What are the treatment options for tooth sensitivity?

Treatment Options for Tooth Sensitivity

For tooth sensitivity, fluoride varnish is the most effective first-line treatment, followed by potassium nitrate products, which build increasing protection against painful sensitivity to cold, heat, acids, sweets, and contact. 1, 2

First-Line Treatments

• Fluoride Products:

  • Fluoride varnish (2.26% sodium fluoride) is highly effective for reducing tooth sensitivity and can be applied professionally as a root desensitizer 1
  • Fluoride varnish has practical advantages including ease of application, non-offensive taste, and requires smaller amounts of fluoride than gel applications 1
  • Application frequency is typically semi-annual, though some research suggests three applications in one week annually may be more effective 1

• Potassium Nitrate Products:

  • Available as toothpastes (5% potassium nitrate) and mouthwashes (3% potassium nitrate) 3
  • Builds increasing protection against sensitivity to cold, heat, acids, sweets and contact 2
  • Shows significant reduction in sensitivity within 1-4 weeks of regular use 4
  • Both toothpaste and mouthwash formulations are effective in reducing symptoms of dentinal hypersensitivity 3

Dietary and Lifestyle Modifications

• Avoid crunchy, spicy, acidic, or hot food/drinks that may trigger sensitivity 1
• Maintain a soft diet if sensitivity is severe 5
• Improve hydration and limit caffeine intake 1
• Apply cold compresses to reduce discomfort 5

Additional Topical Measures

• Use saliva substitutes and moisture-preserving mouth rinses for associated dry mouth 1
• Consider high-potency topical steroids (gel or dental paste) for severe cases 1
• Use sugarless chewing gum, lozenges, or candy as salivary stimulants 1
• Viscous lidocaine can provide temporary relief for severe pain 1

Systemic Medications

• NSAIDs (such as ibuprofen) are recommended as first-line treatment for acute dental pain following tooth fracture 5
• Acetaminophen is an alternative when NSAIDs are contraindicated 5
• Gabapentin may be considered for oral dysesthesia (burning sensation) 1
• For severe cases with dry mouth, systemic sialagogues (cevimeline or pilocarpine) may be prescribed 1

Treatment Based on Severity

Mild Sensitivity

• Continue regular oral hygiene with desensitizing toothpaste containing potassium nitrate 3, 4
• Use fluoride-containing mouth rinses 1
• Avoid triggering foods and beverages 1

Moderate to Severe Sensitivity

• Professional application of fluoride varnish 1
• Consider high-concentration fluoride products for home use 1
• Dental referral for evaluation of underlying causes 5
• For exposed dentin or pulp, prompt dental referral is necessary 1, 5

Timing of Dental Referral

• Immediate referral (same day): Crown fractures with pulp exposure, severe mobility, or significant pain 5
• Referral within a few days: Enamel and dentin fractures with sensitivity 5
• Less urgent referral (within a week): Enamel-only fractures with minimal symptoms 5

Common Pitfalls to Avoid

• Delaying referral for crown fractures with pulp exposure can lead to pulpal necrosis 5
• Underestimating pain from dentin exposure requires prompt coverage to prevent bacterial contamination 5
• Failing to address underlying causes of sensitivity (such as aggressive oral hygiene practices or diets rich in acids) 6
• Using water to store avulsed teeth or tooth fragments can cause osmotic lysis of cells 5