Sometimes you can get a sudden bout of sensitive teeth pain when you’re eating cold foods or beverages and that is if you’re fortunate. For the unfortunate ones, they pretty much have to live their life with constant teeth sensitivity on a daily basis.
Attaining pain relief from sensitive teeth seems to be more elusive than finding a unicorn in the forest. Whenever you go in for your dental check up and mention your teeth sensitivity, all you ever get told is to use a “toothpaste for sensitive teeth”.
You’ve probably already been doing that because the last five dentists have told you the same thing! Is there possibly be a way to stop the sensitive teeth pain or is it simply impossible?
We’re here to teach you about Dr David Chen’s protocol on how to stop sensitive teeth pain immediately. The reasons why we use all of these products will be thoroughly explained along with evidence to support it. You will walk away with everything that you need to know about how to get rid of this dentin hypersensitivity.
Protocol on how to stop sensitive teeth pain immediately
In order to successfully treat sensitive teeth pain, it will require a combination of in-office as well as at-home treatment. Dentin hypersensitivity is incredibly complex and getting rid of it will require the help of every known anti-sensitive product known to mankind.
The protocol to getting pain relief from sensitivity quickly:
- Apply a calcium oxalate desensitizer.
- Receive fluoride varnish treatment at the dentist.
- Use a potassium nitrate toothpaste without pyrophosphates twice a day.
- Use a nano-hydroxyapatite toothpaste twice a day.
The desensitizer is used to immediately reduce the sensitivity. The varnish will produce desensitizing effects for the next few months but may need to be reapplied at regular dental check ups. The two toothpastes should be used daily to maintain the anti-sensitivity effect.
Yes, you read that correctly because we are asking you to brush with two different toothpastes. As you will find out as you finish reading this article, they actually desensitize your teeth via two different mechanisms.
Therefore in our opinion, you should try to maximize the desensitizing effect by utilizing all methods at your disposal. Of course, you don’t have to use two different toothpastes because there are Japanese and European toothpastes which have all of the ingredients combined but they cost significantly more than our recommendation.
Calcium oxalate desensitizer
A calcium oxalate desensitizer such as the KoR Complete Desensitizer, will eliminate sensitivity immediately. This is the desensitizer, which dentists give to patients to use for their take home whitening kit. It is applied on the teeth prior to every single whitening session because it reduced the pain and sensitivity.
How it works:
- Calcium oxalate clogs up all of the open orifices of the dentinal tubules.
- It reacts with and fuses with the hydroxyapatite inside of the tubules.
- This clog extends 7-12μ deep within dentinal tubules.
In our experience, mild sensitivity usually stops immediately after applying this. Patients all report drastic improvements right after the treatment.
Why does clogging up the tubules prevent sensitive teeth pain?
Individuals with a lot of teeth sensitivity tend to have “open” dentinal tubules. That is a problem because that means there is an unimpeded pathway directly to the tooth nerve. So if you drink something cold, eat acidic foods, or try whitening your teeth, all of that can travel straight to the pulp. As you can imagine it will elicit an unpleasant sensation.
What makes it worse is that people with chronic sensitivity can sometimes have enlarged orifices for the tubules. This means even more stimuli can get into it.
The solution that calcium oxalate offers is the ability to plug up all of these openings. That prevents stimuli from entering and interacting with the tooth nerve. Essentially it blocks everything harmful from ever coming into contact with the pulp.
Is there a toothpaste with calcium oxalate?
Despite how amazing calcium oxalate is in stopping sensitive teeth pain near instantaneously, it does need to be applied on dry teeth. That means it will not be effective in toothpaste since everything is wet while you’re brushing.
Think about how much you salivate at the end of brushing vs at the start. All of that water prevents it from being utilized inside of a sensitivity toothpaste. That is truly unfortunate.
Fluoride varnish can be used to effectively treat dentin hypersensitivity. Studies have shown that the varnish, which is basically a 5% sodium fluoride concentration will reduce sensitivity.
The sodium fluoride is the same one that is being used in your toothpaste, except the varnish is a significantly higher concentration. Your toothpaste only contains about 0.25% of sodium fluoride while the varnish has 5.0%. Studies have shown that in order to properly desensitize your teeth, it requires about 100-10,000 ppm of fluoride.
For further support and ehow the sensodyne toothpastes workvidence, a randomized double-blind control study where fluoride varnish was applied three times showed long term lasting effects of decreased sensitivity.
- Fluoride varnish as applied on day 1 and day 2. Then it was applied one last time on day 7.
- The anti-sensitivity effect gradually improved with each week, all the way up to 8 weeks.
How fluoride varnish desensitizes your teeth
The high concentration of sodium fluoride desensitizes your teeth by occluding the open dentinal tubules.
- The sodium fluoride interacts with calcium to form calcium fluoride (CaF2).
- Calcium fluoride can penetrate into the tubules and clog them.
- It also forms a protective layer of calcium fluoride on top of the enamel.
Picture above shows calcium fluoride covering the surface of the enamel after application.
Essentially what happens is that the sodium fluoride forms one big barrier that not only covers over the tooth but plugs in the tubules. The net effect is a decrease in dentin hypersensitivity according to the Journal of the American Dental Association.
Potassium nitrate toothpaste
Potassium nitrate is very effective at desensitizing your teeth and it is actually one of the primary ingredients in the popular sensitivity toothpaste Sensodyne Pronamel.
According to a study in the Journal of Clinical Periodontology, use of potassium nitrate led to a rapid decrease in sensitivity after 2 weeks.
- The symptoms continued to improve over the course of 12 weeks.
- At the 12 week check-in, 67% of participants reported complete sensitivity relief.
Basically what we can take away from the study is that it takes about 2 weeks for the effects to start showing. Then the effect also continues to build and improve over the next 3 months. Apparently the reason for the required time is that potassium nitrate needs to reach a certain concentration threshold to exert nerve desensitization effects.
- An effect was seen when the K+ concentration was in the 8-64 mmol/L range.
- A complete desensitization was observed at 32 mmol/L.
How potassium nitrate desensitizes the nerve
Potassium nitrate (KNO3) does NOT occlude dentinal tubules because it works by desensitizing the nerve instead. Essentially what it does is render the nerve endings unexcitable.
In order to fully understand why KNO3 desensitizes the nerve, we need to understand how molecules move through concentration gradients. They’ll typically move from an area of higher concentration to an area of lower.
Under normal conditions, there is a low concentration of K+ (potassium) outside the cell and a high concentration inside the cell. When the nerve gets stimulated, the potassium flows from inside the cell to the outside.
- High Na
- Low K
- Low Na
- High K
However, when you desensitize the nerve with potassium nitrate, it floods the outside of the cell with K+. This prevents the nerve from firing correctly since the potassium inside can’t flow outside since the concentration gradient has now been reversed.
That is essentially how the sensodyne toothpastes work, at least the ones that use potassium nitrate. Just to be clear, some of them utilize stannous fluoride instead of potassium nitrate and that works via a different mechanism. The stannous fluoride has had reports of teeth staining.
Why pyrophosphates are bad for sensitivity
There is one particular ingredient within toothpaste called pyrophosphates that you should avoid. It’s purpose in toothpaste is as a tartar control agent. Essentially it prevents tartar from forming, which is a good thing.
However according to Dr Rod Kurthy, that is actually detrimental for relieving teeth sensitivity. The reason is that plaque and tartar actually develop via the same mechanism as tooth mineralization. They all use calcium and hydroxyapatite to form. If the pyrophosphates prevent tartar from forming, it will also prevent you from clogging up the open dentinal tubules.
We did find studies, which indirectly supported this claim. Essentially what pyrophosphates do is prevent calcification and tartar is basically calcified plaque. However, in order for your tooth to repair itself it requires calcification because the enamel is made of hydroxyapatite which is essentially calcium and phosphate.
Do you see where we’re going with this? The pyrophosphate is counterproductive to us trying to eliminate sensitive teeth pain.
Nano-hydroxyapatite toothpastes are biomimetic in that it is literally made of the same exact ingredient as your enamel. Your enamel is composed of 97% hydroxyapatite by weight. This material can repair and remineralize the enamel in addition to decreasing sensitivity.
There has been a plethora of studies which have shown nano-hydroxyapatite’s desensitizing effect:
- This study found that it can even reduce teeth whitening sensitivity.
- This randomized clinical trial found that it was equally as effective as arginine and strontium acetate toothpastes in desensitizing.
- Another study also found that it can decrease bleaching sensitivity.
How nano-hydroxyapatite decreases teeth sensitivity
Essentially what it does is that it occludes the open dentinal tubules. That effectively blocks all stimuli from reaching the tooth nerve, thus eliciting pain.
It is able to do this because most nano-hydroxyapatite toothpastes are about 50-100 nanometers. The natural dentin tubules are approximately 2400-3000 nanometers. This means that they are small enough to fit into tubules and clog them. Consequently studies have found that smaller hydroxyapatite particles worked better than larger ones in reducing sensitivity.
In addition to occluding the open tubules, the hydroxyapatite also forms a calcium phosphate rich coating over the enamel. This additional layer gets “sacrificed” during acid attacks and releases calcium and phosphates to buffer the acidic environment. Essentially your body is trying to decrease the acidity so that harm doesn’t come to your teeth.
In that sense it makes you more tolerable or rather have a buffer for encountering acid attacks. That means the acidic foods that you eat may not bother you as much while you’re actively using this desensitizing toothpaste.
Is two desensitizing toothpastes really necessary?
The potassium nitrate and nano-hydroxyapatite toothpastes decrease teeth sensitivity via completely different mechanisms. Some people will choose one over the other and wonder why they aren’t getting the effect that they desire.
In our opinion, why choose between the two when you can simply just use both of them. If you’re having severe teeth sensitivity you might as well do EVERYTHING that you can to reduce the sensitivity.
So yes we do recommend brushing with two different toothpastes. The plus side is that you’ll probably significantly decrease the occurrence of cavities since your oral hygiene will be in tip top shape!
Which two desensitizing toothpastes do you recommend?
In our opinion you should use the Sensodyne Pronamel intensive enamel repair as the potassium nitrate one. For the nano-hydroxyapatite, you can give David’s sensitive + whitening toothpaste a try.
Sensodyne Pronamel Intensive Enamel Repair:
- Cost = $5-6 for 3.4 oz tube
- Low RDA value of 35 which means it is not very abrasive.
- 5% potassium nitrate
- 0.315% sodium fluoride
- Does not contain pyrophosphates
David’s sensitive + whitening toothpaste:
- Cost = $12
- All natural toothpaste
How to use the toothpastes
There are two ways that you can brush with this but we’ll leave it up to you to decide what you want to do.
Use both together:
- Place half of the potassium nitrate toothpaste on your toothbrush.
- Place half of the nano-hydroxyapatite toothpaste on.
- Brush for two minutes.
- Brush with potassium nitrate toothpaste for 2 minutes.
- Brush with hydroxyapatite toothpaste for 2 minutes.
Alternative to using two toothpastes
Alternatively you can just purchase a toothpaste which contains BOTH potassium nitrate and nano-hydroxyapatite. That will save you the effort and time of trying to use two different dentifrices!
The only downside is that there is no American toothpaste which contains both ingredients. We have however found Japanese and European brands which do contain both but you should take into consideration pricing and availability.
Japanese toothpaste: Apadent Sensitive
- You can find this online such as through Amazon but it is quite pricey at $35 for just a small 2 oz tube.
- Interesting fact is that they’re actually the FIRST manufacturer of hydroxyapatite toothpaste. They acquired the patent from NASA back in the 1970s.
- An alternative japanese toothpaste would be Gum Sensivital + which contains similar ingredients.
Netherlands toothpaste: Toothpaste PrevDent nHAp
- This one actually contains the highest percentage of nano-hydroxyapatite coming in at 15%. However, there was one study which found that there were no remineralization differences between 10% and 15%.
Related content: We have ranked Apadent Sensitive as one of the best toothpastes for sensitive teeth due to its dual desensitizing action.
Things to avoid with sensitive teeth
You should minimize or eliminate all activities that may make your teeth more sensitive. If you’re able to get rid of these activities, it will make your desensitizing effects a lot more effective.
- Acidic foods
- Teeth whitening with peroxide
- Hard toothbrushes
If you eat or drink a lot of acidic foods, it can make your teeth more sensitive. Have you ever reeled in pain from biting into a lemon or lime? That is your body’s way of telling you, you shouldn’t be eating that!
How it makes your teeth more sensitive is that the acid will dissolve all of the smear plug or desensitizers that you may be using to block the tubules. Once the dentinal tubules are open again, the nerve will be wide open to stimulation.
In addition to that, an acidic environment is actually how the teeth start to demineralization. If the oral environment drops below the critical pH level of 5.5, the minerals will start to dissolve from the enamel. The hydroxyapatite starts to lose calcium and phosphates.
If you want to be free of sensitive teeth pain, you want your teeth to be healthy and strong. Demineralized teeth is the exact opposite of healthy teeth so please minimize demineralizing activities.
Instead, you should do your best to partake in remineralizing activities which is the act of strengthening and repairing the enamel with minerals. Make sure you get a diet that is rich in calcium and phosphorus to keep your teeth healthy.
Teeth whitening with peroxide
If you’ve ever whitened your teeth before, it can get pretty sensitive at the end of the treatment. It’ll be sensitive to drinking cold water and even sucking in cold air. Once in awhile, some individuals may even feel like their teeth are killing them after whitening. However most people usually have mild or transient symptoms.
The peroxide from the whitening causes sensitivity via two mechanisms:
- Dissolves the smear plugs so the whitening gel can directly enter into the nerve.
- Hypertonicity of the gel pulls the dentinal fluids away from the nerve, thus eliciting nerve pain.
Peroxide dissolves the smear plugs
Our teeth normally have smear plugs that naturally clog the dentinal tubules, preventing stimuli from reaching the tooth nerve. For desensitizing toothpastes, a lot of them will purposefully plug up the open tubules.
Peroxide tries to undo all of that by intentionally dislodging or dissolving all of the dentinal plugs. That leaves the tooth nerve wide open to bleach. Don’t you think its quite painful for the bleach to get into your pulp? It sure does.
Studies have in fact shown that whitening gel can penetrate all the way to the nerve within 15 minutes of application.
According to the hydrodynamic theory of dentin hypersensitivity, baroreceptors can sense fluid movements in the dentinal tubules. The change in fluids will elicit a pain response.
Since whitening typically places a very concentrated peroxide gel on the surface of the teeth, it creates a hypertonic environment on the exterior. This will attempt to pull the fluids away from the nerve and towards the gel. That is essentially how you feel sensitivity from whitening your teeth.
Brushing aggressively with a hard toothbrush can lead to sensitive teeth. The hard bristles can abrade away the gums and cause gum recession which exposes the sensitive root of the tooth.
Once the gums recede it doesn’t grow back on its own. You’ll need to see the gum specialist, the periodontist for a gum graft in order to repair that.
Getting rid of teeth sensitivity may elude most people but we’ve figured out a way on how to stop sensitive pain immediately or at least the best that we can.
It involves a combination of calcium oxalate, fluoride varnish, potassium nitrate, and nano-hydroxyapatite.
- The calcium oxalate is used to immediately stop the pain.
- The fluoride varnish requires 3 separate treatments but will last you for weeks.
- The potassium nintrate and nano-hydroxyapatite needs to be used on a daily basis to maintain the anti-sensitivity effect.
Last but not least, don’t forget to take some ibuprofen to help alleviate some of the pain. Traditional pain killers always work in reducing pain.