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 Table of Contents  
ORIGINAL ARTICLE
Year : 2014  |  Volume : 1  |  Issue : 2  |  Page : 90-93

Dentin hypersensitivity among undergraduates in a university community


Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba, Port Harcourt, Rivers State, Nigeria

Date of Web Publication12-Aug-2014

Correspondence Address:
Dr. Omoigberai Bashiru Braimoh
Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba, Port Harcourt, Rivers State
Nigeria
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1658-6816.138473

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  Abstract 

Background and Aim: There is limited data on dentin hypersensitivity (DH) among young adults in Africa. The objective of this study was to determine the prevalence and trigger factors associated with DH among young adults in a university community in Nigeria.
Materials and Methods: The study population consisted of 360 young adults, 188 males and 172 females, aged 18-33 years. All individuals answered questions regarding demography, self-reported dentin sensitivity, trigger factors, action taken, and impact of DH on quality of life. Statistical analysis used descriptive statistics and the Chi-square test.
Results: The prevalence of DH was 228 (63.3%) among the surveyed population and was significantly higher in females as compared to males (P = 0.03). All the participants who reported DH were right-handed. Among the participants with DH, majority 139 (61.0%) have not taken any action. The major precipitant for the DH was a cold drink 78 (34.2%). Of the 228 who experienced DH, 92 (40.3%) indicated eating as the precipitant, 76 (33.3%) indicated tooth brushing and 22 (9.6%) indicated talking as the precipitant. Approximately, 30% of the participants expressed unhappiness due to tooth sensitivity. Individuals with functional and psychological disturbance were significantly more likely to visit a dentist.
Conclusion: The prevalence of DH found in this study was higher than previously reported, suggesting an increase in the levels of sensitivity within the general population. All the participants were right-handed and left side of the mouth was the most commonly affected.

Keywords: Dentin hypersensitivity, prevalence, quality of life, trigger factor


How to cite this article:
Braimoh OB, Ilochonwu NA. Dentin hypersensitivity among undergraduates in a university community. Saudi J Oral Sci 2014;1:90-3

How to cite this URL:
Braimoh OB, Ilochonwu NA. Dentin hypersensitivity among undergraduates in a university community. Saudi J Oral Sci [serial online] 2014 [cited 2019 Jul 24];1:90-3. Available from: http://www.saudijos.org/text.asp?2014/1/2/90/138473


  Introduction Top


Dentin hypersensitivity (DH) is a relatively common problem, characterized by short, sharp pain arising from exposed dentin response to stimuli typically thermal, evaporative, tactile, osmotic or chemical which cannot be ascribed to any other form of dental defect or disease. [1],[2],[3] This condition may impact on the quality of life of the individual during eating, drinking, brushing and sometimes even breathing, thus limiting dietary choices, effective oral hygiene and esthetics can also be negatively affected. [4],[5] Many people with DH do not specifically seek treatment for this problem, but may only mention it at a routine dental visit. [6] This is probably because they do not view it as a significant dental health problem.

The prevalence of DH is variable depending on the methods used to diagnose the condition for example whether it was self-reported only or confirmed with the specific oral test, variation in the consumption of erosive drinks, variation in the type of sample population and the type of setting where the study was carried out. [3] In Nigeria, prevalence ranging from 1.34% to 68% has been reported. [7],[8],[9],[10],[11] DH is more common among right-handed individuals than the left-handed ones [10] and higher in females than males. [7],[12],[13],[14] The main trigger factor for DH is a cold drink. [8],[12],[15],[16] Cold drinks as explained by hydrodynamic theory, results in a change in osmotic pressure, which is transmitted as a stimulus to the odontoblastic process, generating action potential on the afferent nerve ending located at the pulp-dentin border. [17]

Available data on DH, revealed that previous studies on DH were carried out in hospital settings or general dental practices. [3],[7],[8],[16],[18],[19],[20] These selected dental populations could experience more dental or periodontal diseases than in the general population. Since many people with tooth sensitivity do not necessarily seek professional advice or dental treatment, this therefore, makes it more difficult to obtain an accurate prevalence of DH for the general population than for those seen in hospitals or clinics. There is reported an increase in the incidence and prevalence of DH among young adults due to aggressive brushing. [15] In addition, there is limited data on DH in the entire South region of Nigeria. The objective of the study was to determine the prevalence and trigger factors associated with DH in the general population of young adults in a university community in Port Harcourt, Rivers State, Nigeria.


  Materials and Methods Top


The cross-sectional survey was conducted among undergraduate students of University of Port Harcourt, Rivers State, Nigeria, in January, 2014. The students were recruited at the ceremonial pavilion at the Abuja campus of the University of Port Harcourt. Students from various departments of the university often congregate at the pavilion to receive lectures. Those who had dental caries, fractured teeth, fractured restorations and gingival inflammation were excluded from the survey. The objective of this study was explained to the participants, and informed consent was obtained before the interview. The method of data collection was interviewer-administered questionnaire that elicited information on demography, self-reported dentin sensitivity, the trigger factors, action taken and impact of DH on quality of life. Data were entered into SPSS (IBM SPSS statistics, Armonk, New York, United States) version 20.0 for analysis and entered data were subjected to descriptive statistics in the form of frequency, percentages, cross tabulation. Test of significance was done with Chi-square statistics. P < 0.05 was considered to be significant.


  Results Top


Prevalence of DH among the participants is presented in [Table 1]. A total of 360 participants, made up of 188 (52.2%) males and 172 (47.8%) females participated in the study. The prevalence of DH was 228 (63.3%) among the surveyed population and was significantly higher in females than males (P < 0.03). All the participants who reported DH were right-handed. The sensitivity was significantly more experienced by the participant on the left side 132 (58.0%), than the right side 41 (18.0%) and both sides 55 (24.0%). Among the participants with DH, majority 139 (61.0%) have not sought treatment and few 89 (31.0%) have visited the dentist or used various forms of toothpaste to treat the sensitivity [Table 2]. The major precipitant for the DH was a cold drink 78 (34.2%). Others were tooth brushing, 62 (27.2%); sweet food, 41 (18.0%); cold food, 27 (11.8%) and air entering the mouth, 20 (8.8%) as shown in [Table 3]. A cross tabulation between impact of DH and action taken by participants is presented in [Table 4]. DH impacts the quality of life of the participants. Of the 228 who experienced DH, 92 (40.3%), 76 (33.3%), and 22 (9.6%) of the participants indicated that eating, tooth brushing and talking were disturbed the precipitants respectively. Approximately, 30% of the participants expressed unhappiness due to tooth sensitivity. Participants who expressed unhappiness and disturbance of eating, brushing, and talking were significantly more likely to take action than those who experienced DH without any of these reported situations.
Table 1: Prevalence of dentin hypersensitivity among the respondents

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Table 2: Action taken by the respondents experiencing dentin hypersensitivity

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Table 3: Distribution of pain initiating stimulus among the respondents

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Table 4: Bivariate analysis of the impact of dentin hypersensitivity and action taken

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  Discussion Top


Dentin hypersensitivity impacts the quality of life of the individual during eating, drinking, brushing, and sometimes even breathing, thus limiting dietary choices and effective oral hygiene. [4],[5] Globally, prevalence rates between 1.34% and 74% have been reported. [6-16] The results of the questionnaire in this study showed that the prevalence of DH was 63.3%. This was comparable to 68.4% obtained in the previous survey among similar population in South Western Nigeria, [9] 62.0% obtained in a telephone community survey conducted among Chinese adults and 68.0% reported in a periodontics clinic population both in Hong Kong. [16],[21] However, it was higher than 52.8% reported in the previous survey among similar population in Benin City Nigeria, 16.3% reported among patients attending restorative dental clinic in a Nigeria tertiary health institution, [7] 25% reported in Rio de Janeiro Brazil, [13] 17.3% reported among young people in China, [12] and 32.6% reported among adults in Shanghai. [14] The wide variation in prevalence of DH could be attributed to the number of factors. Difference in methodology of the compared studies, for instance, whether DH was determined by the use of questionnaires, clinical examinations or both is an important factor. The use of the questionnaire as in this study was likely to overestimate the prevalence of DH as the sensitivity recorded could be attributed to other oral conditions. The varied differences could also be due to influence of culture and ethnicity on lifestyle, disease perception and view.

In this study, the prevalence of DH was significantly higher in females than males. This is similar to the findings of previous studies. [7],[12],[13],[14] However, a study conducted in Nigeria among patients in a tertiary health institution, reported a contrasting result. This study reported a higher prevalence of DH among males than females. [8] The reasons for this difference are not yet clear. It has been attributed to the fact that women have better overall healthcare and oral hygiene awareness, which would make them more sensitive to DH. [22] Furthermore, DH was significantly more experienced by the participant on the left side of the mouth than the right side. This was comparable to results obtained from other Nigerian studies, [10],[11] which reported the predominance of DH etiologies on left-side of the mouth among right-handed patients. This is probably due to the fact that the right-hand is the dominant hand in right-handed individuals, resulting in the application of greater force during brushing on the left-side leading to abrasion and recession with consequent DH. However, this contrasted with the study of Tan et al., [12] who reported the right side as the most commonly affected. In this study, all the participants were right-handed; this was similar to the study of Bamise et al. [9],[10] who reported that all the participants with DH were right-handed.

In this study, only 89 (39%) of the participants with DH, had taken action by visiting the dentist and using desensitizing toothpaste. This is in agreement with the finding of a study Brazil, where only a few patients who claimed to have DH had tried treatment with desensitizing toothpastes or sought professional help. [13] Not seeking dental care is due to the fact that DH is not spontaneous but rather provoked, causing affected individuals to develop adaptive behavior of restricting self-from precipitants and avoid using affected side of the mouth. [23] The dependence of Nigerians on self-care for oral health problem and seeking dental care only when situations are unbearable may also be contributory. [11] Among the participants the major stimulus for DH was cold drinks, followed by tooth brushing, sweet food, cold food, and air entering the mouth. This is in agreement with the findings of other studies. [3],[8],[11],[12],[15],[16],[18] These factors result either in a change in osmotic pressure, which is transmitted as a stimulus to the odontoblastic process, generating action potential on the afferent nerve ending located at the pulp-dentin border or can remove the dentinal smear layer and increase the patency of the dentinal tubules, thereby exacerbating DH. [17],[22]

Oral conditions impact negatively on oral functions including eating, swallowing and talking. Oral health-related quality of life is more impaired in individual with DH than the general population. [24] Individuals with DH develop adaptive behavior of avoiding precipitants such as certain foods and beverages that trigger painful response, thereby limiting dietary choices. In this study, 92 (40.3%), 76 (33.3%) and 22 (9.6%) of the participants indicated that eating, tooth brushing and talking, respectively were disturbed. In addition to disturbance of eating, talking, and effective cleaning of teeth, participants 64 (28.1%) with DH expressed unhappiness due to the transient sharp pain. Individuals with DH who recognized that DH impacted them negatively, functionally and psychologically were significantly more likely to take action (visiting dentist, use of desensitizing paste) to resolve the problem than others. Therefore, there is need to educate the general population on DH and a need to seek prompt treatment to reduce its impact.


  Conclusion Top


The prevalence of DH found in this study was higher than previously reported, suggesting an increase in the levels of sensitivity within the general population. All the participants were right-handed and the left side of the mouth was the most commonly affected. Individuals with functional and psychological disturbance were significantly more likely to visit a dentist.

 
  References Top

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.  Back to cited text no. 1
    
2.Addy M. Dentin hypersensitivity: New perspectives on an old problem. Int Dent J 2002;52:367-5.  Back to cited text no. 2
    
3.Rees JS. The prevalence of dentine hypersensitivity in general dental practice in the UK. J Clin Periodontol 2000;27:860-5.  Back to cited text no. 3
    
4.Dababneh RH, Khouri AT, Addy M. Dentine hypersensitivity - An enigma? A review of terminology, mechanisms, aetiology and management. Br Dent J 1999;187:606-11.  Back to cited text no. 4
    
5.Bánóczy J. Dentin hypersensitivity and its significance in dental practice. Fogorv Sz 2002;95:223-8.  Back to cited text no. 5
    
6.Gillam DG, Seo HS, Bulman JS, Newman HN. Perceptions of dentine hypersensitivity in a general practice population. J Oral Rehabil 1999;26:710-4.  Back to cited text no. 6
    
7.Udoye CI. Pattern and distribution of cervical dentine hypersensitivity in a Nigerian tertiary hospital. Odontostomatol Trop 2006;29:19-22.  Back to cited text no. 7
    
8.Bamise CT, Olusile AO, Oginni AO, Dosumu OO. The prevalence of dentine hypersensitivity among adult patients attending a Nigerian teaching hospital. Oral Health Prev Dent 2007;5:49-53.  Back to cited text no. 8
    
9.Bamise CT, Kolawole KA, Oloyede EO, Esan TA. Tooth sensitivity experience among residential university students. Int J Dent Hyg 2010;8:95-100.  Back to cited text no. 9
    
10.Bamise CT, Olusile AO, Oginni AO. An analysis of the etiological and predisposing factors related to dentin hypersensitivity. J Contemp Dent Pract 2008;9:52-9.  Back to cited text no. 10
    
11.Azodo CC, Amayo AC. Dentinal sensitivity among a selected group of young adults in Nigeria. Niger Med J 2011;52:189-92.  Back to cited text no. 11
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12.Tan CS, Hu DY, Fan X, Li X, Que KH. Epidemiological survey of dentine hypersensitivity of young people in Chengdu City. Hua Xi Kou Qiang Yi Xue Za Zhi 2009;27:394-6.  Back to cited text no. 12
    
13.Fischer C, Fischer RG, Wennberg A. Prevalence and distribution of cervical dentine hypersensitivity in a population in Rio de Janeiro, Brazil. J Dent 1992;20:272-6.  Back to cited text no. 13
    
14.Ye W, Wang GY, Lv J, Feng XP. The epidemiology of dentine hypersensitivity among adults in Shanghai municipality. Shanghai Kou Qiang Yi Xue 2009;18:247-50.  Back to cited text no. 14
    
15.Irwin CR, McCusker P. Prevalence of dentine hypersensitivity in a general dental population. J Ir Dent Assoc 1997;43:7-9.  Back to cited text no. 15
    
16.Rees JS, Jin LJ, Lam S, Kudanowska I, Vowles R. The prevalence of dentine hypersensitivity in a hospital clinic population in Hong Kong. J Dent 2003;31:453-61.  Back to cited text no. 16
    
17.Brannstrom M. The hydrodynamic theory of dentinal pain: Sensation in preparations, caries, and the dentinal crack syndrome. J Endod 1986;12:453-7.  Back to cited text no. 17
    
18.Rees JS, Addy M. A cross-sectional study of dentine hypersensitivity. J Clin Periodontol 2002;29:997-1003.  Back to cited text no. 18
    
19.Rees JS, Addy M. A cross-sectional study of buccal cervical sensitivity in UK general dental practice and a summary review of prevalence studies. Int J Dent Hyg 2004;2:64-9.  Back to cited text no. 19
    
20.Taani SD, Awartani F. Clinical evaluation of cervical dentin sensitivity (CDS) in patients attending general dental clinics (GDC) and periodontal specialty clinics (PSC). J Clin Periodontol 2002;29:118-22.  Back to cited text no. 20
    
21.Chu CH, Pang KK, Lo EC. Dietary behavior and knowledge of dental erosion among Chinese adults. BMC Oral Health 2010;10:13.  Back to cited text no. 21
    
22.Chrysanthakopoulos NA. Prevalence of dentin hypersensitivity in a general dental practice in Greece. J Clin Exp Dent 2011;3:e445-51.  Back to cited text no. 22
    
23.Kielbassa A. Dentin hypersensitivity: Simple steps for everyday diagnosis and management. Int Dent J 2002;52:386-96.  Back to cited text no. 23
    
24.Bekes K, John MT, Schaller HG, Hirsch C. Oral health-related quality of life in patients seeking care for dentin hypersensitivity. J Oral Rehabil 2009;36: 45-51.  Back to cited text no. 24
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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