Journal of Indian Society of Periodontology
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GUIDELINES FOR PERIODONTAL CARE
Year : 2022  |  Volume : 26  |  Issue : 4  |  Page : 307-333

ISP good clinical practice recommendations for the management of dentin hypersensitivity


1 Department of Periodontology, Dr. H. S. J. Institute of Dental Sciences, Panjab University, Chandigarh, India
2 Department of Periodontology, Dental College, Regional Institute of Medical Sciences, Imphal, Manipur, India
3 Department of Periodontology, Dental Institute, Regional Institute of Medical Sciences, Ranchi, Jharkhand, India
4 Department of Periodontology, Renupriya Dental Health Care, Bengaluru, Karnataka, India
5 Department of Periodontology, Dr. Grover's Dental Clinic, New Delhi, India
6 Department of Periodontology, D. A. V Dental College and Hospital, Yamunanagar, Haryana, India
7 Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha “O” Anusandhan (Deemed to be University), Bhubaneswar, Odisha, India
8 Department of Periodontology, Government Dental College, Kottayam, Kerala, India
9 Department of Periodontics, Mahe Institute of Dental Sciences and Hospital, Mahe, Puducherry, India
10 Department of Periodontology, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
11 Department of Periodontics, Saraswati Dhanvantari Dental College and Hospital, Parbhani, India
12 Department of Periodontology, Dental College and Hospital, Bharati Vidyapeeth (Deemed to be) University, Navi Mumbai, India
13 Department of Periodontology, K. M. Shah Dental College, Sumandeep Vidyapeeth Deemed to be University, Vadodara, Gujarat, India
14 Department of Periodontology, Kalka Dental College, Meerut, Uttar Pradesh, India
15 Department of Periodontology, Ragas Dental College and Hospitals, Chennai, Tamil Nadu, India
16 Department of Periodontics, GSL Dental College, Rajahmundry, India
17 Department of Periodontics, Sri Sai College of Dental Surgery, Kaloji Narayana Rao University of Health Sciences, Vikarabad, Telangana, India
18 Department of Periodontics, Sudha Rustagi Dental College, Faridabad, Haryana, India
19 Department of Periodontology, Buddha Institute of Dental Sciences and Hospital, Patna, Bihar, India
20 Department of Periodontology, Government Dental College and Hospital, Mumbai, India
21 AFMC, Pune, India
22 Department of Periodontology, G. Pulla Reddy Dental College and Hospital, Dr. NTR University of Health Sciences, Kurnool, Andhra Pradesh, India
23 Department of Periodontology, Government Dental College and Hospital, Guntur, Andhra Pradesh, India
24 Department of Periodontology, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
25 VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
26 Department of Periodontics and Implantology, VSPM Dental College and Research Centre, Nagpur, Maharashtra, India
27 Department of Periodontics, Sibar Institute of Dental Sciences, Dr. NTR University of Health Sciences, Guntur, Andhra Pradesh, India
28 Department of Periodontics, AECS Maaruti Dental College and Research Center, Bengaluru, Karnataka, India

Correspondence Address:
Ashish Jain
Dental Institute, Regional Institute of Medical Sciences, Bariatu, Ranchi - 834 009, Jharkhand
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jisp.jisp_233_22

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Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry “Dentin Hypersensitivity,” based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.


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