New consensus guidance on managing dentine hypersensitivity

Dental Tribune International

Wed. 3. December 2025

save

LEIPZIG, Germany: A recent expert review has set out evidence-based consensus recommendations to help dental teams in the Middle East and Africa (MEA) diagnose and manage dentine hypersensitivity systematically in daily practice. The guidelines, developed by an advisory board panel of 12 dental experts from eight MEA countries, emphasise routine screening and a stepwise care pathway. The review also calls for better education of both clinicians and the public and highlights the urgent need for MEA-specific epidemiological and clinical research.

One of the key nuances of the guidance is the recommendation that all dental patients in the MEA region be routinely screened for dentine hypersensitivity. The authors propose starting with a single, standardised screening question at every visit, optionally supported by brief pre-visit questionnaires to flag at-risk patients. For those who report sensitivity, the review advises taking a structured history that captures pain characteristics, medical background, diet, lifestyle and oral hygiene behaviours. Where feasible, the panel encourages the use of validated quality-of-life instruments such as the Dentine Hypersensitivity Experience Questionnaire to document functional impact, but also pointed out the need for simpler and quicker means of assessment.

On the diagnostic side, the review stresses that dentine hypersensitivity should remain a diagnosis of exclusion. Clinicians are reminded to rule out caries, cracked tooth syndrome, pulpitis, postoperative sensitivity and periodontal disease, among others, using standard tests and radiographs before confirming the condition. Once other causes have been excluded, the panel recommends using stimulus-based testing, starting with gentle probing and proceeding to cold air. It recommends assessing the pain evoked by scoring the clinician-observed response on the Schiff scale and recording patient-reported pain on a numerical rating scale. The guidance places particular emphasis on meticulous charting of tooth, site, severity and lesion status to support longitudinal monitoring and evaluation of treatment outcomes.

Management is organised into a clear stepwise algorithm that begins with patient education and behaviour change, leads next to home-based care and escalates only when necessary. The first stage focuses on risk factor control: instruction in gentle Bass brushing with soft brushes, cautious use of electric brushes, avoidance of water flossers in sensitive areas, adjustment of the timing and frequency of acidic intake, and management of occlusal trauma and bruxism. The authors underline that these measures are not ancillary but central to long-term success and prevention of recurrence.

As first-line treatment, the panel recommends sustained use of desensitising toothpastes containing tubule-occluding agents or potassium salts, applied twice daily and continued long-term to prevent tubule reopening. It suggests the use of fluoride mouthrinses and high-fluoride toothpastes as adjuncts, especially in patients at elevated risk of caries or erosion. Only if symptoms persist or worsen despite optimal self-care does the algorithm move to in-office therapy. In this regard, the panel lists professionally applied fluoride varnishes, glutaraldehyde and HEMA desensitisers, and laser treatments and highlights that restorative, endodontic or periodontal plastic procedures should be reserved for cases with significant structural or soft-tissue defects.

Regular follow-up is an integral part of the proposed pathway. The panel recommends review every two to three months for most patients and monthly follow-up for severe cases. These reviews can be conducted chairside or via telephone and can be delegated in part to hygienists or dental assistants, allowing practices to integrate dentine hypersensitivity care into existing recall systems. For more complex cases, the authors advocate a multidisciplinary approach involving nutritional and psychological support, especially in patients whose dentine hypersensitivity is linked to diet, reflux, stress or coping behaviour.

Beyond clinical practice, the review calls for dentine hypersensitivity to be integrated more fully into undergraduate and postgraduate curricula for dentists and hygienists in the MEA region through competency-based learning—which ensures that learners can apply specific clinical skills—and problem-based learning—which fosters critical thinking through real-world case scenarios. The review also encourages greater visibility of the topic at scientific meetings and the development of clinic- and web-based patient education resources and social media campaigns tailored to regional populations.

For dental professionals in the MEA region, the review offers a concrete, regionally relevant framework that elevates dentine hypersensitivity from a background complaint to a condition that is actively screened for, systematically diagnosed and managed along a clear, systematic pathway.

The review article, titled “Evidence-based recommendations for diagnosing and managing dentine hypersensitivity in clinical practice: Insights from the Middle East and Africa”, was published online on 7 November 2025 in Frontiers in Oral Health.