The untold secrets of managing dentinal hypersensitivity
Dentinal hypersensitivity (DH) undoubtedly affects a significant portion of the population. This common clinical condition touches all age groups. Despite extensive investigation of DH, this disorder remains underdiagnosed and underreported. This annoying disease can lead to physical and psychological problems for patients and impact their quality of life.
There have been many hypotheses proposed in an attempt to understand pain mechanisms related to DH; however, the most commonly accepted physiological explanation for this clinical disease is the hydrodynamic theory. Interestingly, in a recent study Anderson and colleagues noted that hypersensitive teeth, when compared to nonsensitive teeth, have roughly eight times the number of tubules per unit and wider tubule diameters. Pain associated with DH is highly subjective, and patients can experience very minor discomfort or be subjected to severe agony. Because there are a host of etiological factors associated with DH and patients experience a range of discomfort levels, there is no recognized gold standard for treatment. The ideal desensitizing agent should be fast-acting, nonirritating, painless, and easy to use; provide long-term effects; and should not stain the teeth. Part one of this article series discussed the usage of fluoride varnish for the management of dentinal hypersensitivity, yet this treatment does not provide relief for all hypersensitive teeth. As such, additional therapies must be considered for clinical management of the condition.
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