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# Dentine hypersensitivity

- Oral pathology

Short, sharp pain from cold, air, sweet or touch on exposed dentine. It stops when the trigger stops, and it is diagnosed only after other causes are ruled out.

Updated Nov 12, 2026

**See it in 3D:** [Gums (gingiva)](https://durgical.com/en/anatomy/gums/)

## Key points

- Hydrodynamic theory: fluid moving in open tubules.
- Short, sharp, provoked pain from exposed dentine.
- Block the tubules or calm the nerve, and remove the cause.

## What it is

When the gum recedes or enamel wears away, dentine is exposed and its tubules open to the mouth. A stimulus such as cold makes the fluid in the tubules move, and the movement triggers the pulp nerves: this is the hydrodynamic theory. The pain is short and sharp and stops with the stimulus. Treatment either blocks the tubules or calms the nerve, and removes the cause.

## How to recognise it

- Typical site: the necks of canines and premolars, often on the cheek side.
- Triggers: cold drinks or air, sweet or acidic food, toothbrushing or a probe.
- Causes: gum recession, erosion from acids, abrasion from hard brushing, and after scaling or tooth whitening.
- It is a diagnosis of exclusion: caries, a cracked tooth, a leaking filling and pulpitis can feel similar.
- Lingering or spontaneous pain is not dentine hypersensitivity; it points to the pulp.

## Differential and risks

- Toothpastes for sensitive teeth work by blocking tubules (stannous fluoride, arginine, calcium phosphates) or by calming the nerve (potassium salts); they need regular use for weeks.
- In the clinic: fluoride varnish, bonding agents or glass ionomer on exposed necks, and sometimes gum grafting.
- If the cause is not stopped (acidic diet, reflux, hard brushing), sensitivity returns.

## Next step / Initial management

- Confirm the pattern (short, sharp, provoked) and look for caries, cracks and leaking fillings.
- Advise a desensitising toothpaste used daily, a soft brush with gentle technique and fewer acidic drinks; consider reflux or bulimia if erosion is marked.
- Pain that lingers, wakes the patient or no improvement after a few weeks: refer to the dentist.

## Test yourself

Think of the answer, then tap the question to see it.

## What theory explains dentine hypersensitivity?

The hydrodynamic theory: stimuli move the fluid in open dentine tubules, which activates the pulp nerves.

## How do desensitising toothpastes work?

Some block the open tubules (stannous fluoride, arginine, calcium phosphates); potassium salts reduce nerve excitability.

## Which features suggest the pain is not dentine hypersensitivity?

Pain that lingers after the stimulus, spontaneous or night pain, or pain on biting point to pulpitis, caries or a crack.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/dentistry/dentine-hypersensitivity/)

## Connections

## See it in 3D 1

The structures of Durgical's 3D anatomy where it is found.

- [Gums (gingiva)](https://durgical.com/en/anatomy/gums/)

## Related 4

- [Tooth wear and sensitivity: erosion, attrition, abrasion and bruxism](https://durgical.com/en/dentistry/tooth-wear-and-sensitivity-erosion-attrition-abrasion-and-bruxism/)
- [Pulpitis: reversible or irreversible](https://durgical.com/en/dentistry/pulpitis-reversible-or-irreversible/)
- [Cracked tooth and vertical root fracture](https://durgical.com/en/dentistry/cracked-tooth-and-vertical-root-fracture/)
- [The tooth: crown, root, enamel, dentine and pulp](https://durgical.com/en/dentistry/the-tooth-crown-root-enamel-dentine-and-pulp/)

## Related conditions 1

- [Gastro-oesophageal reflux disease (GERD)](https://durgical.com/en/conditions/gastro-oesophageal-reflux-disease/)

## In Pharmacology 1

- [Fluoride](https://durgical.com/en/pharmacology/fluoride/)

[← All of dentistry](https://durgical.com/en/dentistry/)

Educational content; it does not replace assessment by a dentist or doctor and is not a clinical instruction. For facial or neck swelling with difficulty swallowing or breathing, a knocked-out tooth or bleeding that will not stop, go to an emergency department at once.

Sources: [Dentin hypersensitivity: etiology, diagnosis and treatment; a literature review](https://pmc.ncbi.nlm.nih.gov/articles/PMC3927677/) (Journal of Dentistry (Shiraz) (PMC open access), 2013); [Physiology, Tooth](https://www.ncbi.nlm.nih.gov/books/NBK538475/) (StatPearls Publishing (NCBI Bookshelf), 2023); [Cracked Tooth Syndrome](https://www.ncbi.nlm.nih.gov/books/NBK606115/) (StatPearls Publishing (NCBI Bookshelf), 2024).

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Representative model, for educational purposes only.

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Source: https://durgical.com/en/dentistry/dentine-hypersensitivity/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/dentistry/dentine-hypersensitivity/