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.

Managing dentin hypersensitivity

Dentinal hypersensitivity (DH) is a common clinical condition usually associated with exposed dentinal surfaces. It can affect patients of any age group and most commonly affects the canines and premolars of both the arches. This article concisely reviews the patho-physiology, mechanism and clinical management of the DH. Treatment of DH should start with an accurate diagnosis. Differential diagnosis should be made and all other probable causes should be excluded. An often neglected phase of clinical management of DH is the identification and treatment of the causative factors of DH. By removing the etiological factors, the condition can be even prevented from occurring or recurring. There are various treatment modalities available which can be used at home or may be professionally applied. The "at home" desensitizing agents include toothpastes, mouthwashes or chewing gums and they act by either occluding the dentinal tubules or blocking the neural transmission. This article also discusses the recent treatment options like bioglass, Portland cement, lasers and casein phosphopeptide.

Dentin hypersensitivity: Recent trends in management.

This bibliographic review provides a general view of the etiology, characteristics and treatment of dentinal hypersensitivity, so that professionals can use this information in the therapeutic management of this clinical condition. For this purpose, the authors have analyzed whole texts of relevant articles on the subject. This study showed that the predisposing factors associated with the causes of dentinal hypersensitivity must be controlled or eliminated, by educating the patient regarding the excessive intake of acidic food, as well as providing guidance on the proper tooth brushing technique and analysis of occlusion. Effective treatment must be preceded by a proper diagnosis, established after the exclusion of any other possible causes of the pain. These cases must be managed efficiently, quickly and permanently. The availability of a wide variety of treatment could be an indicator that there is still no effective desensitizing agent to completely resolve the patient's discomfort, or that it is difficult to treat, irrespective of the available treatment options. Even with the large number of published studies, it has not been possible to reach a consensus about the product that represents the gold standard in the treatment of dentinal hypersensitivity. (J Oral Sci 51, 323-332, 2009)

Diagnosis and treatment of dentinal hypersensitivity

Dentin hypersensitivity: etiology, diagnosis and treatment; a literature review.

Objective: The aim of this randomized longitudinal clinical study was to assess different treatment protocols for dentin hypersensitivity with high-power laser, desensitizing agent, and its association between high-power laser and desensitizing agent, for a period of 6 months. Background data: The literature shows a lack of treatment for dentin hypersensitivity, and lasers are contemporary alternatives. Methods: After inclusion and exclusion analysis, volunteers were selected. The lesions were divided into three groups (n=10): G1, Gluma Desensitizer (Heraeus Kulzer); G2, Nd:YAG Laser (Power Laser™ ST6, Lares Research®) contact mode, laser protocol of 1.5 W, 10 Hz, and 100 mJ,≈85 J/cm2, four irradiations performed, each for 15 sec, in mesiodistal and occluso-apical directions, totaling 60 sec of irradiation with intervals of 10 sec between them; G3, Nd:YAG Laser+Gluma Desensitizer. The level of sensitivity to pain of each volunteer was analyzed by visual analog scale (VAS) using cold air stimuli a...

Comparative evaluation of the effects of Nd:YAG laser and a desensitizer agent on the treatment of dentin hypersensitivity: a clinical study.

PURPOSE To evaluate clinically whether the addition of glutardialdehyde to the one-bottle enamel-dentin adhesive Gluma Comfort Bond (GCB) has a desensitizing function, as insinuated by the brand name Gluma Comfort Bond+Desensitizer (GCB+D). MATERIALS AND METHODS Two pain studies following identical protocols were conducted in Abu Dhabi (A) and Bologna (B). Each of the 60 and 59 patients selected, respectively, had two sensitive cervical tooth sites, characterized by a score three or higher on a five-step pain scale: 1 (no), 2 (slight), 3 (mild), 4 (severe), 5 (very severe) discomfort upon application of a 2-second cold air stimulus. The buccal sensitive sites treated in A were generally small, in B larger and in most cases extending into the proximal tooth area. The patients indicated their discomfort level according to the pain scale prior to and immediately after topical application of GCB and GCB+D, respectively, and then at recalls after 1 week, 1 (A) or 3 (B) months, and 6 months. The data was statistically analyzed by chi2-tests (P < 0.05). RESULTS With the cumulative scores 1 and 2, the following percentage success rates were found for GCB/GCB+D. A: postoperatively 93/98, 1 week and 1 month 98/98, and at 6 months 92/100. In B, the respective decrease in sensitivity was uniformly 43/100 throughout the entire evaluation period, postoperatively through 6 months. The 33 teeth (57%) of GCB with scores 3 and 4 in the B-study received a rescue treatment with Gluma Desensitizer immediately after the 1 week recall. This regimen reduced the sensitivity instantaneously to scores 1 and 2 until the end of the evaluation after 6 months. In the A-study, GCB+D was significantly more effective than GCB after 1 week, 1 month, and 6 months, in the B-study at all recall sessions. It is hypothesized that a thin film of adhesive applied to a sensitive area may not polymerize and seal the dentin surface adequately due to oxygen inhibition. In particular, proximal sensitive tooth sites with poor access for adhesive application are suspected to remain inadequately sealed with a polymer film and thus sensitive. In this latter case however, glutardialdehyde as a component of the adhesive compound will result in coagulation of peripheral tubular liquid protein and thus desensitization, due to hampering of the liquid shift across the tubules upon excitation of a cold stimulus. In conclusion, glutardialdehyde played an active and effective role as a desensitizing agent, when added to the ethanol-water based one-bottle adhesive Gluma Comfort Bond.

Clinical evaluation of the role of glutardialdehyde in a one-bottle adhesive.

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Clinical evaluation of the role of glutardialdehyde in a one-bottle adhesive.