A cross-sectional study of dentine hypersensitivity

AIM: The aim of this study was to establish the prevalence of dentine hypersensitivity in a cross-sectional study of patients visiting general dental practitioners in the United Kingdom over a period of one calendar month. METHODS: Nineteen dental practioners examined 4841 patients over a period of one calendar month and patients that had dentine hypersensitivity diagnosed were questioned further about their occupation and smoking habits. The amount of buccal gingival recession associated with the sensitive teeth was also recorded using a study form. RESULTS: 201 patients were diagnosed as having dentine hypersensitivity, giving a prevalence figure of 4.1%. The commonest teeth affected were the upper premolar teeth and the commonest initiating factor was cold drinks. A tendency for a greater number of sensitive teeth was also found for patients with periodontal disease who also smoked. There was also a tendency for the patients with sensitive teeth to come from higher social groups.     

The prevalence of dentine hypersensitivity in Chinese adults

Dentine hypersensitivity is a common oral problem. This study investigated the prevalence of dentine hypersensitivity in the adult population of Shanghai, China. A multi-stage, stratified, random sampling method was used to investigate the study population. A total of 2120 subjects were examined at 10 investigation points in Shanghai City. Subjects were divided into age groups (10 years per age group) and included the same number of male and female subjects in each group. Participants completed a dentine hypersensitivity questionnaire and underwent clinical examination. The diagnosis of dentine hypersensitivity was confirmed clinically as a sharp well-localised pain in response to administration of a blast of cold air from a triple syringe. Gingival recession of sensitive teeth was measured by a Williams periodontal probe. Among 2120 participants, 723 were diagnosed as having dentine hypersensitivity, indicating a prevalence of 34·1%. The male to female ratio of dentine hypersensitivity was 1:1·5. The prevalence of dentine hypersensitivity was highest in the 40- to 49-year age group at 43·9%. The number of teeth with dentine hypersensitivity was 3·2 per patient. Dentine hypersensitivity occurred predominantly in the premolars (49·6%), followed by the anterior teeth (30·5%). A total of 84·3% of dentine hypersensitive patients had gingival recession. The prevalence of dentine hypersensitivity in Shanghai adults was 34·1%, indicating that it is a common condition. Therefore, public education about the condition and effective treatment of dentine hypersensitivity are required.     

The prevalence of dentine hypersensitivity in general dental practice in the UK

AIM: The aim of this study was to establish the prevalence of dentine hypersensitivity in a cross-sectional study of patients visiting general dental practitioners in the South West region of the UK over a period of 1 calendar month. METHOD: Twelve dental practitioners examined 3593 patients over a period of 1 calendar month and 137 patients were diagnosed as having dentine hypersensitivity, giving a prevalence figure of 3.8%. RESULTS: The commonest teeth affected were the upper premolar and molar teeth and the commonest initiating factor was cold drinks. CONCLUSIONS: The prevalence of dentine hypersensitivity in general dental practice in the UK was 3.8%.     

A cross-sectional study of buccal cervical sensitivity in UK general dental practice and a summary review of prevalence studies

Abstract: 
Aim:  The initial aim of this study was to establish the prevalence of dentine hypersensitivity (DH) in a cross-sectional study of patients visiting general dental practitioners in the UK over a period of one calendar month.
Methods:  Eighteen dental practitioners examined 5477 patients over a period of one calendar month, and patients who were diagnosed with DH were questioned further about their occupation and smoking habits. The amount of buccal gingival recession associated with the sensitive teeth was also recorded, as was the presence of periodontal disease.
Results:  One hundred and fifty-two patients were diagnosed as having DH, giving a prevalence figure of 2.8%. The commonest teeth affected were the first molars and premolars, and the commonest initiating factor was cold drinks. A tendency for a greater number of DH teeth was also found for patients with periodontal disease who also smoked. There was also a tendency for the patients with DH teeth to come from higher social groups.
Conclusion:  At the time of conducting this study, the European Federation of Periodontology had not recommended that sensitive teeth associated with periodontal disease and treatment be termed root sensitivity (RS). The title of this paper was therefore chosen to reflect this decision, and the data represent teeth both within and between subjects with DH and RS.     

Dentine hypersensitivity in a private practice patient population in Australia

Summary Although dentine hypersensitivity (DH) has been widely investigated, studies based on randomly selected general practice populations are scarce. This study aimed to examine the intra‐oral distribution of DH and its association with age, sex, symptoms, stimuli, pre‐disposing factors and management strategies in a private practice patient population in Australia. A randomly selected sample of 800 Australian private dental practice dentists was invited to participate in a questionnaire‐based survey. A log diary about the total number of patients seen during a typical week in practice and the details of patients with DH were recorded. The details included teeth and sites involved with DH and the age and sex of people affected, symptoms, stimuli, pre‐disposing factors and management strategies. The prevalence of DH was 9·1% among patients seen over the typical week with 2·3 teeth/person and 1·2 surfaces/tooth affected. Women (60·7%) were more affected than men (39·3%) whilst 30‐ to 49 ‐year‐olds (48·8%) were the most common among those affected. Premolars (36·5%) and buccal surfaces (54·8%), respectively, were the most commonly affected teeth and tooth sites. Although cold stimulation (80·1%) was the commonest stimulus, dietary acid was the only stimulus that was significantly associated with DH. Gingival recession and erosion emerged as significant pre‐disposing factors, whereas using desensitising toothpastes was the most important management strategy. The findings suggested that dietary acid, gingival recession and erosion were significantly associated with DH, while desensitising toothpastes was the key management strategy used for DH in this patient population.     

Dentine hypersensitivity in Jordanian dental attenders. A case control study

BACKGROUND: Dentine hypersensitivity (DH) is a common painful condition which affects a significant proportion of the adult population. AIMS: To investigate the relationship between DH and factors such as gingival recession, oral hygiene practices and smoking in Jordanian adults. METHODS: A case control study was performed on dental attenders in the Irbid region of Jordan. A DH group was composed of 126 subjects with a history of sensitivity who also reported discomfort of least two non-carious teeth after an air blast. Each case quantified their personal perception of the severity of pain associated with sensitivity by making a mark on a visual analogue scale The presence and extent of gingival recession was measured on plaster models. An age- and sex-matched control group of 134 subjects who complained of no discomfort was recruited. RESULTS: Independent predictors of DH in multivariate analysis were whether an individual had noticed their teeth getting longer (P = 0.01), infrequent (less than once per day) toothbrushing (P = 0.001), smoking (P = 0.0006) and the presence of recession >or= 3 mm (P = 0.0005). Within the multivariate analysis, the odds ratio for recession of >or= 3 mm to be associated with sensitivity was 2.80 (confidence interval 1.57-4.99). The number of teeth which responded to an airblast was significantly higher in males (P = 0.0004), smokers (P < 0.0001) and those with recession of >or= 3 mm (P < 0.0001). CONCLUSIONS: It is concluded that DH is associated with gingival recession in Jordanian dental attenders. However, the relationship is complex. Infrequent toothbrushing and smoking, which was almost exclusively a male habit, were also factors associated with DH.     

Prevalence of dentine hypersensitivity in Chinese rural adults with dental fluorosis

The aim of this study was to estimate the prevalence of dentine hypersensitivity (DH) among residents of rural China with dental fluorosis aged 30–69 years. A village located in northern China in which dental fluorosis was common was selected. Some 1250 residents with fluorosis ranging in age from 30 to 69 years completed a structured questionnaire and underwent clinical examination. Diagnosis of DH was based on the combination of the subject's self‐evaluation and clinical examination. Dental fluorosis was evaluated using Dean's index (DI). In the village, the fluoride concentration in drinking water was 1·15–1·50 mg L^?1. The community fluorosis index was 1·47, and 74 (9·7%) of the participants with dental fluorosis were diagnosed with DH. There was no significant difference between men and women. DH was most commonly observed in the lower incisors, and the most common cause of DH was cold stimulation. Logistic regression analysis showed acid reflux to be the only risk factor for DH in the current study. Among subjects with DH, none took treatment measures, visited a hospital or clinic, or used antisensitivity toothpaste. The prevalence of DH in the selected subjects with dental fluorosis was 9·7%. Acid reflux was found to be a risk factor for DH in the current study.     

Ultrastructure of hypersensitive and non-sensitive dentine

Abstract Patients with cervical dentine exposures do not always complain of dentine hypersensitivity. The identification of morphological features connected to symptoms is important for both prevention and management of dentine hyper-sensitivity. The aim of the study was to determine the relationship between the dentine ultrastructure and clinical symptoms in patients with cervical dentine exposures. Replica models for a total of 28 teeth (from 10 patients) with cervical non caroius lesions and dentine exposures were obtained before and after acid etching. The replica models were studied blindly in the scanning electron microscope (SEM). 12 of these were classified clinically as hypersensitive and 16 as non-sensitive. Because of the morphological heterogeneity of all specimens, a grid was used to isolate smaller, more homogeneous areas. 120 (75 non-sensitive and 45 hypersensitive areas) grid areas randomly selected from the 28 dentine surfaces were analyzed. The presence and morphology (amorphous or crystalline) of smear layers and the density and diameter of dentine tubules were recorded. The %2 test was used for statistical analysis. In unetehed specimens, the surfaces classified as non-sensitive were frequently coated by an amorphous smear layer (88.0 %) and occasionally by a crystalline smear layer (2.7%). Only a few and narrow tubules were observed (9.3%). On the other hand, the unetehed specimens of the hypersensitive dentine exhibited less frequently (3l.3%) an amorphous smear layer. The presence of crystalline smear layer (33.3%), many and wider patent tubules and, sometimes, loss of intertubular dentine manifested as grooves between tubules, were observed (35.6%). The differences were significant (p<.00l). In hypersensitive dentine, the acid etching always removed the smear layer whereas removal in non-sensitive dentine was partial or absent. These morphological findings underline the role of smear layer in reducing permeability of dentine in patients with dentine sensitivity.     

The prevalence of periodontal disease measures in elderly adults, aged 79 and older

From 1996-98, we examined 449 adults (mean age 85 years) from the 1982 Iowa 65⁺ Rural Health Study, in the field using headlight, mirror, and periodontal probe. Ninety-six of the 342 dentate subjects were excluded from the follow-up examination due to contraindications to probing, and 10 could not be assessed due to refusals, fatigue or other reasons. For all remaining subjects (n=236), attachment loss, defined as recession plus probing depth, was determined at four sites per tooth. Ninety-one percent of the subjects had at least one site with 4⁺ mm of attachment loss, 45% had one or more sites with attachment loss of 6⁺ mm, and 15% had 8⁺ mm of attachment loss. Moderate periodontal disease is prevalent among very old dentate adults while advanced periodontal disease is much less prevalent, suggesting that most periodontal treatment needed by this age group can be provided by general dentists and dental hygienists rather than periodontists.     

不同检测方法在牙颈部牙本质敏感的临床比较研究

目的：本研究拟对老年人群唇颊侧牙颈部牙本质敏感的不同检测方法间的差异性及临床特征等进行了系统研究。方法：研究通过冷空气和敏感压力探针筛选出牙本质敏感症状明显的患者,比较两种检测方法的差异性、相关性,并结合敏感患病部位临床特征进一步细化分类研究。结果：冷空气和敏感压力探针方法间有统计学差异（P〈0.01）,检测方法间的检出率差异与病损特征存在相关性,病损区域形态分类表明,67.98%的牙颈部敏感单纯由牙龈退缩发生后根面暴露引起,29.47%的则是由牙颈部楔状缺损引起,牙本质敏感的冷空气检测和压力敏感探针检测分级评价结果没有明显相关性（P〉0.05）。结论：两种牙本质敏感检测方法具有一定的互补性,检出率差异与病损形态有关系。     

氟离子导入治疗牙本质敏感症的临床研究

目的探讨氟离子导入法治疗牙本质敏感症的临床疗效。方法51例牙本质敏感症患者共61对磨牙,将每对磨牙随机分为实验组和对照组。分别采用氟离子导入法和Gluma涂擦法脱敏。记录治疗前后即刻、1周和1个月时的数字化疼痛评判法(visual analogue scale,VAS)的差值,计算两种方法的有效率并进行统计学分析。结果氟离子导入法术后即刻、1周和1个月时有效率分别为86.89%、81.97%、80.33%;Gluma涂擦法分别为90.16%、78.69%、78.69%。两组在即刻、1周和1个月时的有效率呈下降趋势,但术后同一时间两组间有效率无显著差异。结论氟离子导入法治疗牙齿敏感症与Gluma涂擦法在疗效上无显著差异,可用于临床的脱敏治疗。     

牙本质敏感症的体外研究方法

临床上治疗牙本质敏感症的方法有很多,对其作用机制及疗效的体外研究方法包括牙本质表面观察、牙本质表层和深层的矿物质检测及牙本质通透性研究等.本文对这些研究方法作一综述.     

Guidelines for the design and conduct of clinical trials on dentine hypersensitivity*

Abstract Clinical trials on dentine hypersensitivity have been numerous and protocols varied. To date there is little consensus as to the conduct of studies on this poorly-understood yet common and painful dental condition. A committee of interested persons from academia and industry was convened to discuss the subject of clinical trials on dentine hypersensitivity and a consensus report is presented. A double-blind randomized parallel groups design is recommended, although cross-over designs may be used for the preliminary screening of agents. Subjects may have multiple sites scored. Sample size will be determined by estimating the variability in the study population, the effect to be detected and the power of the statistical test to be used. Subject selection is based on a clinical diagnosis of dentine hypersensitivity, excluding those with conflicting characteristics such as currently-active medical or dental therapy. The vestibular surfaces of incisors, cuspids and bicuspids are preferred as sites to be tested. A range of sensitivity levels should be included. Tactile, cold and evaporative air stimuli should be applied. Negative and benchmark controls should be incorporated. Most trials should last 8 weeks. Sensitivity may be assessed either in terms of the stimulus intensity required to evoke pain or the subjective evaluation of pain produced by a stimulus using a visual analog or other appropriate scale. The subject's overall assessment may be determined by questionnaire. Outcomes should be expressed in terms of clinically significant changes in symptoms. Follow-up evaluation is required to determine the persistence of changes. At least 2 independent trials should be conducted before a product receives approval.     

Dentine hypersensitivity in subjects recruited for clinical trials: clinical evaluation, prevalence and intra-oral distribution

Relatively few studies have reported on the frequency, distribution and severity of dentine hypersensitivity (DH) in subjects recruited for clinical trials of desensitizing agents. Potential subjects (n= 48 M, 81 F, mean age 35.1 years) for inclusion into such a study were screened to determine the extent of the problem. 117 subjects (41 M, 76 F) mean age 24.9 years were clinically examined. Evaluation by questionnaire indicated that the prevalence of DH was proportionately higher in the 20-29.9 years (34.9%), and 30-39.9 years groups (33.3%), respectively. Sensitivity to cold was the main presenting symptom. Tactile (probe) and cold air (dental air syringe) stimuli were used to clinically evaluate DH. Of the teeth eligible for evaluation 1561/3136 (49.8%) responded to either one or both of the test stimuli; 274/3136 (8.7%) responded to tactile only stimulation, 779/3136 (24.8%) to thermal only stimulation and 508/3136 (16.2%) to both tactile and thermal stimulation. Of those teeth responding to the stimuli, 477 (30.6%) were premolars, 437 (28%) incisors, 415 (26.8%) molars and 232 (14.9%) canines. The results agree with those of previously reported studies in that DH is most frequently observed on premolars and that proportionately more teeth are sensitive to evaporative than to tactile stimulation. Furthermore it would appear from the results of the study that tactile is less effective than thermal/evaporative stimulation in the evaluation of DH.     

广东省中小城镇牙本质敏感的流行病学调查

目的：了解广东省中小城镇牙本质敏感的流行状况及影响因素。方法：采用多阶段、分层随机抽样方法,对广东省中小城镇800名成人进行牙本质敏感问卷调查和口腔检查,研究牙本质敏感的患病率,并对其在不同年龄段的分布,诱发因素,好发牙位,与附着丧失的关系等因素进行分析。结果：广东省中小城镇通过问卷调查牙本质敏感的发生率为38．6％,临床检查为27．2％。40～49岁为牙本质敏感的高峰期,最常见牙位为第一前磨牙,最常见的诱因是冷刺激,80．3％的牙本质敏感者存在有牙龈附着丧失。结论：广东省中小城镇牙本质敏感症广泛存在,应加大对牙本质敏感预防及治疗措施的宣传教育。     

The prevalence and distribution of gingival recession in subjects with a high standard of oral hygiene

Abstract The aim of this study was to evaluate the prevalence and the development/progression of attachment loss and gingival recession at buccal tooth surfaces in a population sample with a high standard of oral hygiene. An additional aim was to study the relationship between attachment loss and gingival recession. The subject sample examined comprised 225 regular denial care attendants at 12 community dental clinics in Sweden. Ail subjects were subjected to a baseline examination in 1977–78 and were re-examined after 5 years and 12 years. The clinical examinations involved assessment of plaque, gingivitis, probing depth, probing attachment loss and gingival recession. A full-mouth set of intra-oral radiographs was obtained at each examination and used for determination of the height of periodontal bone support. The results of the cross-sectional and longitudinal analyses performed showed that in subjects with a high standard of oral hygiene (i) buccal gingival recession was a frequent finding, (ii) the proportion of subjects with recession increased with age. (iii) the prevalence as well as the incidence of recessions within the dentition showed different patterns depending on age, (iv) sites with recession showed susceptibility for additional apical displacement of the gingival margin and (v) loss of approximal periodontal support was associated with gingival recession at the buccal surface.     

��ͬճ�Ӽ����������ʹ���֢��Ч����

目的比较3种粘接剂治疗牙本质过敏症的临床疗效。方法选择2010年5月至2011年9月到首都医科大学附属北京口腔医院口腔内科就诊的牙根颈部暴露和后牙矜面磨耗致牙本质过敏症患者80例,共256颗患牙,分别使用G-BOND（GC组,85颗）、AdpeV？SingleBond2（3M组,85颗）、iBONDSelfEtch（iBOND组,86颗）粘接剂进行脱敏治疗,对比观察3组的临床脱敏效果。结果脱敏治疗后即刻有效率：GC组为27．1％,3M组为63．5％,iBOND组为93．0％;iBOND组即刻有效率明显高于GC组和3M组,差异有统计学意义（P〈0．05）。脱敏治疗后3、6个月,GC组有效率为14．1％和12．9％,3M组为58．8％和56．5％,iBOND组为70．9％和61．6％。3组在治疗后3、6个月的有效率均低于其即刻有效率,差异有统计学意义（P〈0．05）。iBOND组和3M组在治疗后6个月的有效率差异无统计学意义（P〉0．05）。结论iBONDSelfEtch自酸蚀光固化粘接剂治疗牙本质过敏症操作简便,近期效果满意,远期效果有待观察。