Surgical Management of Dentin Hypersensitivity Associated With Noncarious Cervical Lesions in a Patient With a Psychiatric History: A Case Report

Oral and mental health have a linked and complex relationship. We report the case of a 47-year-old female with severe cold sensitivity localized to the upper right premolar region, who was unresponsive to desensitizing agents, behavioral interventions, and brushing modifications. Her psychiatric history included atypical psychosis requiring hospitalization, and she remained stable on antipsychotic medication at the time of the dental consultation. Despite conservative management, hypersensitivity persisted in the regions with significant wedge-shaped defects and gingival recession. Periodontal surgical intervention with a coronally advanced flap and subepithelial connective tissue graft was performed, resulting in complete and sustained resolution of symptoms at four months post-surgery. Beyond local symptom control, the patient also reported reduced anxiety associated with oral discomfort. The elimination of cold-induced pain during meals and tooth brushing decreased somatosensory preoccupation and improved daily functioning. Although no change in psychotropic medication dosage was made - specifically, brexpiprazole (1 mg daily), quetiapine (25 mg daily), and clonazepam (0.5 mg daily, with an additional as-needed dose permitted, maximum once daily) - her psychiatrist noted stable affect with less focus on somatic distress. While anecdotal and based on patient self-report, these observations suggest that alleviating persistent orofacial symptoms may contribute to improved psychological well-being in medically complex patients. This case illustrates that with interdisciplinary communication and medical stabilization, psychiatric disorders need not preclude periodontal plastic surgery and that individualized, coordinated management can extend the indications of root coverage procedures to include the treatment of therapy-resistant hypersensitivity.