Dental hypersensitivity (DH) is defined as a transient, sharp pain arising from exposed dentin in response to external stimuli, which cannot be attributed to any other dental pathology.
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Its prevalence ranges from 10% to 30% of the population, with higher incidence among young adults and patients with periodontal disease (Addy, 2021). Understanding its multifactorial etiology and implementing appropriate therapeutic approaches are essential for effective management.
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Etiology of Dental Hypersensitivity
The most accepted explanation is the hydrodynamic theory, proposed by Brännström, which suggests that fluid movement within dentinal tubules triggers nerve responses leading to pain. Multiple local and systemic factors contribute to DH, often involving dentin exposure and loss of protective enamel or cementum.
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📊 Causes of Dental Hypersensitivity
| Category |
Specific Causes |
| Mechanical |
Aggressive tooth brushing, bruxism, attrition |
| Chemical |
Acidic diet (citrus, sodas), gastric reflux, erosion |
| Periodontal |
Gingival recession, root exposure, periodontal treatment |
| Iatrogenic |
Whitening agents, scaling and root planing |
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Treatment Approaches
Management of DH requires addressing both symptoms and underlying causes. Current treatments include:
➤ At-home desensitizing agents:
° Potassium nitrate toothpastes (reduce nerve excitability).
° Fluoride-based products (occlude dentinal tubules).
➤
In-office therapies:
° Application of fluoride varnishes or gels.
° Use of desensitizing agents such as arginine-calcium carbonate and casein phosphopeptide-amorphous calcium phosphate (CPP-ACP).
° Laser therapy and resin sealants for severe cases.
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Behavioral modifications:
° Education on proper brushing techniques.
° Dietary counseling to reduce acidic food and beverage intake.
° Management of parafunctional habits like bruxism.
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💬 Discussion
Recent research highlights that a multimodal approach is most effective for DH management. While desensitizing agents provide symptomatic relief, long-term success depends on addressing etiological factors such as gingival recession, occlusal trauma, and erosive dietary habits. Laser therapy and biomimetic agents show promising results, but cost and accessibility remain limitations. Furthermore, patient compliance plays a pivotal role in preventing recurrence.
✍️ Conclusion
Dental hypersensitivity is a multifactorial condition with a significant impact on oral health and quality of life. Accurate diagnosis, patient education, and evidence-based treatment strategies are fundamental for successful management. Continuous advances in biomaterials and preventive approaches are expected to enhance long-term outcomes for patients affected by this common condition.
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📚 References
✔ Addy, M. (2021). Dentine hypersensitivity: New perspectives on an old problem. Journal of Dentistry, 108, 103632. https://doi.org/10.1016/j.jdent.2021.103632
✔ West, N. X., & Seong, J. (2021). Managing dentine hypersensitivity: Challenges and solutions. Clinical Oral Investigations, 25(2), 337–349. https://doi.org/10.1007/s00784-020-03600-5
✔ Bartold, P. M., & Kocher, T. (2022). Periodontal considerations in dentine hypersensitivity. Periodontology 2000, 89(1), 64–78. https://doi.org/10.1111/prd.12437
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