Treatments

Classifications of Desensitizing Agents based on:

I.     Mode of administration

At home treatment

In-office treatment

II.    Mechanism of action

Nerve desensitization

  • Potassium nitrate
Protein precipitation
  • Gluteraldehyde
  • Silver nitrate
  • Zinc chloride
  • Strontium chloride hexahydrate
Plugging dentinal tubules
  • Sodium fluoride
  • Stannous fluoride
  • Strontium chloride
  • Potassium oxalate
  • Calcium phosphate
  • Calcium carbonate
  • Bio active glasses (SiO2–P2O5–CaO–Na2O)
Dentine adhesive sealers
  • Fluoride varnishes
  • Oxalic acid and resin
  • Glass ionomer cements
  • Composites
  • Dentin bonding agents
Lasers
  • Neodymium:yttrium aluminum garnet (Nd-YAG) laser
  • GaAlAs (galium-aluminium-arsenide laser)
  • Erbium-YAG laser
Homeopathic medication
  • Propolis

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.

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 two common approaches to treating dentinal hypersensitivity, nerve depolarization 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 those treatments that disturb the neural response to pain stimulus and those that block/occlude the dentinal tubules.