The Best Toothpaste For Sensitive Teeth That Works

Written & Reviewed by Dr David Chen

So you’ve tried twenty different “sensitive toothpastes” and NONE of them seems to work. It didn’t matter which one you used because whenever you drank cold water afterwards, it still hurt. It has certainly got you wondering if it even desensitized your teeth at all.

Well, we’re not surprised because you haven’t been using the best product this whole time. Chances are you’ve most likely never even heard of it before so the probability of you using it is highly unlikely.

Apadent Sensitive

The best toothpaste for sensitive teeth, which actually works is called Apadent Sensitive. If you did a quick search, what you’re thinking is correct because it is a Japanese brand and not American. Nonetheless, you can still find it online but it is fairly pricey.

Why Apadent Sensitive is the best sensitivity toothpaste

Despite not being an American brand, it does encompass everything that you would want in a desensitizing toothpaste. What makes it stand out above the crowd is that it utilizes two anti-sensitivity agents, nano-hydroxyapatite and potassium nitrate. That is in contrast to the vast majority of sensitive toothpastes which only use one desensitizer.

How this sensitive toothpaste works:

It is also fluoride-free in case that is an important factor in your decision making process.

Nano-hydroxyapatite – remineralization and dentinal tubule occlusion

Nano-hydroxyapatite in toothpaste can not only remineralize tooth decay but also reduce sensitivity by occluding open dentinal tubules.

Under normal conditions, the dentinal tubules in our teeth are closed due to the presence of smear plugs. The plugs prevent stimuli from interacting with the nerve endings inside of the tubules, thus effectively preventing sensitivity.

Smear Plugs with and without
Credit: KoR

However individuals with sensitive teeth tend to be missing these smear plugs but that is where the nano-hydroxyapatite toothpaste comes in. It possesses the ability to form its own plug by filling in all of the open orifices of the tubules.

In addition to blocking all of the openings, it also forms an additional layer of hydroxyapatite that covers the entire surface of the enamel. This is essentially an extra layer of protection to prevent the tooth from being in contact with any stimuli.

schema of hydroxyapatite reducing dentin hypersensitivity
Credit: Lijie Chen, Suma Al-Bayatee, Zohaib Khurshid, Amin Shavandi, Paul Brunton and Jithendra Ratnayake

Studies have demonstrated that nano-hydroxyapatite is an effective desensitizer when compared to fluoridated toothpastes. In fact, it has also been shown to be effective enough to be used for treating sensitivity from teeth whitening.

Is hydroxyapatite safe?

Fear not because the hydroxyapatite is highly biocompatible and biomimetic because it is literally what your teeth and bones are made of. Your enamel is actually made of 97% hydroxyapatite by weight while the dentin is 70%.

Studies have shown that it will not produce any irritation when used in oral care products.

If that wasn’t persuasive enough, hydroxyapatite is actually just made up of calcium and phosphates, Ca10(PO4)6(OH)2. If you swallow any, the gastric acids will just break it up into individual calcium and phosphates which your body will reabsorb. It will go towards remineralizing or repairing your bones and teeth.

Potassium nitrate – desensitize the nerve

Potassium nitrate does not occlude dentinal tubules but it will desensitize the nerve by interfering with the firing of pain signals.

In order to understand how it works, you need to understand that molecules move from an area of higher concentration to a lower one. Under normal conditions when the tooth gets stimulated, potassium ions flow from the inside of the nerve to outside of it.

crest depolarization repolarization
Credit: Crest

The reason is because the inside of the cell has a higher concentration of potassium than the outside. However, potassium nitrate (KNO3) will supply an overabundance of potassium to the outside of the cell. This reverses the concentration gradient and the potassium ions can no longer flow out of the cell. In essence it prevents the nerve from firing sensitivity signals.

The effect of this is a marked decrease in teeth sensitivity when used on a daily basis twice a day. A study in the Journal of Clinical Periodontology, found that there was an improvement in symptoms after 2 weeks of toothpaste use. However sensitivity relief continued to improve further at the 4, 8, and 12 week mark.

Basically what the study is telling you is that you do need to use the toothpaste for a long period of time to see an effect. It won’t show its complete potential until after 3 months of using it. Even after then you do need to continue using it because the desensitizing effect may dissipate if you stop.

Does not contain pyrophosphates

The Apadent toothpaste does not contain any pyrophosphates, which is beneficial if you have sensitive teeth. According to Dr Rod Kurthy, pyrophosphates are a tartar control ingredient that can make your teeth more sensitive.

Studies have shown that it prevents plaque from calcifying into hard tartar. That is great news from a gum health perspective but bad news if you have sensitivity. Results from the study indicated that hypersensitivity was observed in those who used dentifrices containing pyrophosphates.

demineralization remineralization of enamel-plaque-saliva interface
Credit: Adam Hellen

The reason is because how your teeth form the smear plugs is actually a calcifying process which utilizes calcium. Unfortunately the way the plaque calcifies also uses a similar mechanism. This means that the pyrophosphates will disrupt your body from forming natural smear plugs and that is NOT what we want.

Therefore it is important to make sure that your sensitivity toothpaste does not contain any pyrophosphates. You may experience an increase in sensitivity if it has any.

How it compares to the competition

The reason why Apadent Sensitive is head and shoulders above other sensitive toothpastes is because it uses two desensitizers and does not contain pyrophosphates. Most of the well known American desensitizing toothpastes will only use one desensitizer at most.

vs Potassium Nitrate based toothpastes

There are plenty of potassium nitrate (KNO3) toothpastes which also come with sodium fluoride. It is actually one of the most commonly used desensitizers in toothpastes.

Common toothpastes with KNO3:

  • Colgate sensitive complete protection
  • Hello sensitivity relief fluoride
  • Arm & hammer sensitive teeth and gums
  • Aquafresh sensitive
  • Twice sensitive with fluoride
  • Sensodyne pronamel intensive enamel repair
  • Crest pro health sensitivity whitening

Some of them even contain pyrophosphates so you do want to be careful and read the ingredients carefully! It could very well be counter productive to what you’re trying to achieve.

Nonetheless the main reason why these toothpastes are not as effective is that they only use one desensitizer and nothing else. Well, they’ll still work in desensitizing the teeth but just not as good!

vs Stannous Fluoride based toothpastes

Despite being a type of fluoride, stannous fluoride (SnF2) can desensitize teeth by occluding dentinal tubules. It works in a similar manner to hydroxyapatite except it utilizes the “Sn” to form complexes to clog the orifices.

Common toothpastes with stannous fluoride:

  • Sensodyne rapid relief
  • Crest pro health gum and sensitivity
  • Colgate total advanced whitening

Once again, the reason why toothpastes that only utilize stannous fluoride is not as effective as Apadent is because it only has one desensitizer. One desensitizing agent is never going to win over two working simultaneously together!

Another downside to using stannous fluoride is its potential to stain teeth. It is actually a part of the statement from the FDA regarding the use of it.

vs Nano-hydroxyapatite based toothpastes

Most toothpastes which use it tend to market themselves as fluoride-free and all natural. It is a legitimate replacement for fluoridated toothpastes since studies have shown it to be equally as effective in remineralizing cavities.

Examples of toothpastes that contain hydroxyapatite:

  • Davids sensitive + whitening nano-hydroxyapatite premium natural toothpaste
  • Risewell mineral toothpaste
  • Boka ela mint

These toothpastes are effective in reducing dentin hypersensitivity and if it works for you then that is great. However if it doesn’t then you may want to explore options which contain more than one desensitizing agent.

vs Arginine based toothpastes

Arginine based toothpastes are actually a lot less common because there is literally only one that we can find in the US.

  • Tom’s of maine rapid relief

The mechanism that it blocks tooth sensitivity is by occluding dentinal tubules. That means it works in a similar manner as stannous fluoride and nano-hydroxyapatite. However there was one study which showed that arginine was not as efficacious as stannous fluoride when it came to sensitivity reduction.

We rate these as less effective than Apadent overall due to the fact it only utilizes one anti-sensitivity agent.

Pros and Cons for Apadent Sensitive

Despite Apadent Sensitive being the best toothpaste for sensitive teeth, it is not flawless. There are advantages and disadvantages to using this product.

Advantages:

  • Two desensitizing agents (potassium nitrate and nano-hydroxyapatite)
  • No pyrophosphates
  • Fluoride-free

Disadvantages:

  • Expensive – $35 for 2.1oz tube
  • May be difficult to procure since it is a Japanese brand
  • Does not contain fluoride

Alternative option to Apadent

We have no complaints in regards to what Apadent Sensitive can do for your sensitive teeth because it definitely does work. There isn’t a single American toothpaste which utilizes two desensitizing agents so that makes it unique.

It rightfully deserves the title of being the best sensitive toothpaste.

However due to its disadvantages of being a foreign brand and its price point, we would like to offer you an alternative option. You should just brush with a potassium nitrate toothpaste AND a nano-hydroxyapatite toothpaste together.

As an example, our recommendation is to use Davids toothpaste WITH Sensodyne Pronamel intensive enamel repair.

  • You can substitute Davids with any other nano-hydroxyapatite toothpaste to your liking. We simply chose it because it shares the same name as Dr David Chen.
  • For the potassium nitrate toothpaste, you can choose a different one but just make sure it doesn’t have any pyrophosphates.

Why we believe it is a superior option

We actually believe this alternative to be even better than Apadent because it is less expensive and you get the benefit of fluoride.

The Apadent is not cheap because it costs almost $35 for a 2oz tube. This is in comparison to our recommendation above which costs $12 for Davids (5.25 oz) and $6 for the Pronamel (3.4 oz). The alternative option costs less and you get a lot more toothpaste.

You may argue all you want about fluoride but it is helpful in remineralizing teeth. It is a pro and a con for Apadent to not have any fluoride. If you choose the alternative, you will get exposure to sodium fluoride in the Pronamel toothpaste, which is a plus in our opinion.

Last but not least, it is simply much easier to procure the alternative options since they’re American made toothpastes. Since the Apadent is Japanese, you may have trouble finding it and if you do, you’re paying a price premium since it is imported!

The Verdict

We’re confident that one of the best toothpastes that is available for sensitive teeth is the Apadent Sensitive. It stands heads and shoulders above the rest of the pack because it uses dual desensitizers instead of just one. That automatically makes it more effective than the rest.

However if it wasn’t due to semantics of picking the best “toothpaste” which is singular, we do believe that our alternative option is superior. Using two sensitive toothpastes together such as a potassium nitrate with a nano-hydroxyapatite will offer even more benefits.

You get the addition of fluoride and it being less costly! Yes, we are asking you to brush two times but if you’ve been following our articles, we have recommended it before. It was suggested in our guide on how to stop sensitive teeth pain immediately.

  • You can brush with one after the other or you can just put half of each toothpaste on your toothbrush and just brush once.

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