Pathogenesis, diagnosis and management of dentin hypersensitivity: an evidence-based overview for dental practitioners

Abstract

Though dentin hypersensitivity (DHS) is one of the most common complaints from patients in dental clinics, there are no universally accepted guidelines for differential diagnosis as well as selection of reliable treatment modalities for this condition. The neurosensory mechanisms underlying DHS remain unclear, but fluid movements within exposed dentinal tubules, i.e., the hydrodynamic theory, has been a widely accepted explanation for DHS pain. As several dental conditions have symptoms that mimic DHS at different stages of their progression, diagnosis and treatment of DHS are often confusing, especially for inexperienced dental practitioners. In this paper we provide an up-to-date review on risk factors that play a role in the development and chronicity of DHS and summarize the current principles and strategies for differential diagnosis and management of DHS in dental practices. We will outline the etiology, predisposing factors and the underlying putative mechanisms of DHS, and provide principles and indications for its diagnosis and management. Though desensitization remains to be the first choice for DHS for many dental practitioners and most of desensitizing agents reduce the symptoms of DHS by occluding patent dentinal tubules, the long-term outcome of such treatment is uncertain. With improved understanding of the underlying nociceptive mechanisms of DHS, it is expected that promising novel therapies will emerge and provide more effective relief for patients with DHS.

Aesthetic Management of Erosive Tooth Wear in a Young Egyptian Swimmer: A Case Report

“…Dentine hypersensitivity is defined as “short, sharp pain that arises from exposed dentin in response to non-noxious stimuli, typically thermal, evaporative, tactile, osmotic or chemical”. 20 His complaints were attributed to erosive tooth wear. The frequent exposure of the patient’s dentition to an erosive medium (swimming pool water) has been superimposed with a mechanical insult to the tooth enamel by improper oral hygiene practice.…”

Long-Term Effectiveness of Treating Dentin Hypersensitivity with Bifluorid 10 and Futurabond U: A Split-Mouth Randomized Double-Blind Clinical Trial

“…In clinical practice, the diagnosis is provided only after excluding other causes of unpleasant sensations. Several clinical conditions could cause symptoms similar to dental hypersensitivity; thus, there is a need for differential diagnosis [ 4 ]. The most common symptoms arise from pulpitis caused by caries or a trauma, such as enamel/dentine fracture [ 5 ].…”

Bonding Performance of Universal Adhesives Applied to Nano-Hydroxyapatite Desensitized Dentin Using Etch-and-Rinse or Self-Etch Mode

“…Through exposed dentin of the sensitive tooth, external stimulus initiates rapid fluid flow within dentinal tubules which are patent from pulp, and triggers nerve responses of pain sensation [ 9 , 10 , 11 ], causing transient but terrible suffering to the patients. The main therapeutic strategies include: (1) stabilizing the nerve and block nerve response in the pulp; (2) occluding the exposed dentinal tubules and preventing the fluid flow in the tubules [ 9 , 12 ]; the latter have achieved broad success in DH relief [ 7 , 13 , 14 , 15 ]. According to the handbook of treating dentin hypersensitivity, home-use desensitizing toothpaste is considered as the initial choice for mild discomfort or pain [ 9 ].…”