Re: Practicing with a hygienist

The role of the dental hygienist is pivotally important in the prevention and management of dentin hypersensitivity. Prevention of hypersensitivity is the most cost-effective treatment option for patients. Through promotion of good oral hygiene practices, nutritional counseling, nonsurgical periodontal therapy, and application of desensitizing agents, dental hygienists are uniquely placed to be a first line of defense in the prevention of dentin hypersensitivity and its major predisposing conditions.

Patients may be reluctant to report symptoms of dentin hypersensitivity to the dentist during the comprehensive or periodic oral examinations. The first discussion is frequently with the dental hygienist during the dental prophylaxis, when hypersensitive areas may be stimulated.

When symptoms of hypersensitivity first become apparent to the dental hygienist, it is important that a thorough health questionnaire is completed and that the sites of sensitivity are documented, including duration, onset, and the nature of stimuli (if any) initiating the symptom. All contributory and predisposing factors and conditions should be explored, such as gingival recession, tooth wear, oral hygiene, and any harmful or factitious habits.

Due to the common nature of symptoms of hypersensitivity, a differential diagnosis is essential. The dentist, as diagnostician, should follow the appropriate protocol to ensure that the most appropriate restorative or surgical treatment is rendered.