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Dentine Hypersensitivity

Dentine hypersensitivity is a short, sharp pain in the teeth that happens in response to a typically non-noxious stimulus. Often referred to as tooth sensitivity or sensitive teeth, it occurs suddenly when the dentine of the tooth is exposed to external stimuli, such as hot, cold or acidic foods, stimulating nerve fibres in the inner tooth.

Aetiology, Causes & Symptoms
Dentine hypersensitivity is caused by exposure of the dentine layer of the tooth. Normally, the soft dentine is protected by either the gums around the roots or the hard dental enamel at the crown. Dentine has tubules, or narrow channels, that lead to the pulp of the tooth, where the nerve fibres are located. When external stimuli can reach these tubuli, they can stimulate the nerve fibres and are registered as pain.

The major cause for exposed dentine is recession of gum tissue. When the gums receed, they expose the dental neck where the dentine is only protected by a thin layer of cementum which is easily removed.

Enamel loss can also lead to dentine hypersensitivity when the complete enamel layer protecting the underlying dentine is removed through erosion, abrasion or attrition.

Dentine hypersensitivity pain can be triggered by a number of external stimuli. Common triggers include:

Hot, cold, sugary or acidic foods and drinks.

Cold air.

Tactile, e.g. toothbrushing or scratching over the exposed dentine surface.

Dentine hypersensitivity is common but underreported, so it is difficult to accurately measure incidence. However, studies estimate that prevalence can be up to 60%. Whilst the risk for exposed dentine increases with age, dentine hypersensitivity peaks usually around the age 30 to 40 as the tubulies can naturally clog up.
Impact on Patient Quality of Life

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Dentine hypersensitivity can be very painful for the patient. Despite this, it is common for patients not to report sensitive teeth to their dental professional.

In the early stages, when pain is sporadic and short-lived, many simply accept the problem and avoid the triggers that cause them pain.

However, dentine hypersensitivity can progress to the point where the pain is frequent, lasting and intense. It can make it difficult to perform everyday actions like eating, speaking and brushing the teeth, causing even more severe oral health problems.

People suffering from significant dentine hypersensitivity also report that it impacts their quality of life by taking the enjoyment out of eating and drinking, and making them feel anxious or self-conscious about doing so in social or public settings.
Prevention, Management & Treatment

Dentine hypersensitivity can be treated with specially formulated toothpastes and dental rinses. These typically work by occluding the dentine tubules to prevent stimuli transmission or desensitising the tooth nerve.

The Pro-Argin Technology in Colgate's toothpastes works by physical occlusion of dentine tubuli. It offers instant relief from dentine hypersensitivity by massaging the active formula onto the affected area on the tooth with the fingertip. Daily use of the toothpaste further strengthens the pain protection delivering long lasting relief to sensitivity sufferers.

In any case, the underlying cause for the exposed dentine (gum recession or enamel wear) should be adressed so that not more dentine surfaces get exposed.