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Dentinal hypersensitivity (DH) remains one of the most persistent and significant challenges we face as dental professionals. Our primary goal is clear: achieve rapid, reliable sealing of the dentinal tubules to ensure patient comfort.
A deep understanding of DH pathogenesis is the foundation for all modern treatment development. While we have an arsenal of physical, chemical, and combined approaches, there is a clear need for improvements in the speed, efficacy, and durability of our solutions.
This post reviews our current strategies and explores the exciting future of DH management.
Physical occlusion strategies primarily involve laser desensitization and invasive restorations5.
Chemical occlusion strategies are diverse, focusing on ion precipitation, nerve desensitization, and protein precipitation.
These desensitizing compounds work by:
The Challenge: The complex oral microenvironment with its constant thermal stimuli and mechanical forces from chewing gradually depletes these ions. As a result, in some patients the symptoms may re-emerge, meaning the patient requires continuous replenishment of the active agents to maintain function.
This category includes laser-assisted desensitizing agents, dual-mechanism desensitizers, and biomimetic mineralization. When a laser is combined with a desensitizer, the ions released from the agent can actually help repair hard tissue micro-fractures caused by the laser’s heat.
The next step is to develop durable, acid-resistant materials that enhance the immediate and long-term efficacy of these combination therapies.
This has become a cornerstone of next-generation DH treatment. Instead of simply “blocking” a tubule, this approach mimics the natural mineralization process to create a stable, long-term solution.
The primary clinical consideration for biomimetics is that it is a slow,
progressive process. Therefore, its therapeutic efficacy is inherently dependent on long-term patient compliance.
Ultimately, effective DH management comes down to two goals: sealing tubules and reducing neural sensitivity. The future of development will focus on a few key areas:
1. Advanced materials: We need materials with better biocompatibility and sealing efficacy. This includes advanced forms of calcium phosphate (CaP), bioactive glass (BAG), and other agents that promote natural remineralization.
2. Nanotechnology: Nanoparticles and nanocoatings are being designed to penetrate tubules more effectively, providing a more durable, long-lasting barrier against stimuli.
3. At-home devices: Developing more effective home-use varnishes or gels that provide sustained release of active ingredients is crucial for convenient, long-term patient management.
4. Biotechnology: Looking further ahead, methods like gene therapy and tissue engineering offer new pathways to address the root causes of DH. Research into stem cell therapies may one day lead to regenerative treatments that can fully repair or regenerate dentin and pulp tissue.
Li X, Wang Q, Sun Y, Wang G, Zhang C, Ding J. Advances in physical and chemical strategies for dentin hypersensitivity therapy. J Adv Res. 2025 Sep 23:S2090-1232(25)00749-0. doi: 10.1016/j.jare.2025.09.041. Epub ahead of print. PMID: 40998255.
