Dentin hypersensitivity: a review

Abstract

Dentin hypersensitivity may be defined as brief, sharp pain arising from exposed dentin. It occurs typically in response to chemical, thermal, evaporative or osmotic stimuli and cannot be explained as arising from other dental defects or pathology. The primary cause of dentin hypersensitivity is loss of enamel on the tooth crown and gum recession exposing the tooth root, with subsequent loss of cementum. The exact mechanism of dentin hypersensitivity is still being researched, but many accept the hydrodynamic theory as an explanation of the symptoms. A Hong Kong survey found a prevalence of dentin hypersensitivity greater than 60% among patients attending a dental hospital; lower incisors were the most commonly affected teeth. Studies have found that many dental clinicians have misconceptions about dentin hypersensitivity and lack the confidence to manage this oral health problem. It is important that Hong Kong dentists know how to diagnose dentin hypersensitivity and provide appropriate treatments and recommendations for patients. Many treatments have been proposed but no universally accepted or highly reliable desensitizing agent or treatment has been identified. When a patient presents with symptoms that may be attributed to dentin hypersensitivity, a thorough clinical examination should be carried out to rule out other likely causes before making a diagnosis and embarking on treatment. Depending on the identified cause, a combination of individual oral health behavior instructions, use of self-care products, and professional treatment may be required to manage the problem.