Sensitivity and specificity of assessment scales of dentin hypersensitivity – an accuracy study

Abstract The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.

摘要
本研究旨在比较用于评估牙本质敏感（dentin hypersensitivity, DH）的各类疼痛量表的灵敏度与特异度，并调查受试者偏好使用的疼痛量表及刷牙习惯。本横断面研究纳入巴西某联邦大学确诊牙本质敏感的学生与教职工作为研究对象。受试者填写关于刷牙及饮品摄入习惯的调查问卷。研究人员对敏感牙齿与非敏感牙齿分别施加触觉刺激与冰棒刺激，随后让受试者在视觉模拟量表（visual analogue scale, VAS）、数字量表（numeric scale, NS）、面部疼痛量表（faces pain scale, FPS）及言语评估量表（verbal evaluation scale, VES）上标记自身疼痛程度。此外，采用希夫量表（Schiff scale, SS）对牙本质敏感程度进行评估。数据采用威尔科克森检验、卡方检验及受试者工作特征（ROC）曲线进行统计学分析。本研究样本共72名受试者（56名女性、16名男性），平均年龄为27.8岁。最常见的酸性饮品为咖啡（占比36.0%），最受偏好的疼痛量表为数字量表（占比47.2%）。牙本质敏感牙齿的疼痛水平显著高于非敏感牙齿（p < 0.05）。各量表的诊断准确率介于0.729（希夫量表）至0.750（数字量表）之间。数字量表的灵敏度最高，达81.9%。希夫量表的特异度最高，为91%。视觉模拟量表、数字量表、言语评估量表、面部疼痛量表及希夫量表均可用于牙本质敏感的准确诊断。希夫量表是牙本质敏感评估中最受偏好的量表。