A dentist compiles a thorough dental history and performs an examination of the mouth when diagnosing the source of sensitive teeth. During the examination, the dentist looks for signs of decay or damage to restoration work. The dentist also looks for exposed tooth roots and may use a metal device with a sharp point (explorer) to check the sensitivity of teeth.

In some cases, no treatment is necessary. For example, patients who have recently had an amalgam filling or composite resin filling may experience pulpal sensitivity to cold for several weeks. Amalgam conducts cold easily and transmits it to the pulp, while fillings that bond to the tooth, such as composite resin, sometimes require acid-based etching of the tooth that wears away enough enamel to cause sensitivity. In most cases, sensitivity associated with recent restoration work disappears over time.

However, other instances of sensitivity may indicate a problem that requires the appropriate treatment. Sensitive teeth usually can be treated either at home or at the dentist’s office.

At home, patients who regularly use fluoride toothpaste decrease their vulnerability to sensitivity. In addition, special desensitizing toothpastes are available over-the-counter for patients who have sensitive teeth. These toothpastes contain compounds (e.g., potassium nitrate) that block sensations from traveling from the tooth surface to the nerves. Patients may need to use these toothpastes for up to a month before the desensitizing effect is apparent and continue to use them regularly to maintain the effect.

Product label warnings against long-term use of desensitizing toothpastes are meant to advise patients to consult a dentist about their tooth sensitivity. If tooth sensitivity does not decrease after two to four weeks of regular use of a desensitizing toothpaste, it may indicate another problem that requires treatment by a dentist. Desensitizing toothpaste has not been tested on children under the age of 12, and is not generally recommended for this age group.

Use of fluoride mouth rinses also may decrease sensitivity for some patients. Patients considering using a mouth rinse are urged to speak with their dentist about the best available options. It is best to avoid acidic rinses and to instead use rinses with neutral sodium fluoride. When purchasing over-the-counter dental products, it is important to look for the American Dental Association Seal of Acceptance.  

Sensitive teeth also may require treatment in a dentist’s office. Some patients who have sensitive teeth may need a local anesthetic or nitrous oxide before having their teeth cleaned in a dentist’s office. In addition, dentist can apply a fluoride gel or varnish, or other desensitizing agents (e.g., bonding, sealants) to the teeth that help reduce sensitivity temporarily. Some treatments block the tubules in the teeth to keep them from transmitting stimuli to the pulp. Others bond to the tooth root and act as a seal over the sensitive teeth.

If these treatments fail to reduce a patient’s sensitivity, other procedures may be necessary. Sensitive teeth may be the result of tooth decay that may need to be treated with a restorative procedure such as a filling, crown or inlay. When lost gum tissue causes the sensitivity, patients may require surgical gum graft to cover the root of the tooth that is sensitive. If these treatments fail to reduce pain in the tooth, a root canal treatment may be necessary.

Finally, some instances of sensitive teeth can be reduced or eliminated by treating an underlying condition. For example, pulpal sensitivity resulting from grinding or clenching of teeth (bruxism) usually goes away once the underlying condition is treated.

Researchers continue to investigate new, better treatments for sensitive teeth. For example, some scientists are looking into the use of a tiny particle to bond with and strengthen tooth enamel as a long-term treatment.