**3.3 Clinical presentation**

Pain associated with DH is considered transient in nature and once the initiating stimulus, such as cold air from a dental air syringe or a cold drink, has been removed, the problem will have been resolved. The clinical features of DH as reported in the published literature primarily deal with the features associated with DH in patients with a well-maintained oral hygiene rather than clinical features associated with RS *per se*. It is reasonable, however, to acknowledge that some of the aetiological and predisposing factors will be similar (**Figure 1**). For example, the combination or synergistic effects with attrition, abrasion, erosion, and so on, together with overzealous tooth brushing on exposed dentine in the cervical/root area of a tooth may accelerate the tooth wear process. The loss of gingival tissue due to the impact of the above factors or because of periodontal disease and/or periodontal therapy may also expose the underlying dentine resulting in DH/RS. The importance of the underlying bone texture, thickness of the buccal plate as well as the thickness of the gingival (periodontal) biotype may also result in gingival recession (loss of attachment), particularly following scaling procedures in shallow pockets (≤4 mm). Although DH/RS may affect any tooth or tooth surface, the intra-oral distribution involves the buccal (facial) surfaces of incisor, canine, premolar, and molar teeth RS, which may also affect the interdental, palatal, and lingual surfaces. Non-carious cervical lesions (NCCL) with or without DH/RS may also be present.
