the biological process responsible for bond degradation. This means our bonded restorations last longer before we see the marginal breakdown, leakage, and secondary caries.
4. Moisten Dentin for Bonding
The last function is to moisten the dentin to allow optimal penetration of the primer in our dentin adhesives. This means better hybrid zone development and better bonds and sealing of dentinal tubules.
Key Takeaway
So the answer to do they have benefits is a resounding yes. I have used Gluma on every tooth I have prepared for many years. I consider it extremely cost-effective as I am not sure how to put a price on greater restorative longevity and less patient dissatisfaction due to sensitivity or post-operative issues. The true cost should be about $2 a prepared tooth if dispensed properly, so that’s hard to argue with.
The benefits of prep scrubs are undeniable. For years, I’ve applied Gluma to every tooth I prepare, finding it incredibly cost-effective. The small investment— should be approximately $2 per tooth when dispensed properly—pales in comparison to the value of increased restorative longevity and reduced patient complaints due to sensitivity or post-operative complications.
Discover more about today’s top clinical tips to maximize patient comfort and your restorative outcomes by exploring The Pankey Institute’s advanced dental education programs. I am happy to be the direction of education at Pankey, so join me if you want to deepen your expertise with more practical tips that will span the areas of prevention, posterior composites, and indirect all ceramics.
