Guia prático de dessensibilização: manejo da hipersensibilidade dentinária

Abstract

Dentin hypersensitivity (DH) is characterized by a sharp, short-lasting pain arising from exposed dentin in response to thermal, evaporative, tactile, osmotic, or chemical stimuli, in the absence of any other identifiable dental pathology. With an estimated global prevalence of approximately 11.5%, it represents a frequent clinical challenge due to its multifactorial etiology, the lack of a standardized therapeutic protocol, and the wide range of available desensitizing agents. The present study aimed to develop a practical guide to assist dentists and undergraduate students in the diagnosis and management of dentin hypersensitivity. This study consists of a clinical case report associated with the development of a technical-educational product, conducted at the Integrated Clinic of the School of Dentistry of the Federal University of Uberlândia, with approval from the Research Ethics Committee. A detailed anamnesis was performed, etiological factors were identified, neural and obliterating desensitizing agents were sequentially applied, and pain levels were reassessed using the Visual Analog Scale (VAS). The literature indicates that desensitizing agents may act either by modulating neural transmission or by occluding dentinal tubules, with no consensus regarding the superiority of a single approach. Considering that the hydrodynamic theory proposed by Brännström—based on intratubular fluid movement as the mechanism responsible for pain—is the most widely accepted pathophysiological model to explain dentin hypersensitivity, obliterating agents demonstrate consistent biological rationale, as they directly reduce or block this fluid displacement. Clinical evidence suggests that both neural and obliterating agents can significantly reduce pain, and their combined use represents a plausible and rational strategy for the clinical management of DH. It can be concluded that the development of an evidence-based practical guide contributes to the systematization of clinical conduct, promoting greater safety in the management of DH and expanding its applicability, including in public healthcare settings.