In Office, Chairside Desensitizing Treatment

Thank you for your question regarding an in-office treatment for a patient diagnosed with dentin hypersensitivity (DH). As you know, dentin hypersensitivity occurs when the dentinal tubules become exposed (due to gingival recession) and when those exposed tubules become open or patent. The patient experiences a short, sharp pain to a stimulus such as a hot/cold beverage or the touch of an explorer. I assume at this point you have counseled the patient regarding any destructive habits such as forceful toothbrushing and the consumption of soda or other low pH beverages that can exacerbate or trigger DH. After that I would recommend that the patient use a desensitizing toothpaste with 5% potassium nitrate KNO3. The KNO3 toothpaste will block the pain pathway when a stimulus is applied (such as cold or hot beverages, explorer, etc.) whereas all other available products will work by plugging the dentinal tubules. Professionally-applied desensitizing agents all work by sealing off the dentinal tubules for a period of time. These products are available as creams, liquids, gels, prophylaxis paste, and varnish that are applied directly to the sensitive root surface. There are so many products on the market that it can be overwhelming so instead of talking about specific brands let’s discuss the various categories of agents. The categories of professionally applied desensitizing products include: 1) Oxalates, 2) Gluma, 3) Fluoride Varnish, and 4) Amorphous Calcium Phosphate (ACP) products. Within the last category of ACP there are three different proprietary types – Recaldent®, NovaMin®, and Pro-Argin®. Here is a table of example products within each category. Please consult the application instructions for each product; some have an at-home follow-up product.