Treatment Strategies and Interventions

There are numerous methods used to treat, eliminate or manage hypersensitivity. Long-term management is most successful when, in addition to pain control, treatment strategies include the elimination or reduction of contributing factors. Dentin sensitivity is managed best through self-care, professional care, or a combination of the two. Not all gingival recession and subsequent cementum or dentin exposure elicits a painful response. Exposed surfaces that do not elicit pain need only be monitored and treated as needed to reduce caries risk.

Communication between client and clinician is an initial and crucial step in the management of sensitivity. Listening to a client’s description of the pain and the activities that elicit the pain response is an integral part of the diagnosis and subsequent treatment of hypersensitivity. By utilizing the trigger questions listed in Table II, the client can articulate the specifics of their discomfort. The client responses contribute to the development of an individualized management strategy. Counseling can be provided to encourage behavior changes aimed at preventing further gingival recession and subsequent loss of tooth structure that contribute to hypersensitivity.

Individual clients should be informed of the risk for increased sensitivity following various surgical and restoration treatment procedures before consenting to the treatment. Advance notice of the possibility of developing hypersensitivity would likely minimize client dissatisfaction and enhance the likelihood of compliance with the recommended treatment and follow-up care. Such information should be properly documented in the client’s record. Evaluation and follow-up communication after use of various treatment modalities is an often overlooked aspect of treating sensitive teeth.

Once other causes for tooth pain have been ruled out, and hypersensitivity has become the established diagnosis, determining the level or intensity of a client’s reported pain will help determine treatment recommendations. Current research does not indicate any one treatment approach that offers the greatest efficacy and duration with the least potential for adverse effects.