The dentine hypersensitivity patient - a total management package

Abstract

One of the most frequently occurring presenting symptoms in dental practice is the oral pain condition of dentine hypersensitivity, which may be of only minor inconvenience to some patients and yet very disturbing and an issue affecting quality of life to others. Resolution of the aetiologies and the symptoms can be extremely difficult and frustrating, being both time consuming for clinician and patient. The aetiology of the condition is multifactorial, however over recent years the contribution of tooth erosion has escalated in magnitude. For dentine hypersensitivity to occur the lesion must be first localised on the tooth surface either through enamel loss, predominantly due to erosion; or dentine exposure due to gingival recession. Secondly, the lesion is initiated predominantly by erosion and abrasion by exposing dentine tubules on the tooth surface. More individuals are likely to experience this episodic pain condition due to the increasing longevity of the dentition and the rising prevalence of erosive toothwear. Conclusive evidence of successful treatment regimens is still elusive, despite a wide variety of products available for treatment. The two basic principles of treatment are altering fluid flow in the dentinal tubules or modifying the pulpal nerve response. These treatment regimens can be professionally applied in the dental practice, or at home by the patient. Desensitising toothpaste is the most common first line of treatment for use at home. Care should be taken to address the common predisposing conditions of gingival recession and acid erosion if long term success is to be achieved.