|Year : 2014 | Volume
| Issue : 2 | Page : 90-93
Dentin hypersensitivity among undergraduates in a university community
Omoigberai Bashiru Braimoh, Nzube Anthony Ilochonwu
Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba, Port Harcourt, Rivers State, Nigeria
|Date of Web Publication||12-Aug-2014|
Dr. Omoigberai Bashiru Braimoh
Department of Preventive Dentistry, Faculty of Dentistry, College of Health Sciences, University of Port Harcourt, Choba, Port Harcourt, Rivers State
Source of Support: None, Conflict of Interest: None
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
| Introduction|| |
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. ,, 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. , Many people with DH do not specifically seek treatment for this problem, but may only mention it at a routine dental visit.  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.  In Nigeria, prevalence ranging from 1.34% to 68% has been reported. ,,,, DH is more common among right-handed individuals than the left-handed ones  and higher in females than males. ,,, The main trigger factor for DH is a cold drink. ,,, 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. 
Available data on DH, revealed that previous studies on DH were carried out in hospital settings or general dental practices. ,,,,,, 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.  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|| |
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|| |
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 2: Action taken by the respondents experiencing dentin hypersensitivity|
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|Table 4: Bivariate analysis of the impact of dentin hypersensitivity and action taken|
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| Discussion|| |
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. , 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,  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. , 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,  25% reported in Rio de Janeiro Brazil,  17.3% reported among young people in China,  and 32.6% reported among adults in Shanghai.  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. ,,, 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.  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.  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, , 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.,  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. , 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.  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.  The dependence of Nigerians on self-care for oral health problem and seeking dental care only when situations are unbearable may also be contributory.  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. ,,,,,, 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. ,
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.  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|| |
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.
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[Table 1], [Table 2], [Table 3], [Table 4]