DENTIN HYPERSENSITIVITY: ETIOLOGY, DIAGNOSIS, and MANAGEMENT

Dentin hypersensitivity may present as anything from a mild discomfort, ache, or “electrical” sensation, to being overtly painful. It is typically transient and can be initiated by the same types of things as toothache type pain such as temperature variation or irritating foods. Any exposure of the dentin such as wear, abrasion, bone loss, periodontal problems, and tooth brush abrasions (to name a few), can cause this.

I read with interest an article from 2019 in a general dental journal claiming that it was a thorough discussion on dental hypersensitivity (Compendium of Continuing Education in Dentistry Vol 40 Number 10 Pgs. 653-657). I have written on this subject in the past from several different points of view. This article in my opinion represents “fake news in dentistry.” The authors seem to be trying to put forward a scientific article with recommendations and conclusions that seem well supported and logical, but they fall way short in my opinion and frankly do not even address the main point – thus “fake news.”

The story-behind-the-story is that as a science, dentistry is influenced by politics and culture. And where this intersects here is where the politics of fluoride use and fluorination of community water supplies. There is a strong movement here in the United States and frankly around the world to demonize fluoride use. I understand how an ill-informed person might be able to take basic information out there and think that ions such as potassium or fluoride (for example) may be dangerous things. They certainly can be and they are poisonous in larger quantities. The plain truth is that fluoride in appropriate amounts is one of the most thoroughly studied initiatives in the world. The use of fluorination in water and topical fluoride dental treatments to reduce dental disease is well established. Some in the “fringe medicine” or “anti-medicine” press put forward untrue or frankly harmful information trying to guide people and communities away from using fluoride.

As it relates to this article, fluoride application in my experience is the one easiest and best, most effective, and most cost effective ways to decrease dental sensitivity, especially sensitivity due to dentin exposure and gum disease.

I recommend the use of topical gels such as Gel-Kam®. I do not have any relationship with Colgate, but I just happen to use their product. Use it once or twice a month at nighttime after brushing your teeth.  Apply like toothpaste with a toothbrush. Do not rinse and go to bed. If you are just starting treatment, you repeat it for four days straight. Using it too often or too much is not helpful. I expect your sensitivity will go away.