An audit of dentine hypersensitivity treatments in six general dental practices in Scotland.
OBJECTIVE
This investigation sought to: (a) determine the agents used by nine dentists to treat dentine hypersensitivity and measure their effectiveness; (b) evaluate the adoptive ease and apparent success of the most effective treatment when used by all nine dentists; and (c) validate a novel categorical ranking score for dentine hypersensitivity.


METHODS
A clinical audit methodology was used in the setting of general dental practice. In the initial data-collection round, patients presenting with dentine hypersensitivity were treated using the dentist's favoured regimen. Evaluation of agent effectiveness was made by patient completion of a pre- and post-treatment visual analogue scale (VAS) for the frequency (f) and severity (s) of hypersensitivity. A four-point categorical ranking scale (CRS) was also used to assess the impact of hypersensitivity upon lifestyle (L) (1=No sensitivity/effect on what I eat/drink; 2=Sometimes sensitive, rarely interfering with what I eat/drink; 3=Sometimes sensitive, occasionally interfering with what I eat/drink; 4=Always sensitive, always interfering with what I eat/drink). The most successful treatment was determined and used by all participating dentists. Its effectiveness was then assessed using the same criteria.


RESULTS
Four agents were routinely used to treat hypersensitivity: (Duraphat (D) (Colgate), Duraphat & Sensodyne (DS) (GlaxoSmithKline), Sensodyne (S) (GlaxoSmithKline), Seal & Protect (SP) (De Trey, Dentsply). All produced statistically significant (P<0.001) reductions in VAS (Tukey) and CRS (Kruskal-Wallis) scores, except for DS and S. Of these, the greatest percentage reduction was seen for SP (f=72.01%, s=71.19%, L=45.98%). When SP was applied by all dentists, similar percentage reductions were seen (f=68.74%, s=75.85%, L=38.33%). The CRS, in both data-collection rounds, correlated well with the corresponding VAS scores (Spearman R for f=0.77 (P<0.001) and for s=0.80 (P<0.001).


CONCLUSIONS
For the dentists in this audit, the use of SP was found to be reliable and predictable. The CRS provided a simple and reliable measure of dentine hypersensitivity. Subject to validation in a larger study, this could be used in a future audit as an alternative to multiple VAS scores.
Chadwick
R Graham
RG
Dental School and Hospital, Dundee, UK. r.g.chadwick@dundee.ac.uk
Mason
Andrew G
AG
D017281:Cost of Illness; D019230:Dental Audit; D003807:Dentin Sensitivity / Q000503:physiopathology / Q000628:therapy*; D017220:Dentin-Bonding Agents / Q000627:therapeutic use*; D004338:Drug Combinations; D005459:Fluorides / Q000627:therapeutic use; D005460:Fluorides, Topical; D006801:Humans; D009566:Nitrates / Q000627:therapeutic use; D010147:Pain Measurement; D010710:Phosphates / Q000627:therapeutic use; D015203:Reproducibility of Results; D019279:Resin Cements / Q000627:therapeutic use*; D012606:Scotland; D012720:Severity of Illness Index; D012969:Sodium Fluoride / Q000627:therapeutic use; D016896:Treatment Outcome
D017220:Dentin-Bonding Agents; D004338:Drug Combinations; D005460:Fluorides, Topical; D009566:Nitrates; D010710:Phosphates; D019279:Resin Cements; C442646:Seal and Protect resin cement; C097427:Sensodyne; C023807:sodium fluoride topical preparation; D012969:Sodium Fluoride; D005459:Fluorides