Treatment of Dentin Hypersensitivity Richard D. Trushkowsky, DDS a, *, Anabella Oquendo, DDS b Dentin hypersensitivity is exemplified by brief, sharp, well-localized pain in response to thermal, evaporative, tactile, osmotic, or chemical stimuli that cannot be ascribed to any other form of dental defect or pathology. Pulpal pain is usually more prolonged, dull, aching, and poorly localized and usually lasts longer than the applied stimulus. 1 Up to 30% of adults have dentin hypersensitivity at some period of their lives. 2 Current techniques for treatment may be only transient in nature and results are not always predictable. 3 Two chief methods of treatment of dentin hypersensitivity are tubular occlusion and blockage of nerve activity. 4 A differential diagnosis needs to be accom- plished before any treatment because many symptoms are common to a variety of causes. 5 Items to be considered: the pain—sharp, dull, or throbbing; how many teeth and their location; which part of the tooth elicits the pain; and the intensity of the pain. Clinical and radiographic examination is necessary to elucidate the cause. The following questions need to be asked: Can the pain be localized to one tooth or area of the tooth? Is the area sensitive to a moderate flow of air from an air water syringe? Is the tooth sensitive to percussion? Is there sensitivity to biting pressure or on release? What is the extent of the pain after the stimuli is removed? Do radiographs demonstrate caries or periapical pathology? Is the dentin exposed as a result of recession and are there any cracked cusps, open margins, or occlusal hyperfunction? 5 MECHANISM There are regional differences in dentin sensitivity. 6 Freshly exposed dentin in the coronal part of the tooth is more sensitive than cervical dentin. This may be due to the higher conduction velocity or structural differences in dentinal innervations and The authors have nothing to disclose. a Advanced Program for International Dentists in Aesthetic Dentistry, Department of Cariology and Comprehensive Care, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010, USA b Advanced Program for International Dentists in Interdisciplinary Dentistry, Department of Cariology and Comprehensive Care, New York University College of Dentistry, 345 East 24th Street, 421 First Avenue, New York, NY 10010, USA * Corresponding author. 483 Jefferson Boulevard, Staten Island, NY 10312-2332. E-mail address: ComposiDoc@aol.com KEYWORDS  Dentin hypersensitivity  Pulpal pain  Tubular occlusion  Nerve activity Dent Clin N Am 55 (2011) 599–608 doi:10.1016/j.cden.2011.02.013 dental.theclinics.com 0011-8532/11/$ – see front matter Ó 2011 Elsevier Inc. All rights reserved.