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. 2022 Jul-Aug;26(4):307-333.
doi: 10.4103/jisp.jisp_233_22. Epub 2022 Jul 2.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity

Vishakha Grover  1 , Ashish Kumar  2 , Ashish Jain  3 , Anirban Chatterjee  4 , Harpreet Singh Grover  5 , Nymphea Pandit  6 , Anurag Satpathy  7 , Baiju Radhamoni Madhavan Pillai  8 , Anil Melath  9 , Deepa Dhruvakumar  10 , Roshani Thakur  11 , Nilesh V Joshi  12 , Neeraj Deshpande  13 , Himanshu Dadlani  14 , A Archana Meenakshi  15 , K P Ashok  16 , K Vinathi Reddy  17 , Meenu Taneja Bhasin  18 , Sanjeev Kumar Salaria  14 , Abhishek Verma  17 , Rajesh Prabhakar Gaikwad  19 , Hemant Darekar  20 , Ramesh Amirisetty  21 , Mangesh Phadnaik  22 , Vaibhav Karemore  22 , Ravindranath Dhulipalla  23 , Dhawal Mody  24 , Tushar Shri Rao  25 , Swarna Chakarpani  26 , V Ranganath  27
Affiliations

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity

Vishakha Grover et al. J Indian Soc Periodontol. 2022 Jul-Aug.

Abstract

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Keywords: Classification; DAs; dentin hypersensitivity; diagnosis; differential diagnosis; management.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Diagnostic work flow for dentin hypersensitivity during dental examination
Figure 2
Figure 2
Classification of desensitizing agents
Figure 3
Figure 3
Classification of occlusive agents used in management of dentin hypersensitivity
Figure 4
Figure 4
Techniques employed for restorative approaches used for management of dentin hypersensitivity
Figure 5
Figure 5
Triple C’ approach to management of dentin hypersensitivity. DH – Dentinal hypersensitivity
See this image and copyright information in PMC

References

    1. Addy M, Mostafa P, Absi EG, Adams D. Cervical dentin hypersensitivity. Etiology and management with particular reference to dentifrices. In: Rowe NH, editor. Proceedings of Symposium on Hypersensitive Dentin Origin and Management. Michigan: University of Michigan; 1985. pp. 147–67.
    1. Holland GR, Narhi MN, Addy M, Gangarosa L, Orchardson R. Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. J Clin Periodontol. 1997;24:808–13. - PubMed
    1. Canadian Advisory Board on Dentin Hypersensitivity. Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc. 2003;69:221–6. - PubMed
    1. Addy M. Introduction and overview: Statement of the problem. In: Gillam DG, editor. Dentine Hypersensitivity: Advances in Diagnosis, Management, and Treatment. Switzerland: Springer International Publishing; 2015. p. 1.
    1. Ishikawa S. A clinico-histological study on the hypersensitivity of dentine. J Jpn Stomatol Soc. 1969;36:68–88. - PubMed