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Dentin Hypersensitivity

Dentin Hypersensitivity

Dentin hypersensitivity (DH, DHS) is dental pain which is sharp in character and of short duration, arising from exposed dentin surfaces in response to stimuli, typically thermal, evaporative, tactile, osmotic, chemical or electrical; and which cannot be ascribed to any other dental disease.

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A degree of dentin sensitivity is normal, but the pain is not usually experienced in everyday activities like drinking a cooling drink.

Therefore, although the terms dentin sensitivity and sensitive dentin are used interchangeably to refer to dental hypersensitivity, the latter term is the most accurate.

Signs and symptoms

The pain is sharp and sudden, in response to an external stimulus.

The most common trigger is cold, with 75% of people with hypersensitivity reporting pain upon application of a cold stimulus.

Other types of stimuli may also trigger pain in dentin hypersensitivity, including:

Thermal – hot and cold drinks and foods, cold air, coolant water jet from a dental instrument.

Electrical – electric pulp testers.
Mechanical–tactile – dental probe during a dental examination, periodontal scaling, and root planning, toothbrushing.

Osmotic – hypertonic solutions such as sugars.
Evaporation – air blast from a dental instrument.
Chemical – acids, e.g. dietary, gastric, acid etch during dental treatments.

The frequency and severity with which the pain occurs are variable.

Prognosis

Dentin hypersensitivity may affect individuals’ quality of life.

Over time, the dentin-pulp complex may adapt to the decreased insulation by laying down tertiary dentin, thereby increasing the thickness between the pulp and the exposed dentin surface and lessening the symptoms of hypersensitivity.

The similar process such as the formation of a smear layer (e.g. from toothbrushing) and dentin sclerosis.

These physiologic repair mechanisms are likely to occur with or without any form of treatment, but they take time.

Epidemiology

Dentin hypersensitivity is a relatively common condition.

Due to differences in populations studied and methods of detection, the reported incidence ranges from 4-74%.

Dentists may under-report dentin hypersensitivity due to difficulty in diagnosing and managing the condition.

When questionnaires are used, the reported incidence is usually higher than when a clinical examination is used.

Overall, it is estimated to affect about 15% of the general population to some degree.

It can affect people of any age, although those aged 20–50 years are more likely to be affected.

Females are slightly more likely to develop dentin hypersensitivity compared to males.

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The condition is most commonly associated with the maxillary and mandibular canine and bicuspid teeth on the facial (buccal) aspect, especially in areas of periodontal attachment loss.

What is Tooth Sensitivity?

Tooth sensitivity is a common name for dentin hypersensitivity or root sensitivity.

If hot, cold, sweet or very acidic foods and drinks, or breathing in cold air, makes your teeth or a tooth sensitive or painful then you have sensitive teeth.

Is Tooth Sensitivity Common?

Tooth sensitivity is very common and it has been estimated that approximately half the population experiences tooth sensitivity. Tooth sensitivity can come and go over time.

Why does Tooth Sensitivity (Dentin Hypersensitivity) Happen?

Tooth sensitivity is usually caused by dentin on root areas exposed due to receded gums or periodontal disease.

Receded gums are very common and up to four-fifths of people have gum recession by the time they are 65.

When the root of a tooth becomes exposed it does not have a layer of enamel like the crowns of your teeth.

Instead, the roots have a very soft covering called cementum, which once lost leaves the dentin of the root exposed.

Overzealous brushing or using a very abrasive toothpaste can also cause abrasion of the tooth’s enamel surface and expose dentin.

A very acidic diet – for example, a diet with a lot of citrus food, pickles or soda pop — can cause tooth erosion and dissolve the tooth surface, exposing the dentin.

Bulimia and GERD can also result in dental erosion and sensitivity due to acid in the mouth.

It is important to tell your dentist or hygienist if you have any sensitive teeth so that he or she can examine your mouth, see if the problem is tooth sensitivity (dentin hypersensitivity) and help you choose the best treatment.

When teeth are sensitive it can be painful to brush them and if you brush poorly because of pain then there is more risk of tooth decay and gum disease.

Pain after hot, cold, sweet or acidic food and drinks can also be a sign of decay with a cavity or hole in the tooth, or a sign of a broken tooth, and if this is the case your dentist will treat you with a filling or other treatment.

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Can I Prevent Tooth Sensitivity?

You can reduce your chances of getting tooth sensitivity by keeping your mouth as healthy as possible with good oral hygiene to help prevent receding gums and periodontal disease.

Brushing and flossing properly as recommended by your dentist or hygienist and using a low abrasion toothpaste can help reduce the chance that you will have tooth sensitivity.

A diet that is not acidic also helps prevent tooth sensitivity.

Ignoring your sensitive teeth can lead to other oral health problems, especially if the pain causes you to brush poorly making you vulnerable to tooth decay and gum disease.

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