Dentine Hypersensitivity: A Review of its Management Strategies

Dentine hypersensitivity or more colloquially “sensitive teeth” is a common problem encountered in routine clinical practice. The diagnosis of it, at times, is intriguing for even the most experienced clinician. The condition, though not alarming, is important diagnostically and therapeutically because it tends to disturb the routine day to day life of the patient, often becoming troublesome during eating, drinking, brushing, and in some cases mere breathing through mouth. This article attempts to discuss this topic in regards to its epidemiology, hypothesis regarding pain production, various etiological factors with special emphasis on the management strategies in a routine clinical scenario. Key Words: Dentine bonding agent, dentine hypersensitivity, hydrodynamic theory, treatment Introduction Dentine hypersensitivity is simply stated is the sensation produced by the stimulation of dentinal nerve endings. Dowell and Addy have defined dentinal hypersensitivity as a transient pain arising from exposed dentine, typically in response to chemical, thermal, tactile or osmotic stimuli, which cannot be explained as arising from any other form of dental defect or pathology.1 It may affect as many as one in seven of adult patients attending for dental treatment2 with the buccal surface of canines and premolars being affected the most. Hypersensitivity has its peak prevalence in young adult and then decreases with age.3 It is reported to exhibits a slight female predilection.4 Hypersensitivity is caused by exposure of dentine due to loss of enamel or denudation of root4 owing to varied reasons predominantly being gingival recession with advancing age, chronic periodontal disease, certain form of periodontal surgery, tooth brushing and chronic trauma from habits.5 The mechanism of pain production because of dentine hypersensitivity is still not clearly understood. Many hypotheses have been propounded of which the Hydrodynamic theory is the most accepted.6,7 The pain arising from exposed dentine varies in both frequency and severity. While, it may be sudden, sharp and of short duration in some in others it might be a persistent, dull or vague sensation in one or more tooth.8 Management of a patients suffering from dentine hypersensitivity begins with correct diagnosis. The diagnosis of this condition is usually arrived at, by ruling out other conditions that may present with similar feature in the orofacial