How on earth can a neck injection eliminate teeth sensitivity?

Can a patient’s tooth sensitivity really be linked to their occlusion?

Is occlusal adjustment ever indicated for sensitivity?

And what’s the actual mechanism behind those cases where everything looks fine — no cracks, no significant wear, no exposed dentine — yet the patient still complains their teeth are sensitive?

In this episode, Dr. Nick Yiannios shares the concept of Sympathetic Dental Hypersensitivity (SDH), a groundbreaking way of understanding sensitivity that goes beyond the usual suspects like caries, erosion, or leakage.

We dive into how the sympathetic nervous system in the pulp can drive unexplained pain, why traditional approaches often fail, and how objective tools like T-Scan and EMG can reveal what articulating paper misses.

This could completely change the way you diagnose and manage those “mystery” sensitivity cases that just don’t add up.

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<figcaption class="wp-element-caption">Watch PDP240 on Youtube</figcaption></figure>

Protrusive Dental Pearl: When fitting a resin-bonded bridge (RBB), if you’re unsure about the fit and cement gap, use light-bodied PVS on the intaglio surface of the wing. After setting and peeling it away, the thickness of the PVS shows you the expected cement layer. Ideally, it should be thin and even; a thicker area highlights where your gap is excessive.

Need to Read it? Check out the Full Episode Transcript below!

Key Takeaways:

• The T-scan technology revolutionizes occlusal analysis.


• Sensitive teeth can be linked to occlusion and bite adjustments.


• Frictional dental hypersensitivity (FDH) is a key concept in understanding sensitivity.


• Sympathetic responses may contribute to dental hypersensitivity.


• Innovative treatments include laser therapy and ozone application.


• Addressing root causes is essential for long-term solutions.


• Dentists should explore literature for new insights and techniques.


• Critical thinking is vital in dental practice.


• Advanced technology can enhance patient care and outcomes. Objective data is essential for effective occlusal adjustments.


• Understanding joint function is crucial for dental health.


• Differentiating between types of dental hypersensitivity is important.


• The sympathetic nervous system plays a significant role in dental pain.


• Educating patients about their conditions fosters better outcomes.


• The beaker of pain concept helps in understanding patient symptoms.


• Continuous learning is vital for dental professionals.


• Objective metrics are necessary for accurate diagnosis and treatment.

Highlights of this episode:

• 00:00 Teaser


• 00:39 Intro


• 03:51 Protrusive Dental Pearl


• 05:42 : Dr. Nick Yiannios’ Journey and Innovations


• 07:46 T-Scan and Digital Occlusal Analysis


• 08:29 FIRST INTERJECTION


• 13:46 T-Scan and Digital Occlusal Analysis


• 14:07 Discovery of Occlusion–Sensitivity Link


• 20:44 Second interjection


• 24:25 Student Case – Sensitivity from a Bridge


• 26:04  Dentine Hypersensitivity


• 28:39 Cervical Dentine Hypersensitivity


• 30:44 The Role of Lasers and Ozone in Dental Treatment


• 35:24 Alternatives for Dentists Without Lasers


• 43:12 Alternatives for Dentists Without Lasers


• 44:00 Frictional Dental Hypersensitivity Explained


• 47:15 The Importance of T-Scan in Dentistry


• 50:57 Neck Blocks and Sympathetic Responses.


• 58:24 Third interjection


• 01:00:01 Neck Block Mechanism


• 01:12:34 The Beaker of Pain Concept


• 01:14:38 Fourth interjection


• 01:16:23 The Beaker of Pain Concept


• 01:16:59 Community and Collaboration


• 1:20:57 Outro

Curious to dive deeper?
You can explore more of Dr. Nick’s work and insights through these resources:

• Upcoming course: CNO6 – Sympathetics in Dentistry: The Missing Link in General & Specialty Practice


• AES (American Equilibration Society) – check out their upcoming conference for world-class learning in occlusion and TMD.


• CNO – Center for Neural Occlusion


• Facebook community: Neural Occlusion


• YouTube channel: Dr. Nick DDS – packed with case examples, lectures, and protocols.


• CNO YouTube playlist

Studies & Resources

• Sympathetic Dental Hypersensitivity – An Alternative Etiology for Dental Cold Hypersensitivity


• Greater Auricular Nerve Block Reduces Dental Hypersensitivity to Intraoral Cold Water Swish Challenge: A Retrospective Study


• Dr. Mark Piper Lecturing at the American Academy of Craniofacial Pain: Sympathetics & CRPS1 

If this episode helped you, check out PDP199: How to Eliminate Sensitivity During Teeth Whitening

#PDPMainEpisodes #OcclusionTMDandSplints #BreadandButterDentistry

This episode is eligible for 1 CE credit via the quiz on Protrusive Guidance. 

This episode meets GDC Outcomes C.

AGD Subject Code: 180 OCCLUSION

Aim: To provide dentists with an updated understanding of tooth sensitivity, highlighting the role of sympathetic nervous system involvement, occlusion, and modern treatment approaches beyond traditional desensitizers.

Dentists will be able to –

1. Explain the concept of Sympathetic Dental Hypersensitivity (SDH) and its link to occlusion and cervical nerves.

2. Identify diagnostic tools (e.g., T-Scan, JVA, imaging) that provide objective data for managing sensitivity.

3. Evaluate treatment options, including laser-ozone therapy, occlusal adjustments, and neck block techniques.

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Click below for full episode transcript:

Teaser: I want you to think the sideways incursive movements like speed bumps. The more speed bumps, the more likely the nervous system doesn't like all that extra bump, bump, bump, bump. So you want to kind of smooth out the ride when you're going left and right. Imagine you're in a car, you want it to be a little smoother.