Self-Care Strategies

Dentifrice

Fluoride—Although toothbrushing is a factor in gingival recession, in vitro research evidence suggests that it is the dentifrice rather than the toothbrush that abrades the enamel or dentin and leads to hypersensitivity. 40,41 Use of a standard fluoridated dentifrice can cause abrasive particles to be deposited at dentinal tubule openings and encourage their closure.60 Anecdotal reports indicate that some individuals experience hypersensitivity as a result of using tartar control dentifrices, possibly due to the pyrophosphate content.6 An initial pilot study reported a tartar control dentifrice containing pyrophosphates resulted in significantly greater dentin sensitivity than the control dentifrice.61 Further longterm studies are needed to answer questions related to such products and hypersensitivity.

Desensitizing dentifrice—This is appropriate for mild to moderate hypersensitivity. Currently, the active agent in commercial dentifrices is 5% potassium nitrate in gel or paste. The action of potassium nitrate (5%) is thought to penetrate through the dentinal tubules towards the pulp, depolarizing the nerve and prevent-ing repolarization, thereby blocking pain transmission. Several desensitizing dentifrices contain both potassium nitrate alone or with fluoride which promotes tooth remineralization. An in vitro study showed that the abrasive agent in a desensitizing dentifrice can occlude dentinal tubules and remain resistant to removal.62 Desensitizing dentifrices generally require two to four weeks before sensitivity is reduced and discontinuation frequently results in a return of the sensitivity. Continued use is recommend to maintain desensitization benefits.