Dentinal hypersensitivity (DH) is a global oral health issue and a significant challenge for most dental professionals. Symptoms of dentinal hypersensitivity are generally reported by the patient and are difficult to describe and challenging to accurately diagnose because other dental diseases have to be ruled out first, such as dental caries, cracked-tooth syndrome, and defective restorations, among others. The most common symptom reported is a short, sharp transient pain arising from exposed dentin responding to one of several different stimuli: thermal, chemical, tactile, evaporative and osmotic (Figure 1).

Figure 1. Pictorial display of origin of pain associated with sensitive teeth.
Image: Origin of pain associated with sensitive teeth.

The prevalence of dentinal hypersensitivity has been reported over the years in a variety of ways: 3.8% to 74.0% depending upon the population, study setting and study design,1 14.3% of all dental patients,2 between 8% and 57% of adult dentate population,3 and up to 30% of adults at some time during their lifetime.4 Among periodontal patients, the frequency is much higher (60%-98%).5-7

Dentinal hypersensitivity has been shown to peak in 20 to 30 year olds and then rise again when in their 50s.4,8 A more current study conducted in India by Sood et al, with 2051 subjects, found that the highest prevalence of DH occurred in 40-49 year old age group and the age group of 60-69 years showed minimum hypersensitivity.9 These results further demonstrate the difficulty of diagnosing the condition and accurately reporting prevalence. The condition generally involves the facial surfaces near the cervical aspect of teeth and is very common in premolars and canines.4 Patients undergoing periodontal treatment are particularly susceptible to this condition, as mentioned above, because of the recession following periodontal surgery or loss of cementum following non-surgical periodontal therapy.9,10 In addition periodontal disease and improper brushing habits can also result in gingival recession accompanied by sensitive teeth. Dentinal hypersensitivity has been researched extensively through the years and many authors express an agreement that dentinal hypersensitivity is either under-reported by the dental patient population or under-diagnosed, and excludes the underserved population when estimating prevalence of the condition.