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• Location: general vs. local<br />
• Severity: slight, moderate, severe<br />
• Location: papillary, marginal, diffuse<br />
• Color: Coral Pink, red, bluish red<br />
• Contour: knife-edge, enlarged, bulbous, cratered<br />
• Consistency: firm and resilient, edematous, fibrotic<br />
• WNL is not acceptable<br />
Dentin hypersensitivity<br />
Defined<br />
• Short transient pain due to exposed dentin<br />
• usually occurs in response to stimuli (thermal, tactile, osmotic, chem)<br />
• Can occur after dental procedure, more likely to be self-limiting<br />
• cannot be attributed to some other pathology<br />
• What is required?<br />
• Dentin exposure<br />
• tubule open from pulp to oral cavity<br />
Hydrodynamic theory<br />
• Brannstrom and Astron proposition<br />
• opening of tubules => movement of dentinal fluids<br />
• movement indirecty stimulates the extremities of plural nerves, causing pain<br />
• exact mechanism of stimulation not understood<br />
Pain dependent on<br />
• Age (peak at 30, majority 20-40)<br />
• Gender (females>males)<br />
• Situation<br />
• Past dental experience<br />
• Patient expectations<br />
Some Causes<br />
• Gingival recession and tooth wear (erosion)<br />
• Most common sites: buccal-cervical sites of premolars and canines<br />
• DH most commonly caused by recession<br />
• Removal of smear layer also initiates<br />
• <strong>Perio</strong>dontal therapy are 2-3 times more likely<br />
• 73-98% perio patients<br />
• self-limiting - tubules will occlude<br />
• bleaching<br />
Management<br />
• plaque control is paramount<br />
• soft brush, less aggressive brushing
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