Manage tooth sensitivity with potassium nitrate toothpaste as the first-line treatment, recommended by dentists to reduce sensitivity by calming nerves in exposed dentinal tubules. Fluoride varnish can be used as an adjunct for added protection. For enhanced relief, consider newer formulations like arginine with calcium carbonate or zinc hydroxyapatite nanocrystals to seal dentin tubules and promote enamel remineralization.
January 13, 2025

Tooth Sensitivity: What Your Dentist Would Do

Evidence-Based Over-The-Counter Guide

William Shen

William Shen

Co-founder & CPO

See all guides. Have more questions?

Tooth sensitivity (dentin sensitivity) arises from exposed dentinal tubules, typically due to enamel loss or gum recession. First-line recommendations are over-the-counter treatments, as published in the Journal of the American Dental Association based on management patterns by the Practitioners in the National Dental Practice-Based Research Network.

First-line recommendations:

  • Potassium nitrate toothpaste: Most common single treatment recommendation from American dentists for the treatment of tooth sensitivity. Sensodyne Pronamel Intensive Enamel Repair

  • Fluoride varnish: Most common adjunctive treatment (in addition to potassium nitrate toothpaste) offered by American dentists. 3M OMNI Gel Brush-On.

Second-line recommendations:

  • Arginine and calcium carbonate: Newer formulation of toothpaste has been shown to provide both instant and lasting relief of dentin hypersensitivity by physically sealing dentin tubules. Colgate Toothpaste Sensitive Plus.

  • Zinc hydroxyapatite nanocrystals: effective in clinical trials for managing tooth sensitivity by occluding dentinal tubules and promoting enamel remineralization. Biorepair Paste Oralcare Intensive Night Repair.

Professional treatment:

  • Desensitizing agents like glutaraldehyde/HEMA can be considered. These treatments help to occlude dentin tubules and reduce sensitivity

  • Surgery: For persistent cases, more invasive options such as adhesive restorations or mucogingival surgery may be necessary. These procedures aim to establish a physical barrier over the exposed dentin

Citations

Cummins, D. (2010). Recent advances in dentin hypersensitivity: clinically proven treatments for instant and lasting sensitivity relief. American Journal of Dentistry, 23, 3A-13A.

Kopycka-Kedzierawski, D. T., Meyerowitz, C., Litaker, M. S., Heft, M. W., Tasgaonkar, N., Day, M. R., ... & National Dental PBRN Collaborative Group. (2017). Management of dentin hypersensitivity by practitioners in the National Dental Practice-Based Research Network. The Journal of the American Dental Association, 148(10), 728-736.

What OTC evidence is reviewed?

  • For each condition, we performed a literature review to find a recent widely cited expert group guideline published in the leading specialty-specific peer-reviewed journal or top general medical journal.

  • Based on the recommendations in the publication, we identify recommended active ingredients and devices that are available over-the-counter per FDA regulations.

What evidence is prioritized?

Levels of evidence considered:

  • Tier 1 (Safe and Definitely Effective): Professional field consensus or multiple randomized controlled clinical trials showing the same conclusion. Wherever possible, we use Tier 1 evidence for "first-line" recommendations.

  • Tier 2 (Safe and Probably Effective): Individual clinical trials which may be discordant or large-scale observational experience. Tier 2 evidence may inform "first-line", "second-line", or "supplement" recommendations.

  • Tier 3 (Safe and Maybe Effective): Mechanistic plausibility without high-quality clinical evidence of efficacy but high-quality evidence of safety. Tier 3 evidence may inform "second-line" or "supplement" recommendations.

How does MDandMe select recommended products?

  • Based on the top clinical recommendation, we evaluate products containing the recommended active agent with FDA-approved dosage based on price, average customer reviews, how often it is purchased, and how quickly it will ship to home. 

  • We provide public documentation of the active ingredients in our recommendations, using all 32 FDA monographs, Prescription-to-Nonprescription (Rx-to-OTC) Switches, as well as New Drug Application (NDA) approvals.

How does MDandMe select recommended devices?

  • Based on the top clinical recommendation, we evaluate devices that are FDA-cleared or comply with other medical guidelines (if not a FDA-regulated category) by reputability, price, and average customer reviews.

  • We provide public documentation of supporting evidence for each device.