Method: Two semi-structured interviews were held with 20 participants (19 females, aged 20-58) with self-reported dentine hypersensitivity (DH) 6-9 months apart. Interviews explored participants’ experiences of their DH. During each interview, participants also completed a quality of life measure to investigate the appraisal process and to identify response shift in relation to DH-related quality of life. Transcripts were analysed using Framework analysis.
Result: Evidence of response shift found in participants’ accounts included changes in: internal standards related to the pain assessment (recalibration), the importance of dentine hypersensitivity and oral health (reprioritisation) and changed understanding of oral health and quality of life (reconceptualisation).
These shifts were closely related to psychosocial mechanisms: acceptance, habits, social comparisons, problem-oriented and cognitive avoidance coping, social support, cognitive redefinitions and changed appraisals. Response shift was initiated by DH, other new pain experiences and major life events. Anxiety acted as a barrier whereas optimism acted as a facilitator of the occurrence of response shift. Participating in the study acted as an intervention in itself, and facilitated the occurrence, of response shift via psychosocial mechanisms such as social comparison.
Conclusion: Response shift is responsible for adaptation to DH. It can result in either diminished or increased perceptions of the impact of DH on quality of life and can undermine evaluations of treatments. New mechanisms and catalysts of the response shift were identified.