What to know about dentin hypersensitivity

Teeth are the hard structures in the mouth that help with biting and chewing. The teeth consist of four different dental tissues, one of which is dentin.

Dentin predominantly helps with the structure of teeth, and it also helps transmit sensations from the teeth. As dentin contains nerve tissue, it is sensitive to stimuli such as temperature.

DH is one of the more common dental problems a person may experience.

In this article, we will discuss what causes DH, symptoms to look out for, and the available treatment options.

DH describes short, sharp, intense bursts of pain and discomfort that originate from the teeth in response to certain stimuli. It occurs when the top protective layers of the tooth, enamelTrusted Source and cementum, wear away and expose dentin.

Dentin has a role in supporting the structure of the tooth, and it also helps relay sensations to the brain. This helps prevent a person from biting too hard on foods that could damage their teeth.

To help transmit these sensations, dentin contains tubules made up of nerve fibers. Without a protective layer, these tubules are vulnerable to various stimuli, such as temperature and pressure, which can cause sensitivity and pain.

DH is a very common dental condition and can have many potential causes. Dental experts note that DH can be very painful and may affect a person’s quality of life by causing problems with eating, drinking, and sometimes even speaking. However, many treatment options are available to help relieve symptoms.

Symptoms

People with DH typically experience pain and sensitivity to stimuli that are generally harmless. For example, gentle touch, mild temperatures, and certain chemicals may induceTrusted Source short, sharp burts of pain that can affect daily activities such as eating, drinking, speaking, and toothbrushing.

Removing the stimuli from the tooth area will typically alleviate the symptoms. Symptoms of DH can include:

  • sensitivity to hot or cold temperatures, such as a cold breeze
  • short, intense bursts of pain when eating or drinking hot or cold foods and drinks
  • pain and sensitivity when touching or applying pressure to the tooth area
  • discomfort when using certain oral products, such as abrasive toothpaste or mouthwash
  • sensitivity to acidic or sweet foods and drinks

Causes and risk factors

Exposure of dentin and dentin tubules causes DH to occur. This can often be the result of:

  • tooth decay
  • tooth fracture
  • worn fillings or tooth enamel
  • gum disease
  • receding gums

Potential risk factors for dentin exposure can include:

  • brushing the teeth too hard, causing wear and tear to the teeth and gums
  • consuming acidic foods and drinks, which can lead to the erosion of the protective tooth enamel and cementum
  • shrinking or receding gums, which can occur naturally or due to gum diseaseTrusted Source
  • teeth grinding, which can wear down the enamel surface
  • using abrasive oral products such as whitening toothpaste or bleaching products

Diagnosis

It can be difficult to diagnose DH, as the symptoms can be very similar to those of other dental conditions causing a person pain. To diagnose DH, a dental professional will conduct a clinical examinationTrusted Source and review a person’s full medical and dental history.

Typically, the exam will involve identifying a site of dentin exposure and performing a stimulation test to determine whether a person has DH or a differential diagnosis.

The dental professional may ask an individual to provide certain information, such as:

  • where the site of discomfort is
  • how often the pain occurs
  • whether the pain resolves when a person removes the stimulus that causes it
  • the severity of the pain, using a pain scale

Treatment

There are several different treatments available for DH. A dental professional may first advise a remedy a person can try at home.

This may include using a desensitizing toothpaste. These products contain ingredients that can help prevent uncomfortable sensations from reaching the nerves. It will typically take several applications before a person notices a reduction in sensitivity.

A person may also consider trying some home remedies to relieve symptoms. A 2017 reviewTrusted Source suggests that propolis can help treat DH. Propolis is a natural, resinous mixture that honeybees produce. While some evidence indicates that it could help with desensitization, further research is still necessary to investigate this.

Other treatments a dental professional can offer will need to take place in a dental practice. Some of these can include:

  • Fluoride gel: This option works by strengthening the tooth enamel and reducing the transference of sensations to the nerve.
  • A crown, filling, or bonding: These techniques cover, fill, or repair cracks and gaps in the teeth, covering any exposed nerves.
  • Gum tissue graft: If sensitivity is due to gum tissue receding from the tooth, a gum graft will repair the gum and protect the root of the tooth.
  • Root canal: In severe and persistent cases of DH, a dental professional may recommend root canal therapy.

Treating DH can be a long process, as sensitivity can take time to resolve. If choosing a nonsurgical option, a person may need to attend several appointments before feeling any significant effect.

Prevention

There are several ways a person can try to help prevent DH from occurring. Some suggestions may include:

  • Thorough oral hygiene: Regular toothbrushing with either a sensitive toothpaste or one containing fluoride, flossing, and gentle mouthwashes can help a person avoid gum disease and other oral health conditions that can lead to DH.
  • Correct toothbrushing: It may be preferable to brush using small, circular movements with a soft-bristled brush. Additionally, people should change their toothbrush roughly every 2–3 months, or as soon as it becomes worn, and brush their teeth last thing at night and at least one other time during the day.
  • Not brushing immediately after eating: A person should try to wait at least 1 hour after eating before brushing their teeth, as certain foods and drinks can soften tooth enamel.
  • Avoiding chemical products: Certain dental products may contain abrasive chemicals that can be damaging to the teeth and gums. A person should always check the ingredients of any dental products before using them and consult a dental professional before using any bleaching or whitening products.
  • Avoiding certain foods and drinks: Some foods and drinks can erode the tooth enamel. A person may wish to limit or avoid fizzy drinks, fruit juices, foods with a high sugar content, and alcohol. If an individual does consume these items, it is advisable to try and have them only at mealtimes.
  • Dental appointments: A person should visit a dental team regularly, as they will be able to assist with tooth care and oral hygiene. For example, if a person grinds their teeth, a dental professional can advise whether they may need to wear a mouthguard at night.

FROM: https://www.medicalnewstoday.com/articles/dentin-hypersensitivity#prevention