A fresh scoop of ice cream, an ice-cold glass of water, or an early morning coffee – dental hypersensitivity can put a dampener on many of the small pleasures in life. Patients may come to the practice with complaints of how sensitive teeth affect their day, from significant and persistent pain, down to discomfort in the smallest moments. It’s the responsibility of the clinician to formulate a treatment plan that can support each individual.
Dentinal hypersensitivity is experienced as a sharp, short pain, described in the literature as a chronic condition with acute episodes.[i] It occurs as the open dentinal tubules are exposed in the dentition, inviting stimuli to overwhelm and cause discomfort.i
Amongst the available solutions for care, fluoride application has been discussed as a possible aid for affected patients. Clinicians must first understand its role in the treatment of dentinal hypersensitivity, and recognise when it may be most effective. With this knowledge, treatment plans can be tailored for successful outcomes and healthier smiles.
Beneath the surface
Exposed dentine is not sufficient for hypersensitivity, because stimuli need access to the dentinal tubules too.[ii] Recession – and subsequent exposure of the dentine and dentinal tubules – at the gingival margin can be brought on by abrasive toothbrushing; erosion of the supragingival surfaces could be caused by excessive acids and sugar intake, or bruxism, and even some periodontal procedures such as periodontal surgery, periodontal pocket scaling, and root planning.ii Tooth whitening has also been linked to increased sensitivity at the time of treatment, and in the following days.[iii]
There are so many possible diagnoses that result in tooth sensitivity being a leading or significant symptom. This can complicate the identification of the problem’s source.ii Speaking to the patient about their previous oral health history, oral hygiene routines and recent difficulties relating to sensitivity may narrow down the cause, which can better inform a treatment plan.
Fluoride treatment can be effective in multiple circumstances. It leads to reparative dentine formation through the formation of insoluble calcium fluoride precipitate.[iv] The use of a fluoride varnish can effectively occlude and seal exposed dentinal tubules, and the addition of bioactive glasses, such as sodium, calcium phosphosilicate and calcium phosphate, help to form apatite hydroxycarbonate on the dentine surface. This further aids the occlusion of the dentinal tubules.[v]
It’s important to recognise that fluoride treatment should be used not only as a reactive treatment solution, but as a preventative one too – and even more essential is to ensure that patients know this.
As part of wider care
Fluoride treatments may be recommended to patients alongside other treatments, especially if the care they are due to receive is linked with hypersensitivity. Patients undergoing tooth whitening have, as mentioned, reported sensitivity and discomfort during care and afterwards.[vi] Studies have reported the greatest increases in sensitivity when using whitening agents containing high levels of hydrogen peroxide.[vii] Such treatment could take pain from mild to moderate in the space of a day.vii
Many solutions now include fluoride within whitening products to minimise sensitivity,vii but additional support may be needed in some circumstances. Fluoride application in the practice could be an effective additional treatment both before and after whitening treatment.
When looking at other solutions for cosmetic outcomes, fluoride treatment once again can be an excellent addition. Microabrasion is a safe, conservative aesthetic procedure for managing superficial enamel stains or defects.[viii] In the literature, fluoride therapy is recommended in addition to promote remineralisation, showing the wide impacts it may have in cosmetic focused care.viii
Effective solutions
Fluoride treatments allow dental professionals to identify issues before they develop further, but also ensure that their patients are accessing high-quality care. This can prevent many individuals developing hypersensitivity throughout the dentition, for happier and healthier lives.
Choosing effective fluoride applications for your patients is key. The 3M™ Clinpro™ Clear Fluoride Treatment is a professional solution from Solventum, formerly 3M Health Care, that helps you and your patients build a strong foundation for healthy smiles – together. The water-based, rosin-free formula is simple to apply and provides protection to enamel and dentine surfaces. A ready-release formula enables effective fluoride uptake with a minimum contact time of just 15 minutes and utilises innovative calcium phosphate technology, which can help you better support your patients today.
Fluoride is a key tool in the fight against dental hypersensitivity. Topical application can be appropriate for many patients, especially those who have undergone cosmetic care such as tooth whitening and microbrasion treatment. Clinicians are well placed to provide support with solutions that they can rely upon.
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[i] Cartwright, R. B. (2014). Dentinal hypersensitivity: a narrative review. Community Dent Health, 31(1), 15-20.
[ii] Petersson, L. G. (2013). The role of fluoride in the preventive management of dentin hypersensitivity and root caries. Clinical oral investigations, 17, 63-71.
[iii] Carey, C. M. (2014). Tooth whitening: what we now know. Journal of Evidence Based Dental Practice, 14, 70-76.
[iv] Mrinalini, U. B., Hegde, M. N., & Bhat, G. S. (2021). An update on dentinal hypersensitivity-aetiology to management–a review. J Evol Med Dent Sci, 10(37), 3289-93.
[v] Qeli, E., Toti, Ç., Odorici, A., Blasi, E., Tragaj, E., Tepedino, M., … & Meto, A. (2022). Effectiveness of two different fluoride-based agents in the treatment of dentin hypersensitivity: A prospective clinical trial. Materials, 15(3), 1266.
[vi] Zanelatto, D. G., & Moreira, J. C. (2024). Major clinical approaches to tooth whitening techniques and differences in terms of sensitivity and protection: a systematic review. MedNEXT Journal of Medical and Health Sciences, 5(2).
[vii] Piknjač, A., Soldo, M., Illeš, D., & Zlatarić, D. K. (2021). Patients’ assessments of tooth sensitivity increase one day following different whitening treatments. Acta Stomatologica Croatica, 55(3), 280.
[viii] Irusa, K., Abd Alrahaem, I., Ngoc, C. N., & Donovan, T. (2022). Tooth whitening procedures: A narrative review. Dentistry Review, 2(3), 100055.
