Clinical survey of dentinhypersensitivity-like toothache induced by steroid therapy

Objective: Patients taking steroid therapy sometime complain of the dentinhypersensitivity (DHS)-like toothache. However, there is no report that steroid therapy induces DHS-like toothache as a side effect. This study was carried out to determine the relationship between steroid therapy and DHS-like toothache.

Method: The subjects were comprised of 157 patients (male: n = 30; female: n = 127), 17 to 84 years of age (mean = 50.1 years), who attended the department of Hematology and Rheumatology of our hospital. One hundred twenty-nine of 157 patients took steroid and 28 patients did not (control). The primary disease for steroid therapy consisted of SLE (55), RA (67), others (74). The questionnaire included the items on the presence, the exciting causes, the region, and the degree of DHS-like toothache. The relationships between the DHS-like toothache and the primary disease/steroid therapy were statistically analyzed. Fisher’s exact test for comparison of qualitative data and Mann-Whitney’s U test for comparisons between groups were used. Differences were considered significant p < 0.05.

Result: The incidence of DHS-like toothache was 15.3% (n=24). There was no significant difference either in age or in sex between subjects with and without DHS-like toothache. DHS-like toothache incidence of patients taking steroid (17.8%) was statistically higher than that of control (3.6%). It was significantly more frequent in pulse therapy patients (45.5%) than non-pulse therapy patients (13.0%). It occurred in incisors in lower and upper jaws with highest frequency. It was evoked by cool water (90.9%) and even by hot water (31.8%), and its degree was sometimes intolerable (40.9%). 

Conclusion: The steroid therapy, especially pulse therapy, would frequently induce severe, sometimes intolerant DHS-like toothache, which should cause decrease in QOL. This is the first report to determine the relationship between steroid therapy and DHS-like toothache.