Self-applied treatments in the management of dentine hypersensitivity

A summary of the research on the different self-applied treatments for hypersensitive dentine provides some support for several agents but invalidates others. This is true for toothpastes, mouthwashes and gels. Direct comparison of studies is difficult because the materials and methods used are different. In addition, the size of patient groups, and methods of stimulation and assessment of the evoked pain reaction are different. Therefore our concept of the efficacy of self-applied treatment is not so much based on a homogeneous pool of data, but rather on a collection of individual studies. If we subtract from these data sets those based on obviously older ways of evaluating efficacy, we are left with surprisingly few studies that properly assess the efficacy of compounds suited to self-applied treatment. Therefore, guidelines should be established for testing such compounds, and publication of the data sets should depend on proper use of such designs. Stimuli, design and pain assessment should be standardized. In addition, patient recruitment could be defined better in relation to criteria for inclusion. Another area of concern is the pretreatment history of the hypersensitive teeth, because some teeth will become hypersensitive during the observation period, whilst others, which were hypersensitive, will spontaneously become insensitive. Therefore one should know the rate of spontaneous change in tooth sensitivity levels in each patient, in order not to assign treatment effects to teeth that would have lost their sensitivity anyway.