My friend and fellow dental educator Dr. Gary DeWood is famous for saying “Gluma, Every Prep, Every Time”. This accurately represents the way that I use Gluma Desensitizer by Heraeus in my practice. It is a part of every set-up in our office, and I have come to depend on it’s benefits based on my real life experience. The combination of Glutaraldehyde and HEMA work both by killing off bacteria, and sealing the dentinal tubules preventing fluid movement. Fluid movement in the tubules is known to be a primary cause of post operative sensitivity. Bacterial contamination of the dentinal tubules is associated with an increased risk of post-restorative endodontic therapy as well as being a contributing factor in sensitivity. Effectively reducing sensitivity combined with the anti-bacterial properties improve my clinical outcomes and the patient’s experience. For these reasons I follow the rule “Every Prep, Every Time”. For indirect restorations, this does mean they get treated both on the day we do the prep prior to placing the provisional, as well as the day we seat the final restoration.
There is a third benefit, the hydration of etched dentinal tubules that have collapsed due to over-drying. One of the challenges of a total etch technique can be figuring out how to dry the tooth, but not too much, after rinsing the phosphoric acid off. The application of Gluma following drying, alleviates this concern as it reopens collapsed collagen. So during total etch techniques it is applied after etching and before the application of primer and resin. It can also be used with self etching systems, and should be applied prior to the dentin adhesive.