How valid and applicable are current diagnostic criteria and assessment methods for dentin hypersensitivity? An overview

Although dentin hypersensitivity is a common clinical condition and is generally reported by the patient after experiencing a sharp, short pain caused by one of several different external stimuli, it is often inadequately understood. The purpose of this paper is to discuss different available diagnostic approaches and assessment methods used in order to suggest a basis to diagnose, monitor, and measure these challenging painful conditions related to dentin hypersensitivity in daily practice and scientific projects properly. A PubMed literature search strategy including the following MeSH terms were used as follows: dentin sensitivity[MeSH Terms] OR dentin[All Fields] AND sensitivity[All Fields] OR dentin sensitivity[All Fields] OR dentin[All Fields] AND hypersensitivity[All Fields] OR dentin hypersensitivity[All Fields] AND diagnosis[Subheading] OR diagnosis[All Fields] OR diagnosis[MeSH Terms] AND assessment[All Fields] AND (methods[Subheading] OR methods[All Fields] OR methods[MeSH Terms]. Furthermore, alternative terms such as validity, reliability, root, cervical, diagnostic criteria, and hypersensitivities were additionally evaluated. The literature search, also including the alternative terms and journals, revealed only a small number of specific papers related to valid diagnosis, diagnostic criteria, and assessment methods of dentin hypersensitivity. Outcomes from these publications showed that the response to different stimuli varies substantially from one person to another and is, due to individual factors, often difficult to assess correctly. Furthermore, the cause of the reported pain can vary, and the patient's description of the history, symptoms, and discomfort might be different from one to another, not allowing a reliable and valid diagnosis. The dental practitioner, using a variety of diagnostic and measurement techniques each day, will often have difficulties in differentiating dentin hypersensitivity from other painful conditions and in evaluating the success of a conducted therapy in a reliable way. Correct diagnosis of dentin hypersensitivity including a patient's history screening and a brief clinical examination in combination with the identification of etiologic and predisposing factors, particularly dietary and oral hygiene habits associated with erosion and abrasion, is essential. The relevant differential diagnosis should be considered to exclude all other dental conditions with similar pain symptoms.