Current strategies for dentist-applied treatment in the management of hypersensitive dentine.

Few of the many dentist-applied treatments for dentine hypersensitivity meet the requirements of an ideal desensitizing agent'. This paper, although not exhaustive, covers methods that may be classified from simplest to most complex. Topical methods are simple, but they are often uncomfortable and the effects usually quite short-lasting, and many fall short of the 'ideal'. Fluorides and oxalates appear to be the best topical methods. Iontophoresis of fluoride represents an intermediate stage of complexity and it meets most of the criteria of an ideal desensitizing agent. Newer restorative materials, such as glass-ionomer cements and dentine bonding agents, are the most complex. These are still under investigation, but when the tooth needs recontouring, or in difficult cases that do not respond to other treatments, the dentist may choose to use a restorative material. Resin primers alone could be promising but the effects are not permanent and investigation into their use is still under way. Finally, laser treatment has been espoused for dentine desensitization. This requires extremely expensive equipment, must be dentist applied, and might produce pulpal irritation. Much more study is needed on restorative treatments and lasers before they can be considered as effective desensitizing agents. Until that research is completed, the dentist must choose one or more of the available methods in order to have a clinical therapy that is likely to relieve the symptoms of hypersensitive dentine.