A decision tree for the management of exposed cervical dentin (ECD) and dentin hypersensitivity (DHS)

Dentin hypersensitivity (DHS) is a problematic clinical entity that may become an increasing clinical problem for dentists to treat as a consequence of patients retaining their teeth throughout life and improved oral hygiene practices. The aim of this review was to develop a decision tree for the management of exposed cervical dentin (ECD) and DHS. A brief PUBMED literature search was performed on dentin hypersensitivity using "MeSH" terms, "review", and "management". In addition, some websites and local guidelines were screened. From this review, it became clear that all dentate patients should routinely be screened for ECD and DHS. In this respect, underdiagnosis of the condition will be avoided and the preventive management can be initiated early. A decision tree process and a flowchart for daily practice were designed which should be started up as soon as a patient present with ECD or suffers from DHS. This approach takes into account the possible improved quality of life of the patient and is further based on a hierarchy of treatment options. In this respect, active management of DHS will usually involve a combination of at-home and in-office therapies. Starting with the use of desensitizing toothpastes is strongly recommended.