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.