Diagnosing the Underlying Cause
Tooth sensitivity arises when dentin— permeated by fluid‑filled tubules— loses its protective enamel or cementum cover. Common etiologies include enamel erosion from acidic diets, cervical abrasion from aggressive brushing, gingival recession exposing root surfaces, and microfractures from bruxism. A clinical exam employs thermal (cold) and tactile (air blast) tests, plus visual inspection, to pinpoint hypersensitive sites and guide targeted therapy.
Desensitizing Toothpastes and In‑Office Agents
Over‑the‑counter toothpastes containing 5 % potassium nitrate or 8 % arginine with calcium carbonate work by depolarizing nerve endings or occluding dentinal tubules. Twice‑daily use can reduce sensitivity by 30–50 % within four weeks. In‑office application of fluoride varnish (5 % sodium fluoride) or 5 % potassium oxalate gel provides immediate relief lasting up to three months, though multiple visits may be required for enduring effect.
Fluoride and Remineralization Protocols
Prescription‑strength fluoride rinses (0.05 % NaF) nightly reinforce enamel, while casein phosphopeptide–amorphous calcium phosphate (CPP‑ACP) pastes supply bioavailable calcium and phosphate to remineralize early lesions. Resin‑modified glass ionomer varnishes release fluoride continuously, offering dual desensitizing and anti‑caries benefits.
Modifying Oral Hygiene Techniques
Switching to a soft‑bristle toothbrush and applying the Modified Bass method reduces cervical abrasion. Patients should avoid brushing immediately after consuming acidic foods—rinsing with water and waiting 30 minutes minimizes further enamel wear. Adjust toothpaste abrasivity to an ADA Relative Dentin Abrasivity (RDA) < 70 for sensitive teeth.
Occlusal Guards and Night‑Time Protection
For sensitivity linked to bruxism, a custom‑fabricated occlusal guard distributes occlusal forces evenly and prevents enamel microfractures. Some guards incorporate desensitizing agents (e.g., fluoridated liners) to deliver continuous protection throughout nocturnal wear.
Dietary and Lifestyle Adjustments
Limiting intake of citrus, carbonated beverages, and wine reduces enamel dissolution. Incorporating alkaline foods—dairy, raw vegetables—and sipping acidic drinks through a straw help preserve tooth integrity. Stress management techniques (biofeedback, relaxation exercises) can mitigate bruxism‑related sensitivity.