Treating dentinal hypersensitivity can be challenging for the dental professional because of the difficulty related to measuring the pain response as the response can often vary from patient to patient. In addition if the dentin exposure is due to personal habits, it may be difficult for patients to change their behavior(s). If the diagnosis confirms dentinal hypersensitivity in the absence of underlying diseases or structural problems of the tooth, then the following steps can be initiated: (1) remove the risk factors by educating the patient about dietary acids and other oral care habits; (2) recommend different toothbrushing methods, if appropriate; (3) initiate treatment by recommending a desensitizing agent for home use; and/or (4) applying topical desensitizing agents in-office.
In 1935, Grossman addressed the requirements for an ideal desensitizing agent as: rapidly acting with long-term effects, non-irritating to the pulp, painless and easy to apply without staining the tooth surface. These requirements still exist today when considering an ideal solution to dentinal hypersensitivity.18 There are various ways to classify treatments: first, they can be categorized based on their ingredients and/or mechanism of action.19,20 There are two common approaches to treating dentinal hypersensitivity, nerve stabilization and tubule occlusion. Furthermore, treatment options can be classified as either invasive or non-invasive in nature. Examples of invasive procedures administered in-office include gingival surgery, application of resin adhesive materials such as dentin bonding agents, or a pulpectomy. Dentifrices and other products for home use are non-invasive. Finally, treatments can be categorized based on whether they can be applied by the patient (over-the-counter) or require professional application. For the purposes of this CE course, the focus is on first line over-the-counter products as well as popular in-office treatments.