APPROACH TO DIAGNOSING AND MANAGING TOOTH SENSITIVITY IN ADULT PATIENTS

Abstract

Dentin hypersensitivity (DHS) is a frequently encountered patient complaint that can present with a number of associated factors, including erosion and abrasion. It is characterized by short, sharp pain that arises from exposed dentin in response to various stimuli. The hydrodynamic theory is the most accepted explanation of DHS. Diagnosis of this condition requires an exclusion of other related conditions that lead to similar symptoms, such as periodontal diseases. Accurate diagnosis is important for its appropriate treatment. Despite the numerous methods proposed for treating DHS, a definitive solution to the issue has yet to be identified. Tooth sensitivity can also be a side effect of dental bleaching; however, it often persists even after treatment, highlighting the urgent need for new products that can manage this bleaching-related side effect. The aim of this review is to investigate current diagnostic and management protocols for dentin hypersensitivity and bleaching-induced tooth sensitivity. The diagnostic process of DHS includes chief complaint and illness history, clinical examination, diagnostic tests, and exclusion of other pathologies. There are two available assessment tools for DHS: stimulus-based assessment and response-based assessment. DHS treatment is classified into at-home treatment and in-office treatment, both of which are largely based on brushing techniques and desensitizing toothpastes. Treatment of bleaching-induced tooth sensitivity includes two approaches: reducing the fluid flow in the dentinal tubules by obstructing open dentinal tubules and reducing pulpal nerve excitability through depolarizing the nerve endings. Future studies should focus on establishing standardized diagnostic criteria and optimal treatment protocols for DHS and bleaching-induced tooth sensitivity.