Treatment
At-Home Desensitizing Toothpastes
First-line management; requires regular, continued use
- • Potassium nitrate 5% (Sensodyne Original, Colgate Sensitive): accumulates in dentinal fluid and depolarizes nerve membranes, raising pain threshold. Requires 4-6 weeks of twice-daily use
- • Stannous fluoride 0.454% (Sensodyne Repair & Protect, Crest Pro-Health): occludes tubules and provides fluoride for remineralization
- • Arginine 8% + calcium carbonate (Colgate Sensitive Pro-Relief): plugs tubules with calcium carbonate precipitate; fast-acting
- • Nano-hydroxyapatite 10%: fills tubule openings with synthetic apatite crystals identical to natural tooth mineral
- • Apply directly to sensitive teeth with fingertip after brushing for maximum effect
In-Office Professional Treatment
For moderate-to-severe cases or poor response to at-home therapy
- • Professionally applied 5% sodium fluoride varnish (Duraphat) — fluoride reacts with dentin to form CaF2 deposits occluding tubules; applied every 3-6 months
- • Potassium oxalate 3% — reacts with calcium ions in dentinal fluid to form calcium oxalate crystals blocking tubule openings
- • Glutaraldehyde 2%/HEMA (Gluma Desensitizer) — coagulates plasma proteins in dentinal fluid, blocking tubules; single application highly effective
- • 35% HEMA (hydroxyethyl methacrylate) resin — wets and seals dentinal tubules; long-lasting
- • Laser therapy: Nd:YAG or diode laser melts and seals tubule openings (dentinal tubule obliteration)
Restorative Treatment
For DH associated with structural defects
- • Composite resin bonding over exposed root surfaces and cervical defects — covers and seals exposed tubules
- • Gingival graft (connective tissue graft or free gingival graft) for recession sites >2 mm — covers exposed root, eliminates the hypersensitive surface
- • Glass ionomer cement placed in cervical erosion/abrasion lesions — fluoride-releasing, seals tubules
- • Treat the causative factor: GERD management, erosion prevention, aggressive brushing modification (correct technique + soft brush)