Factors Influencing Tooth Sensitivity: Insights From the Hospital Universiti Sains Malaysia Using Bootstrap-Enhanced Ordinal Regression.

Introduction Tooth sensitivity, or dentin hypersensitivity (DH), is characterized by sharp, sudden pain in response to stimuli such as cold, heat, sweet, or acidic foods and drinks. In Malaysia, there is limited understanding of the epidemiological aspects of tooth sensitivity, necessitating focused research. The condition results from the exposure of dentinal tubules transmitting stimuli to nerves within the pulp, with contributing factors including gingival recession, enamel erosion, and periodontal disease. This study aims to investigate the factors associated with tooth sensitivity among patients at the Hospital Universiti Sains Malaysia (USM) using advanced statistical methods. Methods This study employed a computational research design to develop an ordinal regression and bootstrap methodology using the RStudio software (Posit PBC, Boston, MA) to analyze secondary data from the Hospital Universiti Sains Malaysia. Six variables were analyzed: tooth wear severity, patient's age, gender, smoking status, alcohol status, and type of toothbrush. The study was conducted in three phases: 1) the development of an ordinal regression model, 2) the development of algorithms for ordinal regression and bootstrap method, and 3) validation using tooth sensitivity data. Results The analysis revealed that the replication with 1000 samples provided the most precise estimates with small standard errors (SE) and consistently significant effects across variables. Tooth sensitivity was influenced by age, toothpaste type, toothbrush type, and brushing frequency. Conclusion The study highlights the importance of considering multiple variables such as age, toothpaste type, toothbrush type, and brushing frequency in understanding tooth sensitivity. The combined ordinal regression and bootstrap technique significantly improved the model's accuracy, providing valuable insights for dental health professionals. These findings underscore the need for specific guidelines on oral hygiene practices to manage and reduce the risk of tooth sensitivity.