Dentine Hypersensitivity — ORE Part 1 MCQ

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EasyRestorative DentistryDentine HypersensitivityORE Part 1

A patient reports generalised sharp pain from their teeth when consuming cold food and drinks. The pain stops immediately when the stimulus is removed. Clinical examination shows no caries, cracks, defective restorations or periodontal disease. What is the most appropriate first-line management?

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Correct answer: D — Recommend desensitising toothpaste and reduce dietary acid exposure

This presentation is dentine hypersensitivity: pain is sharp, stimulus-provoked and short-lived, with other dental causes excluded. First-line management is conservative: recommend a proprietary desensitising toothpaste and address contributing behaviour, particularly frequent dietary acid exposure. SDCEP specifically advises desensitising toothpaste in initial management; evidence supports potassium- and stannous-containing dentifrices for reducing sensitivity. Fluoride varnish may be considered as an additional topical treatment, but not before simple self-care. Systemic analgesics do not address the mechanism and are unnecessary for pain that ends when the stimulus is removed. Root canal treatment is inappropriate without pulpal disease. Composite restoration is reserved for a localised defect requiring restoration, not generalised sensitivity in otherwise sound teeth.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Acute Dental Problems: Dentine hypersensitivity, current. https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/dentine-hypersensitivity/