Symptomatology and clinical features of hypersensitive teeth

Tooth hypersensitivity is associated with exposure of the dentine to the external environment of the mouth. This exposure can result from loss of enamel by processes including abrasion and erosion, or by denudation of the root surface as a result of gingival recession or periodontal treatments. Dentine hypersensitivity can be described as an adverse reaction or pain in one or more teeth resulting from either a thermal, chemical, bacterial or mechanical stimulus. Painful symptoms arising from exposed dentine are a common finding in adults and reportedly affect as many as one in every seven patients attending for dental treatment. Although predisposition to dentinal hypersensitivity is multifactorial, enamel loss as well as gingival recession may be more severe with advancing age. Because of the greater longevity of people who are also keeping their teeth longer, hypersensitivity is a growing concern. Clinical studies show that individuals with less than adequate plaque control experience more root hypersensitivity to air stimuli than others with better oral hygiene. Although plaque does not alter the pulpal threshold, i.e. has no effect on the pulp, it seems that microbial plaque has an effect on root sensitivity.