Dentine hypersensitivity — ORE Part 1 MCQ

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EasyRestorative DentistryDentine hypersensitivityORE Part 1

A 39-year-old patient reports short, sharp pain when cold air is directed at exposed buccal cervical dentine on several premolars. The teeth are vital; no caries or cracks are present, and periapical radiographs are normal. The patient brushes immediately after consuming acidic drinks. What is the most appropriate initial management?

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Correct answer: C — Recommend desensitising toothpaste and modify acid and brushing habits

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

E is correct. The short, sharp cold-air pain from exposed cervical dentine, with vital teeth and no caries, crack or radiographic pathology, is typical of dentine hypersensitivity. SDCEP advises initial use of a proprietary desensitising toothpaste and avoidance of acidic foods or drinks. The additional history is important: brushing immediately after acidic drinks can compound erosive tooth wear by abrasion. RCS guidance therefore advises avoiding toothbrushing immediately after acid exposure. Root canal treatment is not indicated in vital teeth without evidence of pulpal or periapical disease. Antibiotics have no role because there is no infection or spreading disease. Extraction is disproportionate for a conservable tooth, and bleaching is not a treatment for dentine hypersensitivity and may itself provoke sensitivity. If symptoms persist despite conservative measures, topical professionally applied agents may be considered.

Reference: Scottish Dental Clinical Effectiveness Programme. Dentine hypersensitivity: Initial management. Accessed July 2026. https://www.acutedentalproblems.sdcep.org.uk/guidance/management-of-oral-conditions/common-oral-conditions/dentine-hypersensitivity/