Neurophysiological basis, aetiology and clinical aspects of hypersensitive teeth

Dentine hypersensitivity is a common cause of dental pain. The sensitivity has been shown in clinical studies to vary greatly. The response to the treatment of hypersensitive teeth varies. It has been observed that while the treatment might be effective in some teeth, it is not so in other teeth. In some hypersensitive teeth spontaneous reduction in the hypersensitivity has been observed, while in other teeth, the sensitivity has persisted even for years. It seems probable that the hydrodynamic mechanism is the one operating in dentine sensitivity and the condition of dentine, with either blocked or open dentinal tubules, is a decisive factor in the degree of dentine sensitivity. In hypersensitive dentine the dentinal tubules are open and the pulp is inflammed. In cases where treatment is effective, probably the dentinal tubules are successfully blocked and the inflammation is resolved. If the process is not successful the teeth will be resistant to treatment. The correct therapeutic approach should aim at blocking the dentinal apertures and resolving pulpal inflammation. In addition, clinicians should be aware of clinical procedures which might result into dentine hypersensitivity.