Open Access

Research
Dentine hypersensitivity and associated factors: a Nigerian
cross-sectional study

Kofoworola Olaide Savage1, Olabisi Hajarat Oderinu2,&, Adeleke Oke Oginni3, Omolara Gbonjugbola Uti1,
Ilemobade Cyril Adegbulugbe , Oluwole Oyekunle Dosumu
2 4

1
Department of Preventive Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria, 2Department of Restorative
Dentistry, Faculty of Dental Sciences, College of Medicine, University of Lagos, Lagos, Nigeria, 3Department of Restorative Dentistry, Faculty of
Dentistry, Obafemi Awolowo University, Ile-Ife, Ife-ife, Nigeria, 4Department of Restorative Dentistry, Faculty of Dentistry, College of Medicine,
University of Ibadan, Ibadan, Nigeria

&
Corresponding author: Olabisi Hajarat Oderinu, Department of Restorative Dentistry, Faculty of Dental Sciences, College of Medicine, University of
Lagos, Lagos, Nigeria

Key words: Dentine hypersensitivity, prevalence, associated factors, erosion, tooth brushing

Received: 31/12/2018 - Accepted: 19/07/2019 - Published: 30/07/2019

Abstract
Introduction: prevalence of dentine hypersensitivity (DH) may be on the increase as a result of changing lifestyles. This study aimed to assess the
prevalence of DH and relative importance of associated factors in 18-35 year old Nigerians and compare to findings from a similar European study.
Methods: following ethical approval, 1349 subjects from the six geopolitical zones in Nigeria participated in this cross sectional study. DH was
clinically evaluated by cold air tooth stimulation, patient pain rating (yes/no) and investigator rated pain using the Schiff ordinal scale (0-3). Erosive
tooth wear using the BEWE index was assessed. A questionnaire regarding the nature of the DH, erosive dietary intakes, tooth brushing habits and
other factors was completed by patients. Bivariate analysis was conducted. Results: 32.8% of patients reported pain on tooth stimulation and 32.9%
scored ≥1 on Schiff scale for at least one tooth. Questionnaire reported sensitivity was 41.2%. There were statistically significant associations
between Schiff score and clinically elicited DH (p < 0.001); and BEWE erosive tooth wear score and clinically elicited DH (p < 0.001). There were
significant associations between DH and some oral hygiene practices such as brushing frequency, brush movement and brushing after breakfast.
Fresh fruit and fruit/vegetable juice intake also showed significant association. Conclusion: the most important risk factors of DH for this population
in Nigeria appear to be the frequency and characteristics of tooth brushing. This should be considered in its prevention and management.

Pan African Medical Journal. 2019;33:272. doi:10.11604/pamj.2019.33.272.18056

This article is available online at: http://www.panafrican-med-journal.com/content/article/33/272/full/

© Kofoworola Olaide Savage et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons
Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original
work is properly cited.

Pan African Medical Journal – ISSN: 1937- 8688 (www.panafrican-med-journal.com)

Published in partnership with the African Field Epidemiology Network (AFENET). (www.afenet.net)

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Introduction importance has been controversial. DH is likely to increase in
prevalence for a number of reasons; increase in life expectancy,
retention of teeth throughout life, changing life styles notably diet,
Dentine Hypersensitivity (DH) is characterized by short sharp pain
change from traditional African diet to western diet in urban city
arising from exposed dentine in response to thermal, evaporative,
dwellers, and increased intake of fizzy drinks as seen in developing
tactile, osmotic or chemical stimuli that cannot be ascribed to any
African countries. It was therefore the objectives of this study to
other dental defect or disease. It is an exaggerated response to a
determine by questionnaire combined with clinical examination the
sensory stimulus that usually cause no response in a normal healthy
prevalence of DH and its associated factors in 18-35 years old
tooth [1]. Other possible causes of pain that should be eliminated
Nigerians and to compare the findings to a similar study carried out
before a diagnosis of DH is made include fractured or chipped teeth,
in 18-35 years old Europeans [17].
carious lesions, palatogingival grooves, leaky restorations and
cracked cusps [2]. Dentinal pain is mediated by a hydrodynamic
mechanism [3]. A pain provoking stimulus applied to dentine
increases the flow of dentinal tubular fluids, this mechanically
Methods
activates the nerves situated at the inner ends of the tubules. The
pain thus initiated is often associated with mild to severe discomfort Nigeria is divided into six geopolitical zones each comprising of states
which often affects patients' eating and drinking habits [1], hence that share similar culture, ethnic groups and common history. The
affecting their quality of life. It has been reported that cold stimulus zones are North Central, North East, North West, South East, South
is more effective in activating intradental nerves than do heat and South and South West. Not all the states in each zone were identified
probing [4, 5]. This is supported by the observation that close to 75% to have public dental hospitals or clinics in either urban or rural
of patients with DH complain of pain from cold stimuli [6]. The locations. For this reason, in order to effectively perform the clinical
prevalence of DH varies from 1.34% to 98% [7, 8]. Although DH may examination protocol for this study, seven states, each representing
affect patients of any age group, it mostly occurs in patients who are a geopolitical zone and Federal Capital Territory (Abuja) where both
between 30 and 40 years old [2], overall review of literature shows rural and urban dental facilities are available were included. Adults
equal gender. Different distribution patterns have been reported [9], aged 18-35 years from seven states representing the six geopolitical
canines and premolars are most often affected [6, 10] however, it zones in Nigeria and the Federal Capital Territory (Abuja) were
may affect any tooth. DH condition starts with exposure of dentine by recruited. These participants were recruited from patients attending
the loss of enamel and or gingival recession (with loss of cementum), designated dental centres in each of the seven states and the Federal
this has been termed ´lesion localisation´. The exposure of root Capital Territory during the study period. Two centres located in
dentine secondary to gingival recession has been reported to be rural/small-middle sized town and metropolitan city in each of the
associated with overzealous tooth brushing [11], about 70% of seven states were used. The sample size exceeded the calculated
people suffering from DH brush more than twice daily [12]. Not all minimum sample for DH prevalence based on previously reported DH
exposed dentine is sensitive, there must be the opening of the prevalence of 1.34% among a Nigerian population [7) and further
dentinal tubule system to permit activation of the hydrodynamic included the number of participant recruited within specified study
mechanism by appropriate stimuli, termed ´lesion initiation´. This duration (6 months) and this improved the power of the study. Ethical
occurs when the smear layer and or tubular plugs are removed, which approval for the study was obtained from the Medical Ethics
opens the outer ends of the dentinal tubules [13]. Abrasion and more Committee of the Lagos University Teaching Hospital (LUTH). Oral
importantly, dietary acid erosion may be implicated [14]. DH is more and written consent to participate was obtained from all patients after
frequently encountered in patients with periodontal diseases [9, 15]. a comprehensive explanation of the study in local languages where
Hypersensitivity has been reported to occur in about half of patients applicable. The data reported in this study was part of a larger
after periodontal procedures such as deep scaling, root planing and national study patterned after the European Study in Non Carious
gingival surgery [16]. DH may also occur in non-carious cervical Cervical Lesions (Escarcel). Escarel [18] is a Pan European study
lesions especially when exposed to erosive foods and drinks. Although designed to estimate the levels of sensitivity, periodontal disease and
several risk factors leading to the exposure of dentine, tubular tooth wear in young adults. After screening, consenting patients who
opening and subsequent pain have been identified, their relative met inclusion criteria were recruited. Patients were required to be

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healthy, between 18 and 35 years of age, and able to follow all study stimulation, Schiff score and questionnaire declared hypersensitivity;
procedures and restrictions. Exclusion criteria included; patients with and of elicited sensitivity to tooth wear and recession were also
5 teeth or less, currently having orthodontic appliances, cervical analysed. Non-carious cervical lesions were evaluated using the Basic
restorations, taking analgesics, or undergone oral local anaesthesia in Erosive Wear Examination (BEWE) on the facial/buccal, lingual/palatal
the last 24 hour, people requiring antibiotics for dental treatment, on surfaces using an ordinal scale (0 = no erosive wear, 1 = early tooth
anticoagulants or who suffered bleeding disorders, or were employee loss, 2 = surface loss <50%, 3 = wear with tissue loss >50% of the
of the study centre. Examiners calibration was organized by 3 surface) [19]. The location of the lesion (coronal surface, root surface
members of the Escarcel group. Intra- and inter examiner reliability or crown-root junction) was recorded. Bivariate statistical analysis
was evaluated. The Kappa agreement among all the examiners at the was carried out at the patient level. Elicited sensitivity was related to
end of the training phase was 85.5%. A self-administered several categorical variables. Odds ratios were reported in relation to
questionnaire based on the one used for the European study was the appropriate categorical variables, with 95% confidence intervals.
completed by each participant. The questionnaire included data on The relationships between the measures of sensitivity i.e. DH on any
risk factors associated with non-carious cervical lesions (use of tooth on cold air stimulation, Schiff score and questionnaire declared
tobacco, medication, erosive dietary factors) general lifestyle, dietary hypersensitivity; and of elicited sensitivity to tooth wear and recession
and oral health behaviour, perception of dentine hypersensitivity were also analysed.
including intensity, duration and origin. Following completion of the
questionnaire, a clinical examination for dentine hypersensitivity,
erosive tooth wear and loss of periodontal attachment was Results
performed. All eligible teeth excluding the second and third molars
were assessed for presence or absence of DH, erosive tooth wear and
In all, 1349 adults were recruited. The mean number of teeth
periodontal loss of attachment.
evaluated for DH in each subject was 23.7 (range 19-24). The mean
number of teeth with DH was 6.36 (range 0-18). Data analysed was
The exposed dentine surface of each eligible tooth was subjected to
based on number (n) that responded to the variable of interest in the
cold air stimulation by a one second application of air from the air
questionnaire. Table 1 shows the proportions of patients having DH
spray of the dental unit or a triple air dental syringe from a distance
according to the three measures of sensitivity. 443 patients (32.8%)
of approximately 10 mm with adjacent teeth shielded. The patient´s
reported DH in at least one of the teeth evaluated in response to cold
response to the cold air stimulation was recorded by the examiner
air stimulation. A maximum Schiff score of 3 was recorded for 64
using the Schiff ordinal scale [19]: (0 = subject does not respond to
patients (4.7%), while in 220 patients (16.3%) and 444 patients
stimulus, 1 = subject respond to stimulus but does not request
(32.9%) a Schiff score of 2 or 3 and 1 or higher were recorded
discontinuation of stimulus, 2 = subject respond to stimulus and
respectively. Out of the 1349 patients who completed the DH question
request discontinuation or moves away from stimulus, 3 = subject
in the questionnaire, 556 (41.2%) reported DH. These respondents
respond to stimulus, considers stimulus to be painful, and request
were then asked how important the pain was to them. 550 responded
discontinuation of stimulus). The patient was then asked whether the
to this question, out of which 151 (27.5%) said the pain was ''very
stimulus provoked DH or not. This procedure was undertaken for each
important'' (95% C.I. 23.6% to 31.5%) Table 2 shows that there was
eligible tooth in turn. Non-carious cervical lesions were evaluated
a statistically significant association between self-reported
using the Basic Erosive Wear Examination (BEWE) on the
hypersensitivity and clinically elicited sensitivity (p < 0.001); Schiff
facial/buccal, lingual/palatal surfaces using an ordinal scale (0 = no
score and clinically elicited DH (p < 0.001). This table also shows the
erosive wear, 1 = early tooth loss, 2 = surface loss <50%, 3 = wear
association of elicited DH with erosive tooth wear. There were
with tissue loss >50% of the surface) [20]. The location of the lesion
significant associations between elicited DH and erosive tooth wear
(coronal surface, root surface or crown-root junction) was recorded.
(p < 0.001. There was a closer relationship between maximum BEWE
Bivariate statistical analysis was carried out at the patient level.
score and elicited sensitivity. Table 3 shows the relationship of elicited
Elicited sensitivity was related to several categorical variables. Odds
DH to a range of subject's associated demographic factors.
ratios were reported in relation to the appropriate categorical
While Table 4 shows only subjects' associated oral hygiene and
variables, with 95% confidence intervals. The relationships between
dietary factors that had significant association. Statistically significant
the measures of sensitivity i.e. DH on any tooth on cold air

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associations were found between elicited sensitivity and some socio- when considering the treatment need for this condition and its impact
demographic characteristics like age, area of residence (rural or on the quality of life. There was no differences in the prevalence of
urban), and level of education (p < 0.001). Some oral hygiene factors DH according to gender in the present study and the European
such as brush frequency, brush movement, brushing after breakfast study [17]. Similar studies [24-26] have reported the same findings,
were statistically associated with elicited sensitivity. Also, elicited while others [27,28] have reported a female preponderance. This
sensitivity was statistically associated with fresh fruit intake and fruit study finding corroborate the observation from the European study
/vegetable juice intake (p < 0.001). Other life-style factors such as that the clinical elicited method of assessing DH correlate with the
smoking, use of certain medications, snoring and chewing gum did Schiff score for pain of DH. Also, there were significant associations
not show statistical significance (Annex 1). between elicited sensitivity after stimulation and erosive wear which
reinforced the similar findings reported in the European study [17]. A
range of potential associated factors to DH were assessed in this

Discussion study. The results showed a significant association of DH with tooth

brushing frequency, and brushing after breakfast. More than 60% of
participants brushed their teeth 2 or 3 times daily. These associations
This clinical and questionnaire based cross sectional study among
may also be due to the erroneous believe that the harder the tooth
young Nigerian adults to determine the prevalence of DH and its
brush and force of brushing, the cleaner the teeth becomes. A
associated factors, presents data among public hospital attending
combination of these factors will definitely lead to loss of dental hard
participants just as the European study by West et al [17]. These
tissue with dentine exposure. Brushing after breakfast will further
participants can be said to represent young Nigerian adults of varied
enhance the hard dental tissue loss due to dietary acid challenge. In
ethnic, cultural, economic status, occupation and balanced rural and
contrast to our findings, the frequency and characteristics of tooth
urban dwellers. The inclusion and exclusion criteria further eliminated
brushing were not significantly associated with DH in the European
bias towards the disease condition studied. The present study
study [17]. Rather, erosive dietary factors played significantly in the
suggests that about one in every three young adult Nigerian (32.8%)
DH experienced by the young European studied [17].
may have dentine hypersensitivity as determined by responses to cold
air stimulation in a clinical setting. This is relatively low in comparison
with a similar European study by West et al [17] that reported a
prevalence of 41.9%. But comparison to findings from other previous
Conclusion
clinical studies in Nigeria; 1.34% [7], 16.3% [21], in Europe;
2.8% [22] and in Australia 9.1% [23], the reported prevalence of the The prevalence of DH in young Nigerian adults (18-35years) is low
present study (32.8%) was very high. Particularly, the higher compared to their European counterparts. Dentine hypersensitivity
prevalence of DH recorded in this study when compared to previous may be on the increase and most important risk factors for dentine
clinical studies [7,21] among Nigerian population, suggest that hypersensitivity among young Nigeria adult population appear to be
dentine hypersensitivity may be on the increase in our environment. the frequency and characteristics of tooth brushing. This should be
The clinical prevalence of DH (32.8%, 32.9%) versus self-reported considered in its prevention and management.
DH (41.2%) in this present study further support reports that
prevalence data obtained from questionnaires based studies were What is known about this topic
often a little higher than that obtained by clinical examination [24-  Dentine hypersensitivity is a distinct clinical phenomenon
26]. It has been suggested that the majority of patients demonstrated whereby dentine is exposed and reactive;
some coping mechanisms for dealing with pain as shown by the
 Dentine hypersensitivity have been associated to oral
findings of the European study where peoples' perception of their pain
hygiene and acidic dietary risk factors.
is less than that of clinical reporting [17]. This is contrary to the
What this study adds
findings of the current study where peoples' perception of their pain
is more than that of clinical reporting. However, a sizeable percentage  Important risk factors for dentine hypersensitivity is

(27.5%) in the present study felt that the pain intensity was ''very different among populations.

important'' to their lifestyle, this should be put in proper perspective

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Table 1: prevalence of hypersensitivity by 3 criteria

95% confidence intervals
Number Percentage Lower Upper
Total patients 1349
DH any tooth on cold
air stimulation (Clinical
elicited DH)
Yes 443 32.8 30.2% 35.4%
No 906 67.2
Schiff highest score
0 905 67.1 64.5% 69.5%
1 224 16.6 14.7% 18.6%
2 156 11.6 10.0% 13.3%
3 64 4.7 3.4% 5.9%
2-3 220 16.3 14.3% 18.3%
1-3 444 32.9 30.5% 35.4%
Self-reported
hypersensitivity
Yes 556 41.2 38.6% 43.9%
No 709 52.6
Not sure 84 6.2

Table 2: relationship between three measures of sensitivity, and of elicited sensitivity to tooth wear
Elicited Sensitivity Odds 95% Confidence Chi df P-value
Limits
n Yes Percent Ratio Lower Upper Square
(%)
Total patients 1349 443 32.8%
Schiff highest score
0 905 93 10.3% 0.031 0.022 0.042 640.058 3 <0.001*
1 224 177 79.0% 12.161 8.572 17.254
2 156 130 83.3% 14.058 9.050 21.836
3 64 43 67.2% 4.530 2.653 7.735
Self-reported
hypersensitivity
Yes 556 217 39.0% 1.606 1.276 2.021 16.483 2 <0.001*
No 709 203 28.6% 0.669 0.532 0.840
Unknown/not sure 84 23 27.4% 0.759 0.463 1.243
Tooth wear – BEWE
score
0 537 47 8.8% 0.10 0.07 0.14 276.50 3 <0.001*
1 279 95 34.1% 1.07 0.81 1.42
2 397 223 56.2% 4.26 3.32 5.47
3 136 78 57.4% 3.12 2.18 4.48

* = Statistically significant

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Table 3: bivariate analyses for relationship of elicited sensitivity to demographic factors
Elicited Odds 95% Confidence Chi df P-value
Sensitivity Ratio Limits Square
n Yes (%) (OR) Lower Upper X2
Total Patients 1349 443 32.8%
Age (yrs) 1303
18 - 25 466 133 28.5% 0.738 0.578 0.942 6.81 2 0.033*
26 - 35 837 291 34.8% 1.262 0.996 1.600
Gender 1329
Male 592 184 31.1% 0.867 0.689 1.091 1.44 1 0.240
Female 737 252 34.2% 1.145 0.911 1.440
Centre
Osun 200 32 16.0% 0.342 0.230 0.509 87.25 7 <0.001*
Oyo 200 29 14.5% 0.301 0.199 0.454
Edo 100 34 34.0% 1.057 0.687 1.625
Enugu 100 38 38.0% 1.276 0.838 1.943
Kano 200 81 40.5% 1.478 1.086 2.012
Lagos 250 97 38.8% 1.378 1.037 1.831
FCT 200 95 47.5% 2.080 1.534 2.821
Borno 99 37 37.4% 1.239 0.811 1.893
Area of
Residence 1147
Rural 395 106 26.8% 0.672 0.518 0.870 7.95 2 0.019*
Small/Mid-size towns 100 27 27.0% 0.741 0.469 1.170
Metropolitan zone 652 226 34.7% 1.173 0.935 1.473
Education 828
To age 15+ 265 106 40.0% 1.478 1.120 1.950 15.68 3 <0.001*
To age 16 – 19 106 38 35.8% 1.156 0.764 1.750
To age 20+ 185 73 39.5% 1.399 1.016 1.925
Still studying 272 69 25.4% 0.639 0.473 0.863
Occupation 1238
Self employed 201 60 29.9% 0.850 0.613 1.178 10.28 6 0.113
Managers 28 7 25.0% 0.677 0.285 1.604
Other white collars 335 117 34.9% 1.133 0.873 1.470
Manual workers 61 18 29.5% 0.850 0.484 1.492
House person 101 41 40.6% 1.438 0.950 2.177
Unemployed 97 34 35.1% 1.112 0.721 1.716
Student 415 114 27.5% 0.696 0.540 0.898
*= Statistically significant. OR=1; factor does not have effect on elicited sensitivity, OR>1; factor associated with high odds elicited
sensitivity, OR<1; factor associated with lower odds of elicited sensitivity

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Table 4: bivariate analyses for relationship of elicited sensitivity to oral hygiene and dietary antecedent factors
Elicited Odds 95% Confidence Chi df P-value
n Sensitivity Ratio Limits Square
Yes (%) (OR) Lower Upper X2
Total Patients 1349 443 32.8%
Brushing Frequency 1265
Once per day 1009 308 30.5% 0.667 0.517 0.861 10.16 2 0.006*
Twice per day 247 101 40.9% 1.537 1.157 2.042
Thrice per day 9 2 22.2% 0.582 0.120 2.815
Brush Movement 1329
Various motion 403 140 34.7% 1.130 0.883 1.445 10.41 4 0.034*
Horizontal 334 115 34.4% 1.100 0.847 1.428
Vertical 517 151 29.2% 0.763 0.602 0.967
Circular 53 26 49.1% 2.030 1.170 3.522
Don’t know/Not sure 22 7 31.8% 0.954 0.386 2.356
Brush after breakfast
Often 437 109 24.9% 0.575 0.446 0.742 37.42 4 <0.001*
Occasionally 215 104 48.4% 2.197 1.634 2.955
Rarely 240 79 32.9% 1.004 0.746 1.352
Never 303 106 35.0% 1.132 0.865 1.482
Don’t know 154 45 29.2% 0.827 0.572 1.194
Fresh fruits
Often 390 143 36.7% 1.272 0.993 1.628 13.34 4 0.010*
Occasionally 754 237 31.4% 0.866 0.689 1.088
Rarely 154 44 28.6% 0.798 0.551 1.155
Never 24 4 17.4% 0.425 0.144 1.258
Don’t know 27 15 55.6% 2.611 1.212 5.627
Fruit/Vegetable juice
Often 340 139 40.9% 1.604 1.243 2.069 19.79 4 <0.001*
Occasionally 711 213 30.0% 0.759 0.604 0.953
Rarely 234 70 29.9% 0.849 0.625 1.153
Never 44 10 23.3% 0.611 0.298 1.251
Don’t know 20 11 55.0% 2.538 1.044 6.170
*= Statistically significant. OR=1; factor does not have effect on elicited sensitivity, OR>1; factor associated with high odds elicited sensitivity,
OR<1; factor associated with lower odds of elicited sensitivity

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Annex 1: Bivariate analyses for relationship of elicited sensitivity to oral hygiene, dietary and personal antecedent factors

Elicited Sensitivity Odds 95% Confidence Limits Chi df P-value

n Ratio Square
Yes (%) (OR) Lower Upper X2
Total Patients 1349 443 32.8%

Brushing Frequency 1265

Once per day 1009 308 30.5% 0.667 0.517 0.861 10.16 2 0.006*
Twice per day 247 101 40.9% 1.537 1.157 2.042
Thrice per day 9 2 22.2% 0.582 0.120 2.815

Toothbrush used 1265

None 21 4 19.0% 0.476 0.159 1.425 6.40 4 0.171
Manual toothbrush 1193 395 33.1% 1.114 0.776 1.598
Electric toothbrush 26 7 26.9% 0.750 0.313 1.796
Chewing stick 18 2 11.1% 0.252 0.058 1.102
Others 7 3 42.9% 1.538 0.343 6.899

Brush Movement 1329

Various motion 403 140 34.7% 1.130 0.883 1.445 10.41 4 0.034*
Horizontal 334 115 34.4% 1.100 0.847 1.428
Vertical 517 151 29.2% 0.763 0.602 0.967
Circular 53 26 49.1% 2.030 1.170 3.522
Don’t know/Not sure 22 7 31.8% 0.954 0.386 2.356

Brush after breakfast

Often 437 109 24.9% 0.575 0.446 0.742 37.42 4 <0.001*
Occasionally 215 104 48.4% 2.197 1.634 2.955
Rarely 240 79 32.9% 1.004 0.746 1.352
Never 303 106 35.0% 1.132 0.865 1.482
Don’t know 154 45 29.2% 0.827 0.572 1.194

Brush before breakfast

Often 1004 342 34.1% 1.248 0.956 1.629 7.08 4 0.132
Occasionally 195 57 29.2% 0.822 0.590 1.145
Rarely 72 21 29.2% 0.834 0.495 1.405
Never 70 18 25.7% 0.696 0.402 1.204
Don’t know 8 5 62.5% 3.436 0.817 14.443

Brush after lunch

Often 40 12 30.0% 0.873 0.440 1.734 5.89 4 0.208
Occasionally 72 22 30.6% 0.895 0.535 1.497

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Rarely 533 162 30.4% 0.831 0.658 1.051
Never 687 238 34.6% 1.182 0.941 1.484
Don’t know 17 9 52.9% 2.328 0.892 6.075
Brush after dinner
Often 385 139 36.1% 1.227 0.957 1.573 6.61 4 0.158
Occasionally 306 109 35.6% 1.175 0.899 1.535
Rarely 299 92 30.8% 0.885 0.671 1.168
Never 330 96 29.1% 0.795 0.606 1.041
Don’t know 29 7 24.1% 0.645 0.273 1.522
Snoring
Often 88 29 33.0% 1.006 0.635 1.593 4.37 4 0.359
Occasionally 155 45 29.0% 0.818 0.567 1.181
Rarely 306 113 36.9% 1.265 0.969 1.651
Never 587 193 32.9% 1.003 0.798 1.262
Don’t know 213 63 29.6% 0.836 0.607 1.150

Sleeping medication/antidepressant
Often 23 10 43.5% 1.586 0.690 3.647 3.77 4 0.439
Occasionally 64 21 32.8% 0.999 0.585 1.705
Rarely 235 83 35.3% 1.144 0.851 1.537
Never 991 321 32.4% 0.927 0.718 1.197
Don’t know 36 8 22.2% 0.577 0.261 1.276
Smoking
Often 50 20 40.0% 1.381 0.775 2.460 3.00 4 0.558
Occasionally 90 28 31.1% 0.918 0.579 1.457
Rarely 162 60 37.0% 1.235 0.878 1.737
Never 1030 329 31.9% 0.671 0.647 0.970
Don’t know 17 6 35.3% 1.117 0.410 3.041
Chew gum
Often 191 63 33.0% 1.008 0.728 1.396 2.28 4 0.685
Occasionally 580 200 34.5% 1.139 0.906 1.432
Rarely 333 103 30.9% 0.890 0.682 1.162
Never 216 70 32.4% 0.977 0.716 1.333
Don’t know 29 7 24.1% 0.645 0.273 1.522
Acidic foods
Often 345 128 37.1% 1.304 1.010 1.684 5.47 4 0.243
Occasionally 591 190 32.1% 0.946 0.752 1.190
Rarely 280 88 31.4% 0.922 0.695 1.223
Never 109 31 28.4% 0.799 0.518 1.231
Don’t know 23 5 21.7% 0.563 0.208 1.527
Fresh fruits
Often 390 143 36.7% 1.272 0.993 1.628 13.34 4 0.010*
Occasionally 754 237 31.4% 0.866 0.689 1.088
Rarely 154 44 28.6% 0.798 0.551 1.155
Never 24 4 17.4% 0.425 0.144 1.258

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Don’t know 27 15 55.6% 2.611 1.212 5.627
Fruit/Vegetable juice
Often 340 139 40.9% 1.604 1.243 2.069 19.79 4 <0.001*
Occasionally 711 213 30.0% 0.759 0.604 0.953
Rarely 234 70 29.9% 0.849 0.625 1.153
Never 44 10 23.3% 0.611 0.298 1.251
Don’t know 20 11 55.0% 2.538 1.044 6.170
Isotonic/energy drinks
Often 81 34 42.0% 1.519 0.962 2.399 3.64 4 0.457
Occasionally 342 113 33.1% 1.018 0.784 1.322
Rarely 384 126 32.8% 0.998 0.776 1.284
Never 502 157 31.3% 0.893 0.705 1.131
Don’t know 40 13 32.5% 0.984 0.503 1.927
Soft drinks
Often 361 113 31.3% 0.909 0.701 1.177 8.22 4 0.084
Occasionally 679 237 34.9% 1.208 0.962 1.517
Rarely 222 67 30.2% 0.863 0.632 1.180
Never 67 16 23.9% 0.628 0.354 1.115
Don’t know 20 10 50.0% 2.302 0.929 5.706
Dairy products
Often 167 59 35.3% 1.135 0.808 1.595 0.97 4 0.914
Occasionally 570 189 33.2% 1.025 0.815 1.290
Rarely 446 144 32.3% 0.963 0.756 1.227
Never 126 38 30.2% 0.872 0.585 1.299
Don’t know 40 13 32.5% 1.023 0.521 2.011
*Statistically significant. OR=1; Factor does not have effect on elicited sensitivity, OR>1; Factor associated with high odds elicited sensitivity,
OR<1; Factor associated with lower odds of elicited sensitivity.

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