Managing dentin hypersensitivity.

BACKGROUND The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology. TYPES OF STUDIES REVIEWED The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action. RESULTS The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies. CLINICAL IMPLICATIONS DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.

[1]  R. Gupta,et al.  2% sodium fluoride-iontophoresis compared to a commercially available desensitizing agent. , 2005, Journal of periodontology.

[2]  J. C. Pereira,et al.  Effect of desensitizing agents on the hydraulic conductance of human dentin subjected to different surface pre-treatments--an in vitro study. , 2005, Dental materials : official publication of the Academy of Dental Materials.

[3]  R. Newcombe,et al.  A comparison of a reformulated potassium citrate desensitising toothpaste with the original proprietary product. , 2005, Journal of dentistry.

[4]  N. Karimbux,et al.  The effect of a new toothpaste containing potassium nitrate and triclosan on gingival health, plaque formation and dentine hypersensitivity. , 2005, Journal of clinical periodontology.

[5]  F. L. Pillon,et al.  Effect of a 3% potassium oxalate topical application on dentinal hypersensitivity after subgingival scaling and root planing. , 2004, Journal of periodontology.

[6]  R. Newcombe,et al.  Dentine hypersensitivity: a randomised, double-blind placebo-controlled study of the efficacy of a fluoride-sensitive teeth mouthrinse. , 2004, Journal of clinical periodontology.

[7]  R. Crisp,et al.  The Effectiveness of Systemp.desensitizer in the Treatment of Dentine Hypersensitivity , 2004, Primary dental care : journal of the Faculty of General Dental Practitioners.

[8]  M. Addy,et al.  Dentine hypersensitivity: development and evaluation ofamodel in situ to study tubulepatency. , 2004, Journal of clinical periodontology.

[9]  A. Şengun,et al.  The long‐term effectiveness of five current desensitizing products on cervical dentine sensitivity , 2004 .

[10]  F. Curro,et al.  Clinical evaluation of ferric oxalate in relieving dentine hypersensitivity. , 2004, Journal of oral rehabilitation.

[11]  E. Swift Causes, prevention, and treatment of dentin hypersensitivity. , 2004, Compendium of continuing education in dentistry.

[12]  S. Takagi,et al.  Reduction in dentin permeability using mildly supersaturated calcium phosphate solutions. , 2004, Archives of oral biology.

[13]  Ari-Pekka Forsback,et al.  Mineralization of dentin induced by treatment with bioactive glass S53P4 in vitro , 2004, Acta odontologica Scandinavica.

[14]  W. Devizio,et al.  Comparative investigation of the desensitizing efficacy of a new dentifrice containing 5.5% potassium citrate: an eight-week clinical study. , 2004, The Journal of clinical dentistry.

[15]  R. Palma-Dibb,et al.  Clinical evaluation of low-level laser therapy and fluoride varnish for treating cervical dentinal hypersensitivity. , 2003, Journal of oral rehabilitation.

[16]  C. Eduardo,et al.  Treatment of cervical dentin hypersensitivity using neodymium: Yttrium–aluminum–garnet laser. Clinical evaluation , 2003, Lasers in surgery and medicine.

[17]  D. Pashley,et al.  In vivo sensitivity of human root dentin to air blast and scratching. , 2003, Journal of periodontology.

[18]  F. Eichmiller,et al.  The clinical effect of amorphous calcium phosphate (ACP) on root surface hypersensitivity. , 2003, Operative dentistry.

[19]  R. Vowles,et al.  The prevalence of dentine hypersensitivity in a hospital clinic population in Hong Kong. , 2003, Journal of dentistry.

[20]  T. A. Coleman,et al.  Cervical dentin hypersensitivity. Part III: resolution following occlusal equilibration. , 2003, Quintessence international.

[21]  M. Addy,et al.  Can tooth brushing damage your health? Effects on oral and dental tissues. , 2003, International dental journal.

[22]  E. Lynch,et al.  Treatment of cervical sensitivity with a root sealant. , 2003, American journal of dentistry.

[23]  A. Sicilia,et al.  Evaluation of the efficacy of two potassium nitrate bioadhesive gels (5% and 10%) in the treatment of dentine hypersensitivity. A randomised clinical trial. , 2003, Journal of clinical periodontology.

[24]  M. Sanz,et al.  A systematic review of the prevalence of root sensitivity following periodontal therapy. , 2002, Journal of clinical periodontology.

[25]  M. Addy,et al.  A cross-sectional study of dentine hypersensitivity. , 2002, Journal of clinical periodontology.

[26]  V. Haywood Dentine hypersensitivity: Bleaching and restorative considerations for successful management , 2002 .

[27]  W. Finger,et al.  Clinical evaluation of the role of glutardialdehyde in a one-bottle adhesive. , 2002, American journal of dentistry.

[28]  G. Linden,et al.  Dentine hypersensitivity in Jordanian dental attenders. A case control study. , 2002, Journal of clinical periodontology.

[29]  K. Ishikawa,et al.  Calcium phosphate precipitation method for the treatment of dentin hypersensitivity. , 2002, American journal of dentistry.

[30]  D. Pashley,et al.  The effects of outward forced convective flow on inward diffusion of potassium across human dentin. , 2002, American journal of dentistry.

[31]  P. Gjermo,et al.  Treatment of dentin hypersensitivity by Nd:YAG laser. , 2002, Journal of clinical periodontology.

[32]  E. Reich,et al.  Desensitizing effects of an Er:YAG laser on hypersensitive dentine. , 2002, Journal of clinical periodontology.

[33]  H. Newman,et al.  Dentists' perceptions of dentine hypersensitivity and knowledge of its treatment. , 2002, Journal of oral rehabilitation.

[34]  C. Prati,et al.  Treatment of cervical dentin hypersensitivity with resin adhesives: 4-week evaluation. , 2001, American journal of dentistry.

[35]  R. Pereira,et al.  Efficacy of a 3% potassium nitrate desensitizing mouthwash in the treatment of dentinal hypersensitivity. , 2001, Journal of periodontology.

[36]  B. Willershausen,et al.  Clinical effectiveness of a potassium chloride containing chewing gum in the treatment of hypersensitive teeth. , 2001, European journal of medical research.

[37]  R. Davies,et al.  Comparative investigations of the desensitising efficacy of a new dentifrice. , 2001, Journal of clinical periodontology.

[38]  J. Knowles,et al.  The effects of oxalate-containing products on the exposed dentine surface: an SEM investigation. , 2001, Journal of oral rehabilitation.

[39]  V. Çanakçi,et al.  Clinical evaluation of an electron-ionizing toothbrush with a tooth paste containing stannous fluoride in treatment of dentine hypersensitivity following periodontal surgery. , 2001, Dental materials journal.

[40]  S. Cadden,et al.  An update on the physiology of the dentine-pulp complex. , 2001, Dental update.

[41]  E. Swift,et al.  Clinical evaluation of Prime & Bond 2.1 for treating cervical dentin hypersensitivity. , 2001, American journal of dentistry.

[42]  H. Worthington,et al.  Potassium nitrate toothpaste for dentine hypersensitivity (Cochrane Review) , 2001 .

[43]  K. Matsumoto,et al.  Treatment of dentine hypersensitivity by lasers: a review. , 2000, Journal of clinical periodontology.

[44]  J. Sowinski,et al.  Desensitizing efficacy of Colgate Sensitive Maximum Strength and Fresh Mint Sensodyne dentifrices. , 2000, American journal of dentistry.

[45]  W. Devizio,et al.  Desensitizing efficacy of a new dentifrice containing 5.0% potassium nitrate and 0.454% stannous fluoride. , 2000, American journal of dentistry.

[46]  M. Addy Tooth wear and sensitivity : clinical advances in restorative dentistry , 2000 .

[47]  J. Sowinski,et al.  A new desensitizing dentifrice--an 8-week clinical investigation. , 2000, Compendium of continuing education in dentistry. (Jamesburg, N.J. : 1995). Supplement.

[48]  G. Singh,et al.  Desensitization of exposed root surfaces using a semilunar coronally positioned flap. , 2000, General dentistry.

[49]  W. Devizio,et al.  A randomized clinical trial of the desensitizing efficacy of three dentifrices. , 2000, Compendium of continuing education in dentistry. (Jamesburg, N.J. : 1995). Supplement.

[50]  R. Orchardson,et al.  The efficacy of potassium salts as agents for treating dentin hypersensitivity. , 2000, Journal of orofacial pain.

[51]  M. Addy,et al.  Dentine hypersensitivity - an enigma? A review of terminology, mechanisms, aetiology and management. , 1999 .

[52]  C. Davidson,et al.  Clinical evaluation of a one-bottle bonding system for desensitizing exposed roots. , 1999, American journal of dentistry.

[53]  H. Newman,et al.  Perceptions of dentine hypersensitivity in a general practice population. , 1999, Journal of oral rehabilitation.

[54]  G. Dondi dall'Orologio,et al.  Dentin desensitizing effects of Gluma Alternate, Health-Dent Desensitizer and Scotchbond Multi-Purpose. , 1999, American journal of dentistry.

[55]  Richards Bw,et al.  Clinical efficacy of two dentin desensitizing agents. , 1999 .

[56]  Triol Cw,et al.  Clinical evaluation of the effect of a remineralizing toothpaste on dentinal sensitivity. , 1999 .

[57]  R. Orchardson,et al.  Action potential conduction block of nerves in vitro by potassium citrate, potassium tartrate and potassium oxalate. , 1999, Journal of clinical periodontology.

[58]  I. Chestnutt,et al.  The influence of toothbrushing frequency and post-brushing rinsing on caries experience in a caries clinical trial. , 1998, Community dentistry and oral epidemiology.

[59]  A. Gaffar Treating hypersensitivity with fluoride varnishes. , 1998, Compendium of continuing education in dentistry.

[60]  I. Marlow,et al.  The effects of a potassium citrate, cetylpyridinium chloride, sodium fluoride mouthrinse on dentine hypersensitivity, plaque and gingivitis. A placebo-controlled study. , 1998, Journal of clinical periodontology.

[61]  C. J. Whitters,et al.  Effects of pulsed Nd:YAG laser radiation on action potential conduction in nerve fibres inside teeth in vitro. , 1998, Journal of dentistry.

[62]  G. R. Holland,et al.  Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. , 1997, Journal of clinical periodontology.

[63]  D. Gillam,et al.  The dentine disc. A review of its applicability as a model for the in vitro testing of dentine hypersensitivity. , 1997, Journal of oral rehabilitation.

[64]  R. Orchardson,et al.  Effect of pulsed Nd:YAG laser radiation on action potential conduction in isolated mammalian spinal nerves , 1997, Lasers in surgery and medicine.

[65]  P. McCusker,et al.  Prevalence of dentine hypersensitivity in a general dental population. , 1997, Journal of the Irish Dental Association.

[66]  H. Newman,et al.  Prevalence of cervical dentine sensitivity in a population of patients referred to a specialist Periodontology Department. , 1996, Journal of clinical periodontology.

[67]  H. Newman,et al.  Efficacy of a potassium nitrate mouthwash in alleviating cervical dentine sensitivity (CDS). , 1996, Journal of clinical periodontology.

[68]  P. Wesselink,et al.  Dentists' views on cervical hypersensitivity and their knowledge of its treatment. , 1995, Endodontics & dental traumatology.

[69]  R. Orchardson,et al.  Effects of Potassium Ions on Action Potential Conduction in A- and C-Fibers of Rat Spinal Nerves , 1995, Journal of dental research.

[70]  B. Matthews,et al.  Interactions between neural and hydrodynamic mechanisms in dentine and pulp. , 1994, Archives of oral biology.

[71]  M. Addy,et al.  Dentine hypersensitivity: its prevalence, aetiology and clinical management. , 1992, Dental update.

[72]  G. Bilotto,et al.  Decreasing intradental nerve activity in the cat with potassium and divalent cations. , 1991, Archives of oral biology.

[73]  Y. Noiri,et al.  Transmission Electron Microscopic Characterization of Hypersensitive Human Radicular Dentin , 1990, Journal of dental research.

[74]  Active Supportive Care Cancer pain relief and palliative care. Report of a WHO Expert Committee. , 1990, World Health Organization technical report series.

[75]  R. Newcombe,et al.  Dentine hypersensitivity: the distribution of recession, sensitivity and plaque. , 1987, Journal of dentistry.

[76]  M Addy,et al.  Dentine hypersensitivity. A study of the patency of dentinal tubules in sensitive and non-sensitive cervical dentine. , 1987, Journal of clinical periodontology.

[77]  R. Orchardson,et al.  Clinical features of hypersensitive teeth , 1987, British Dental Journal.

[78]  D. Pashley,et al.  The Effects of Desensitizing Agents on the Hydraulic Conductance of Human Dentin in vitro , 1981, Journal of dental research.

[79]  P. Fratarcangelo,et al.  Clinical evaluation of a new treatment for dentinal hypersensitivity. , 1980, Journal of periodontology.

[80]  M. Brännström,et al.  Transmission and control of dentinal pain: resin impregnation for the desensitization of dentin. , 1979, Journal of the American Dental Association.

[81]  M. Hodosh A superior desensitizer--potassium nitrate. , 1974, Journal of the American Dental Association.