A review of current approaches to in-office management of tooth hypersensitivity.

In-office treatment of dentinal hypersensitivity should be capable of providing the patient with immediate and lasting relief of pain. Regardless of the type of treatment employed, 20 to 40 per cent of hypersensitive teeth usually improve over a period of 4 to 8 weeks. Partial obturation of open tubules is the most widely practiced treatment, with other forms of therapy being recommended as a backup for patients in whom this approach fails. Obturation can be achieved with topical application of agents that form insoluble precipitates within the orifices of the tubules. Burnishing the exposed root surface produces a smear layer, which in itself can significantly reduce dentin permeability. At times, the use of a restorative resin or dentin bonding agent can be successful in reducing sensitivity when other forms of therapy have failed. Proper patient management should stress dietary counseling when dietary acids are an important etiologic factor. The importance of proper tooth brushing and plaque control must be stressed. At the present time, the use of oxalates for the obturation of tubules shows promise as a future in-office clinical agent; however, further clinical studies are required to evaluate and compare their efficacy with other currently effective methods and agents.