Current management of dentin hypersensitivity

Abstract

ObjectivesThe aim of the article was to present an overview of the management strategies of dentin hypersensitivity (DHS) and summarize and discuss the therapeutic options.Materials and methodsA PubMed literature search was conducted to identify articles dealing with dentin hypersensitivity prophylaxis and treatment. We focussed on meta-analyses of available or controlled clinical trials.ResultsDHS therapy should start with noninvasive individual prophylactic home-care approaches. In-office therapy follows with nerve desensitizing, precipitating, or plugging agents. If the hypersensitivity persists, depending on the hard and soft tissue components at reevaluation, i.e., presence or absence of cervical lesions and the gingival contour, adhesive restorations including sealing or mucogingival surgery may be an option. They allow for the establishment of a physicomechanical barrier. As the placebo effect may play an important role, adequate patient management strategies and positive reinforcement may improve the management of DHS in the future.ConclusionsLifelong maintenance under the premise of strict control of the causative factors is crucial in the management of DHS.Clinical relevanceClinicians are faced with a broad spectrum of therapeutic options. Therapy should not only focus on pain reduction or better elimination but also on the modification of the exposed cervical dentin area based on the defect type.

Fluoride rinse effect on retention of CaF2 formed on enamel/dentine by fluoride application

“…9 In fact, the twice daily NaF treatment significantly increased alkali-soluble fluoride concentrations on the dentine slabs that were not pre-treated with fluoride, but the concentration after 7 days was only approximately 1% of that resulting from the APF treatment ( Table 2). …”

Dentin hypersensitivity: Pre-hybridization as an alternative treatment

“…The resin tags formation within the dentinal tubules and the lateral anastomosis formed by the branches result in hybridization of the peritubular dentine [13]. Apparently, the permeability variations of the adhesively-sealed dentine depends greatly on the adhesive system employed [9,40,51,52].…”

“…M any times, indirect restoration preparations expose the dentine and may lead to post-operative discomforts, such as dentinal hypersensitivity [1]. This has been one of the most reported clinical problems after the final cementation of indirect restorations [2][3][4].…”

“…Doubts still exist on which technique would be the most adequate approach either to eliminate or to decrease the post-operative sensitivity [10][11][12]. So far, none predictable treatment which completely eliminates the long-term pain perception has been defined as the therapeutic "gold standard" [13]. Among the several methods employed, the prehybridization is characterized by the application of either an adhesive system or a flowable resin immediately after the preparation aiming to seal and protect the tooth structure [14][15][16].…”

Exposed Dentin: Influence of Cleaning Procedures and Simulated Pulpal Pressure on Bond Strength of a Universal Adhesive System

“…In an advanced stage, sealing of the open dentin tubules can be established with a mechanical barrier based on adhesive bonding such as the application of adhesive systems as dentin desensitizers. Finally, resin composite restorations may be indicated in an even more advanced stage characterized by loss of dentin substance [1,3]. …”