Dentin Hypersensitivity
The prevalence of dentin hypersensitivity in general dental practices in the northwest United States

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Background

The prevalence of dentin hypersensitivity is uncertain, yet appropriate diagnosis and treatment of dentin hypersensitivity require accurate knowledge regarding its prevalence. The authors conducted a study to estimate the prevalence of dentin hypersensitivity in general dental practices and to investigate associated risk factors.

Methods

The authors conducted a cross-sectional survey of 787 adult patients from 37 general dental practices within Northwest Practice-based Research Collaborative in Evidence-based DENTistry (PRECEDENT). Dentin hypersensitivity was diagnosed by means of participants’ responses to a question regarding pain in their teeth and gingivae, and practitioner-investigators conducted a clinical examination to rule out alternative causes of pain. Participants recorded their pain level on a visual analog scale and the Seattle Scales in response to a one-second air blast. The authors used generalized estimating equation log-linear models to estimate the prevalence and the prevalence ratios.

Results

The prevalence of dentin hypersensitivity was 12.3 percent; patients with hypersensitivity had, on average, 3.5 hypersensitive teeth. The prevalence of dentin hypersensitivity was higher among 18- to 44-year olds than among participants 65 years or older; it also was higher in women than in men, in participants with gingival recession than in those without gingival recession and in participants who underwent at-home tooth whitening than in those who did not. Hypersensitivity was not associated with obvious occlusal trauma, noncarious cervical lesions or aggressive toothbrushing habits.

Conclusions

One in eight participants from general practices had dentin hypersensitivity, which was a chronic condition causing intermittent, low-level pain. Patients with hypersensitivity were more likely to be younger, to be female and to have a high prevalence of gingival recession and at-home tooth whitening.

Practical Implications

Given dentin hypersensitivity’s prevalence, clinicians should diagnose it only after investigating all other possible sources of pain.

Section snippets

METHODS

We conducted a cross-sectional survey to estimate the prevalence of dentin hypersensitivity in general dental practices from September 2010 through May 2011 within the Northwest Practice-based Research Collaborative in Evidence-based DENTistry (PRECEDENT), a practice-based dental research network. The Northwest PRECEDENT dental research network is composed of general and pediatric dentists and orthodontists from five states in the northwestern United States: Idaho, Montana, Oregon, Utah and

RESULTS

The study sample was composed of 787 adults from 37 general dental practices, and the ICC for dentin hypersensitivity within dental practices was 0.01 (95 percent CI, 0.00–0.03). Dentists approached 1,116 patients to ask them to participate in the study; of those, 329 did not enroll. The reasons the patients were not enrolled in the study were refusal to participate (n = 91), time constraints (n = 81), language barrier (n = 15), canceled appointment (n = 71) or other reasons (n = 71).

DISCUSSION

The prevalence of dentin hypersensitivity in the general practice population surveyed in our study was 12.3 percent and was near the low end of previously reported values ranging from 1.3 to 52 percent for general practices.2, 4, 5, 6, 7, 8, 9, 10 Several factors likely contributed to this low value. We used a nonspecific question to identify participants who had pain or sensitivity, relying on the participant’s own pain threshold as a trigger for identifying a positive result, and then used

CONCLUSIONS

Dentin hypersensitivity has a relatively low prevalence, is primarily a chronic condition producing intermittent but not severe pain and affects multiple teeth in most people. This condition occurs most often in women younger than 65 years and is associated commonly with gingival recession and the use of at-home tooth whitening. It is not associated as often with aggressive toothbrushing habits, noncarious cervical lesions, scaling and root planing or obvious occlusal trauma. At-home and

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    Disclosure. None of the authors reported any disclosures.

    This article was submitted on behalf of the Northwest PRECEDENT network, with support from grants DE016750 and DE016752 from the National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, Md.

    The authors thank the dentist-investigator members of the Northwest Practice-based Research Collaborative in Evidence-based DENTistry (PRECEDENT) and their staff members for their invaluable contributions.

    1

    Dr. Cunha-Cruz is a research assistant professor, Department of Oral Health Sciences, School of Dentistry, University of Washington, 1959 N.E. Pacific St., Seattle, Wash. 98195-7475

    2

    Dr. Wataha is a professor, Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle.

    3

    Dr. Heaton is an acting assistant professor, Department of Oral Health Sciences, School of Dentistry, University of Washington, Seattle.

    4

    Ms. Rothen is the lead regional coordinator, Northwest Practice-based Research Collaborative in Evidence-based DENTistry, and a clinic manager, Regional Clinical Dental Research Center, Institute of Translational Health Sciences, University of Washington, Seattle.

    5

    Dr. Sobieraj is a dentist member of Northwest Practice-based Research Collaborative in Evidence-based DENTistry, and maintains a private practice, San Luis, Ariz.

    6

    Dr. Scott is an acting assistant professor, Department of Pediatric Dentistry, School of Dentistry, University of Washington, Seattle.

    7

    Dr. Berg was a professor and the Lloyd and Kay Chapman Chair for Oral Health, Department of Pediatric Dentistry, School of Dentistry, University of Washington, Seattle, when this article was written. He now is a professor, Department of Pediatric Dentistry, and the dean, School of Dentistry, University of Washington, Seattle.

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