Historic review of the management of tooth hypersensitivity

For well over a century, there has been cognizance that sensitivity is a serious problem, that it arises when the dentin and cementum are exposed, that fluid movement within the dentinal tubules acts as a provocative stimulus, that tubules can be sealed off (apparently in most instances) without damage to the tooth or the dental pulp, and that the problem can also be at least partially resolved by suppressing nerve firing within the pulp. Most of the therapies proposed to date for treatment rely on one of two major suppressive mechanisms, that is, sealing off the dentinal tubules or dampening neural impulses, even though at the time of their development and use they have been mostly empiric in nature. At present, there appear to be a number of effective therapies, although admittedly none meet all of the hypothetic requirements proposed by Grossman over 50 years ago. Included among the agents with reasonable documentation of effectiveness and little in the way of negatives are fluorides, strontium chloride, potassium nitrate, potassium oxalate, sodium citrate, surface sealing agents (varnishes, resins, cyanoacrylate), calcium hydroxide, and others. There are many dedicated workers who are still concerned with achieving better insight into the problem and methods to resolve it.