Figure - available via license: Creative Commons Attribution-NonCommercial 2.0 Generic
Content may be subject to copyright.
Source publication
Objectives
The aim of this overview is to consider the problems that may be associated with making a diagnosis of dentin hypersensitivity (DHS) and to provide a basis for clinicians to effectively diagnose and manage this troublesome clinical condition.
Materials and methods
A PUBMED literature research was conducted by the author using the followi...
Citations
... The evaporative (air) sensitivity assessments were assessed a minimum of 5 min after the tactile assessments have been completed [35,36]. Subject's response was categorized into 4-point Schiff sensitivity scores (0 defined as a subject who did not respond to air stimulation; 1 defined as a subject who responded to the air stimulus but did not request discontinuation of the stimulus; 2 defined as a subject who responded to the air stimulus and requested discontinuation or moved away from the stimulus; and 3 defined as a subject who responded to the stimulus, considered the stimulus to be painful and also requested discontinuation of the stimulus). ...
Objectives
To compare the effectiveness of using a 0.454% stannous fluoride-containing dentifrice twice daily in relieving dentinal hypersensitivity (DH) in a Chinese population.
Materials and methods
This was a single-centre, randomized, controlled, examiner-blind, three-treatment-arm, parallel-group study in participants with clinically diagnosed DH. Subjects who met inclusion criteria (n = 197) were randomly allocated into 3 groups: test group (n = 66)—using a 0.454% stannous fluoride-containing dentifrice twice daily; positive control group (n = 64)—using a 5.0% calcium sodium phosphosilicate-containing dentifrice twice daily; negative control group (n = 67)—using a 1150 ppm of NaF dentifrice twice daily. Status of DH was assessed at week 4 and week 8 by the same independent examiner. Changes from baseline in Schiff sensitivity score, tactile threshold and Dentine Hypersensitivity Experience Questionnaire (DHEQ) score were analysed using analysis of covariance models. The DHEQ evaluated subject-perceived oral health-related quality of life (OHRQoL).
Results
Statistically significant improvements in mean Schiff scores (p < 0.0001 for all products at Weeks 4 and 8), tactile threshold (p < 0.0001 for test and negative control at Weeks 4 and 8: Week 4 p = 0.0040 and Week 8 p < 0.0001 for positive control) and all DHEQ scores (p < 0.01 for all groups) were observed. No statistically significant differences were observed in the adjusted mean between all dentifrices at both timepoints, potentially driven by a placebo effect. Forty-two treatment-emergent adverse events (TEAEs) were reported (n = 32 subjects), with 2 serious AEs (n = 1) in the test group. TEAEs were not considered treatment-related.
Conclusions
All groups demonstrated statistically significant improvements in Schiff score, tactile threshold and OHRQoL. However, due to a possible placebo effect in the negative control, there were no statistically significant differences between the dentifrices.
Clinical relevance
This study adds to the growing research exploring why the placebo effect is a common phenomenon in DH studies.
Trial registration: ClinicalTrials.gov Identifier: NCT04950465.
... The quality of a person's life may be impacted by Dentin Hypersensitivity, which is thought to affect at least one in ten members of the general population [3,4]. The hydrodynamic theory, which hypothesizes that tiny fluid movements in dentinal tubules trigger pain responses, is the basis for the Dentin Hypersensitivity mechanism [5]. ...
... Treatment options vary from using desensitizing toothpaste that contains compounds like potassium nitrate or strontium chloride to in-office treatments like application and dentin bonding agents. 20 In cases surgical procedures like grafts may be considered. Effectively managing hypersensitivity starts with a clinical assessment and diagnosis. ...
Dentin sensitivity is a problem characterized by brief sharp pain that occurs in response to things like changes in temperature, sweet or sour substances and mechanical factors. This condition significantly affects the lives of patients leading to restrictions and changes in oral hygiene routines. It is crucial for care to understand the causes, symptoms, diagnosis and management of dentin sensitivity. The development of dentin sensitivity is closely related to the structure of teeth which involves the exposure of tubes in the dentin that contain nerve endings sensitive to stimuli. Different theories, such as the theory and direct innervation theory provide insights into how this pain occurs. Diagnosis involves an evaluation of signs and symptoms along with patient history and specific tests to confirm sensitivity. Management options include adjusting behaviors using desensitizing toothpaste or fluoride applications utilizing bonding agents or even undergoing procedures like gingival grafts. These approaches aim to reduce pain and improve the quality of life for individuals affected by dentin sensitivity. Dental professionals play a role, in diagnosing, treating and educating patients about this condition to ensure results and better oral health.
... Dentin hypersensitivity (DH) is commonly described as sensitive teeth and refers to short and sharp dental pain by patients in dentistry [1]. The mechanism of dentin sensitivity is expressed with the Brännström's hydrodynamic theory [2]. ...
Objectives: The aim of this study is to evaluate and compare the bond strength of different dentin desensitizers and self-adhesive resin cements to dentin surfaces. Methods: The flat dentin surfaces of 72 wisdom molar teeth were randomly divided into six groups for bond strength analysis (n=12): Group CP: No desensitizer + Primer II A&B+ Panavia F 2.0, Group CM: No desensitizer+ Primer A&B+ Multilink N, Group TP: Tokuyama Shield Force+ Primer II A&B + Panavia F 2.0, Group TM: Tokuyama Shield Force + Primer A&B+ Multilink N, Group UP: Universal dentin sealant + Primer II A&B+ Panavia F 2.0 and Group UM: Universal dentin sealent + Primer A&B+ Multilink N. The shear bond strength test was performed using a universal testing machine (0.5 mm/min). ANOVA test was used to detect significant differences at a p < 0.05. Results: The results indicated that bond strength values varied according to the desensitizing and resin cement materials (p < 0.05). The Tokuyama Shield Force desensitizer did not affect the bond strength of the resin cements to dentin (p > 0.05). Conclusion: The different types of dentin desensitizer applications affected on the shear bond strength results of the self-adhesive resin cements.
... Pain due to DH cannot be attributed to any other reason. Cold is the most common trigger for DH [1]. ...
... Air blast (evaporation), cold water, thermal and tactile stimuli, and subjective examination can be used for the assessment and identification of pain, and evaluation of the efficacy of different treatments for DH. Each test employs a specific stimulus for pain induction, such as mild air stream of air spray in air blast test, the tip of a probe in tactile test, and ice in thermal stimulation test [1,4]. Of the abovementioned tests, the air blast and tactile tests are more commonly used for the assessment of DH due to their physiological nature and reproducibility [5]. ...
Statement of the problem:
Dentin hypersensitivity (DH) is a common irritating condition. A precise sensitive test for its assessment can greatly aid in appropriate treatment planning.
Purpose:
This meta-analysis aims to compare the air blast and tactile tests for assessment of the efficacy Nd:YAG laser therapy versus non-laser treatments for DH in short-term and long-term follow-ups.
Materials and method:
For this review, an electronic search of the literature was carried out in three databases by two researchers for English articles published until March 10, 2021. Pooling of the data extracted from the selected articles was performed according to the PRISMA statement by the random-effect model. The mean difference (MD) and 95% confidence interval (CI) of pain score before the treatment onset and during the follow-up period according to the visual analog scale (VAS) were calculated. The level of heterogeneity was assessed by the I2 test, and a funnel plot was drawn to assess the publication bias of the reviewed studies.
Results:
Of 152 articles primarily retrieved, 9 randomized clinical trials (RCTs) using the air blast test and 4 RCTs using the tactile test were subjected to quantitative synthesis. In the short-term follow-up and immediately after treatment, the air blast test showed superiority of laser therapy compared with non-laser treatments (SMD: 0.55, 95% CI: 0.05-1.04, p= 0.03). However, this difference was not significant according to the tactile test (SMD: 0.48. 95% CI: 0.01-0.96, p= 0.06). In the long-term follow-up, the difference between laser therapy and non-laser modalities was not significant according to both air blast (SMD= -0.38, 95% CI: -1.43-0.67, p= 0.48) and tactile (SMD=0.0, 95% CI: -0.38-0.38, p= 0.99) tests.
Conclusion:
Comparison of laser therapy and non-laser modalities in the short-term reveal-ed higher sensitivity of the air blast test due to its mechanism of action compared with the tactile test. Further studies are required to interpret the results in the long-term follow-up.
... The most frequent stimuli are hot, cold, and sweet [2]. DH, which is estimated to afflict at least one in 10 people in the general population, may also affect a person's quality of life [3,4]. According to the severity and extent of the clinical issue, current treatment approaches for DH involve either recommending an in-office (professionally applied) or over-the-counter (OTC) product. ...
Background
Dentinal hypersensitivity (DH) is a common clinical finding that varies greatly in prevalence. An appropriate impulse that detonates noxious stimuli in the pulp/dentin boundary causes the typical DH pain, which is sudden, short, sharp, and of rapid onset. The objective of this research was to ascertain the incidence of DH in Keralites and evaluate some contributory factors, along with other initiating stimuli.
Methodology
Over three months, from June 2022 to August 2022, a cluster sampling technique was employed to conduct the study in 14 districts of Kerala. Patients from five clinics from each district who reported having DH and were aged 25 to 65 years were chosen at random. Using Google Survey forms, a 20-question, closed-ended survey was mailed to patients. The data were collected, evaluated, and analyzed using SPSS Version 23.0 (IBM Corp., Armonk, NY, USA). The statistical difference in the distribution of DH and the patient’s age was determined using analysis of variance (ANOVA). A chi-square test was carried out to test the association between dentinal hypersensitivity, gender, and other parameters; P < 0.05 was considered to be statistically significant.
Results
Among the 2,520 persons to whom questionnaires were mailed, 2,321 responded, with an unresponsive rate of 7.89%. The study revealed a sensitivity predilection among females (54%), although statistically insignificant. Respondents aged 25 to 35 years (41.01%) were commonly reported to have DH, the age distribution of which was found to be highly significant statistically (P < 0.01). Teeth whitening resulted in 82.98% of the sensitivity, whereas 47.99% accepted poor oral hygiene as an additional contributory factor. DH was reported in 52.01% of the patients with gastritis and 63.03% of the patients with gingival recession. Further, blame for poor dental treatment (88.88%) and climate change (82.92%) were also found relevant. The quality of life was claimed to be afflicted in 90.99% of the patients. Desensitizing agents were used by 68.97% of the patients, with which 68.03% reported satisfaction. Of the subjects who underwent professional treatment, 87.03% reported being satisfied. Oral prophylaxis-induced sensitivity was reported in 57.99%, indicating enhanced oral health awareness among Kerala residents. There was a statistically highly significant difference in the patient distribution based on the exposure to DH, and their perception of the causes and factors affecting DH (P < 0.01).
Conclusions
DH is a frequently and widely prevalent dental malady. Respondents demonstrated that they were conversant with DH. The quality of life and enjoyment of daily activities are both impacted by dentin hypersensitivity, and many patients are unaware that it is a treatable illness. Various desensitizing substances are also available and can be applied quickly to sensitive areas. Patients prefer this procedure as it is simpler to apply these agents and the effects are pleasant and beneficial.
... • Osmotic test: Cotton applicator saturated with sucrose solution is applied for a period of 10 seconds. 18 • Scratch device: Made by Smith and Asc in 1964. In this, stainless steel wire moves along the highest arc of curvature on the facial surface of the sensitive tooth. ...
The aim of this review is to provide dentists with comprehensive information regarding dentin hypersensitivity. This includes presenting its etiology, outlining the process of diagnosis, discussing clinical management strategies, and exploring technical approaches aimed at alleviating sensitivity. Dentin hypersensitivity is characterized by distinctive short, sharp pain arising from exposed cervical dentin in response to various external stimuli. The etiological factors cause two specific changes in teeth. First, the dentin surface must be exposed and denuded, which requires the loss of enamel or gingival recession combined with the loss of cementum. The second condition is the opening of the dentin tubules to allow the sensory mechanisms in the pulpal area following stimulation of the dentin surface. The accurate diagnosis of dentin hypersensitivity before receiving therapies is critical for successful treatment. The diagnosis of the disease starts through investigating the medical history of the patient and examination. Generally, the primary approach in addressing dentin hypersensitivity involves the utilization of toothpaste containing potassium salts and fluoride. Newly introduced materials and in-office methods for treating dentin hypersensitivity include bioactive glasses, iontophoresis, , and lasers.
... 3,4 Women are slightly more affected than men, with a higher proportion of sufferers not seeking dental professional advice. 5 Pressure changes in the exposed dentinal tubules in response to thermal, chemical, tactile, and osmotic changes are believed to excite nerves and cause pain. 1 Various physiological factors like attrition, erosion of enamel and cementum, abrasion, occlusal pressure, gingival recession, and faulty tooth brushing can cause DH. 6,7 Iatrogenic factors such as periodontal treatment, tooth whitening, and tooth preparation may also play a part in developing DH. 8,9 Dentin hypersensitivity can impact a patient's quality of life, trigger the development of chronic pain and become a source of consistent frustration, inducing psychological and emotional distress. ...
Objective:
Dentin hypersensitivity (DH) is characterized by a short, sharp pain in response to a thermal or tactile stimulus. The application of desensitizing agents such as GLUMA and laser is a non-invasive and safe approach to decrease sensitivity. The evidence for the efficacy of GLUMA desensitizer compared to laser desensitization in patients with DH was evaluated for 6 months.
Design:
In March 2022, an electronic search of PubMed, Scopus, and Web of Science databases was conducted. Articles published in English that compared GLUMA and laser in the treatment of DH with a follow-up of 6 months or more were included. Randomized, non-randomized controlled trials, and clinical trials were included. Risk of bias assessment tools developed by the Cochrane collaboration ROB 2 and ROBINS-I were used to assess the quality of studies. The GRADE assessment method was used to assess the certainty of evidence.
Results:
About 36 studies were identified in the search results. After applying the predefined eligibility criteria, eight studies with 205 participants and 894 sites were included in this review. Of the eight studies, four were judged to be at high risk of bias, three had some concerns, and one had a serious risk of bias. The certainty of the evidence was graded as low.
Conclusion:
Based on limited evidence, GLUMA and laser appear to be equally effective in providing relief from DH. GLUMA showed an immediate effect and provided pain relief. Over the course of a week, laser showed long-term stable results. GLUMA is effective in providing immediate relief.
... However, to date, the gold standard for DH that provides long-lasting and sustained improvement of the hypersensitivity condition has yet to be discovered. Among the many predisposing factors and etiologies for DH, incorrect tooth brushing technique is cited as the most common cause of DH. 6,24 Thus, dental education is essential to prevent DH and provide better oral health and overall well-being of the patient. Because DH may result from inappropriate/incorrect oral hygiene practices, educating the public on correct dental hygiene techniques may help prevent or improve DH. ...
... The diagnosis of DH is very subjective and difficult to establish despite several DH guidelines already published and available online. 4,24,25 The difficulty in diagnosing DH may partially be due to the numerous dental conditions that can present with symptoms similar to those of DH. 24 For this reason, DH is considered a diagnosis of exclusion-only when the signs and symptoms fail to meet the criteria of any other oral conditions or diseases can the diagnosis of DH be made. The sharp, sudden pain experienced upon consuming hot, cold, and sweet foods and beverages is a common complaint for both DH and reversible pulpitis. ...
... The diagnosis of DH is very subjective and difficult to establish despite several DH guidelines already published and available online. 4,24,25 The difficulty in diagnosing DH may partially be due to the numerous dental conditions that can present with symptoms similar to those of DH. 24 For this reason, DH is considered a diagnosis of exclusion-only when the signs and symptoms fail to meet the criteria of any other oral conditions or diseases can the diagnosis of DH be made. The sharp, sudden pain experienced upon consuming hot, cold, and sweet foods and beverages is a common complaint for both DH and reversible pulpitis. ...
The prevalence of dentin hypersensitivity (DH) is increasing around the world. At least one in 10 individuals in the general population has been diagnosed with DH. It is a diagnosis that has significant negative effects on a person's oral health-related quality of life. This condition, which is characterized by sharp, short tooth pain in response to thermal, chemical, tactile, and evaporative stimuli, is more commonly seen in adults. DH has a tremendous impact on the social and financial aspects of patients and society at large. It is essential to recognize the factors that can contribute to a successful treatment outcome to guarantee the overall well-being of DH patients. The aim of this narrative review was to highlight strategies that can lead to successful DH treatment outcomes, along with current updates on DH mechanisms, treatment options, and the latest management approaches. A positive treatment outcome for DH requires a concerted effort from both the patient and the dental practitioner. Highly motivated patients and dental practitioners with sound knowledge of DH diagnosis and available treatment options will ensure successful long-term improvement of DH symptoms.
... Many conditions enumerated in may produce clinical symptoms similar to DH and be considered for differential diagnosis [ Table 1]. [3,[109][110][111][112] To eliminate the conditions in the differential diagnosis of DHS, a proper include examination is required. The examination should start with recording of chief complaint, symptoms, history of present illness, clinical examination, and diagnostic testing. ...
... A prophylactic treatment for DH is sorted for sensitive and exposed cervical areas. There is evidence suggesting that preventive aspects of DH are often overlooked by professionals [109,111,131] and since not all patients report the hypersensitivity routine screening for DH by the dentists is advised at the time of oral examination visits. [132] Further, it has been demonstrated the value of preventive approach as the treatment efficacy of the active agent used for occlusive treatment for DH, i.e., laser desensitizing treatment increased when associated predisposing etiologic factors were eliminated. ...
... Treatments can be self-administered by the patient at home (simple, cost-effective, targeted to multiple teeth at one point in time) or be applied by a dental professional in the dental office complex, expensive generally limited to one or a few teeth. [111] Generally, the complexity of the treatments increases with the increase in the severity, extent, and persistence or recurrence of DH. Conceptually, minimally invasive and reversible approaches should be instituted at the outset, and in case of persistence of the complaint at reevaluation, more complicated and irreversible treatment options may be opted for patient management. ...
https://www.jisponline.com/text.asp?2022/26/4/307/349728
