Volume 9 • 2022 • Issue 3

with sensitivity or having ‘a condition’, they simply experience sensitivity occasionally and have found ways to cope with it by making lifestyle adjustments. 6,7 But why should they? Professor Gibson believes dentists could be missing an opportunity to engage with a significant sector of their patient population: “Many participants [in our research] indicated that they felt dentin hypersensitivity was actually part of their life.” It’s a chronic complaint but… This emphasizes the fact that DH is a chronic complaint. “I can tell you from the classic sociological literature on this, dentin hypersensitivity certainly fits the picture as a chronic condition,” confirms Professor Gibson. DH can alter the way patients act, restrict their eating habits, cause them to make adaptations to daily life and affect their social interactions, as well as having an emotional impact and affecting their personal identity. 8 Professor Gibson acknowledges that one of the issues is a lack of understanding around DH progression. “But it can and for many people it definitely has done. And when it does, it has really significant impacts on everyday life.” …why don’t people complain? Put simply, people with DH have already learned to cope, even those that say they are less concerned have changed their lifestyle to manage the condition. 9 “One of the fundamental indicators that you have a chronic condition is restrictions, limitations to the performance of daily tasks. Dentists and patients who don’t take the condition very seriously, it’s because they’ve adapted so quickly because pain forces you to adapt,” explains Professor Gibson. Capturing the nuances of DH’s impact on quality of life has resulted in the development of the Dentin Hypersensitivity Experience Questionnaire (DHEQ), which is a validated, condition-specific measure used to evaluate responsiveness to change in oral health- related quality of life measures in DH patients. 10,11 Research utilizing the DHEQ has found that among patients with DH, these adaptive behaviours fall into four categories 10,12 : • Avoid: 77% avoid cold drinks or foods (90% say they have problems eating ice cream); 38% have avoided hot drinks/foods • Adapt: 81% change the way they eat or drink certain things, 79% say they make sure food doesn’t touch certain teeth, 56% make sure they bite their food in small pieces • Compromise: 41% cool foods/drinks down before eating; 73% leave cold drinks to warm up before having them • Tolerate: 67% are careful how they breathe on a cold day; 45% wear a scarf over their mouths on cold days The condition also has an emotional impact. In research, 89% found DH annoying, while a similar proportion found it irritating. 10,12 “Dentin hypersensitivity requires a range of adaptive behaviours to avoid pain and sensitivity,” explains Professor Gibson. I’m fine – I can live without a hot cup of tea It’s the fact that DH patients have already made these changes that makes them so interesting, believes Dr. Asimakopoulou. Generally changing behaviour is the hard part, but she warns DH patients could be setting up longer-term issues. “We use the COM-B model of behaviour change to talk about capability, opportunity and motivation. These people will be ticking all three boxes for behaviour change. Only in this case, their apparent success in the short-term in solving the problem will probably mean they are less likely to want to engage with the dentist to deal with the problem in the long- term, unless the dentist brings it up and if the dentist offers a really easy solution.” Who raises the issue could be a factor. Recent GSK research among dentists worldwide found 53% believed it was their role to raise DH with their patients. 3 However, once raised the “easy solution” that Dr. Asimakopoulou refers to could simply be met by recommending a dentin hypersensitivity toothpaste. Daily use of a sensitivity toothpaste can significantly improve the quality of life impact of DH after eight weeks, in particular the emotional impact, the restrictions around their eating habits and how patients change their habits. 10-12 “Many participants [in our research] indicated that they felt dentin hypersensitivity was actually part of their life.” Sponsored Content