Dentine hypersensitivity – what can be done?
PD Dr. Kristina Bertl, PhD MSc MBA
Exposed dentine often leads to painful teeth and causes a short sharp pain. If this pain occurs regularly, it can substantially impair the patient’s quality of life. The prevalence of dentine hypersensitivity varies according to the population being investigated; as an example, however, one study found it affected 40% of individuals aged 18 to 35 (West et al. 2013). Any treatment should ideally be easy to use, effective, rapid and long-lasting.
In a systematic overview, possible treatment approaches that could be self-administered by patients were divided and grouped according to their ingredients (West et al. 2015): arginine, PVA/MA polymers, potassium, casein derivatives, strontium, tin or tin fluoride, calcium sodium phosphosilicate and oxalates.
Whereas the evidence and effect with regard to alleviation of hypersensitivity is quite slim for products (toothpaste or mouth-rinse) containing PVA/MA polymers, potassium, casein derivatives or oxalates, products containing the other four ingredients (arginine, strontium, calcium sodium phosphosilicate and tin fluoride) showed substantially better results and should be recommended to affected patients. The following toothpastes contain one of these ingredients (this list is for illustrative purposes only and should not be regarded as comprehensive):
- Elmex Sensitive Professional with PRO-ARGININE (ingredient: arginine)
- Sensodyne Rapid Relief (ingredient: strontium acetate)
- Sensodyne Repair and Protect (ingredient: calcium sodium phosphosilicate)
As a rule, the first course of action should be to recommend a product containing one of these effective ingredients. Therapy options that are applied by the dentist, e.g. composite, varnish, laser treatment or similar, should only be considered as a second line of treatment. In addition, any factors that are causing or at least increasing dentine sensitivity should be reduced if possible, such as (over)consumption of erosive or acidic foodstuffs, a traumatic brushing technique and/or brushing too hard.
- West, N. X., Sanz, M., Lussi, A., Bartlett, D., Bouchard, P. & Bourgeois, D. (2013) Prevalence of dentine hypersensitivity and study of associated factors: a European population-based cross-sectional study. Journal of Dentistry 41, 841–851. West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of professionally and self-administered agents. J Clin Periodontol 2015; 42 (Suppl. 16): S256–S302. doi: 10.1111/jcpe.12336.