Clinical Manifestations
Chief complaint: sharp, shooting pain to cold (most common), air, sweet foods, acidic foods, or touch. Pain onset is immediate upon stimulus application and resolves within seconds to minutes of stimulus removal.
Affected teeth: most commonly canines and premolars (highest recession tendency), and the cervical area of any tooth with root exposure or gingival recession.
Clinical examination: gingival recession may or may not be present depending on etiology. Non-carious cervical lesions (wedge-shaped defects at the CEJ), erosion facets, or worn occlusal surfaces may be noted.
Stimulating tests: air blast (Yeaple probe standardized air blast), cold (Endo-Ice or cold water), or explorer tactile stimulation used to reproduce and score pain. Patient rates pain on VAS (0-10 scale).
Critical diagnostic requirement: no other dental pathology explains the pain (no caries, no crack, no pulpitis — these must be ruled out first).