Reviewed by Dr. Samar Samuel, DDS, Park Falls Dental, Ukiah, CA.
The best toothpaste for sensitive teeth is not a brand. It is a short list of ingredients, and once you know what they are you can read any tube in the aisle and choose well. Sensitivity is the sharp, brief pain from cold, sweet, or a toothbrush that comes when the soft inner layer of a tooth, the dentin, is exposed and its microscopic channels carry the stimulus to the nerve. Sensitivity toothpastes work by blocking those channels or by calming the nerve at the other end. This guide from Park Falls Dental in Ukiah explains the ingredients that do that, how to use the toothpaste so it works, and when sensitivity is a sign of something a toothpaste will not fix.
Key Takeaways
- Look for potassium nitrate or stannous fluoride on the label; these are the two ingredients with the most evidence for reducing sensitivity.
- Any toothpaste you choose should contain fluoride and carry the ADA Seal of Acceptance.
- Avoid high abrasion whitening pastes, which wear enamel and exposed root surfaces and make sensitivity worse.
- Sensitivity toothpaste takes two to four weeks of twice daily use to work, and stops working if you stop using it.
- Sensitivity that is sudden, one sided, or lingers after the cold is gone needs an examination, not a new tube.
Why teeth become sensitive
Enamel covers the crown of a tooth and has no nerve supply, so a healthy tooth with intact enamel does not feel cold. Beneath it is dentin, which is porous, and beneath that the pulp with its nerve. When dentin is exposed, fluid in its tiny channels moves in response to cold, sweet, touch or air, and the nerve reads that movement as pain. The Cleveland Clinic lists the common reasons dentin becomes exposed: gum recession uncovering the root, which has no enamel at all; enamel worn thin by hard brushing, acidic food and drink, or grinding; a cracked or chipped tooth; decay; a worn or leaking filling; and the temporary sensitivity that follows whitening or a new filling. The American Dental Association makes the same point that the fix depends on the cause.
The ingredients that work
|
Ingredient |
How it reduces sensitivity |
What to know |
|---|---|---|
|
Potassium nitrate (5 percent) |
Calms the nerve so it stops responding to fluid movement |
The most common active; takes two to four weeks; works while you keep using it |
|
Stannous fluoride |
Forms a layer that plugs the open dentin channels; also fights decay and gum inflammation |
Faster relief for many people; can cause slight surface staining that a cleaning removes |
|
Arginine with calcium carbonate |
Plugs the channels with a mineral seal |
Found in some sensitivity pastes; good evidence in trials |
|
Calcium sodium phosphosilicate |
Deposits mineral into the channels and enamel surface |
Marketed under various names; plugs channels physically |
|
Strontium chloride or acetate |
Blocks the channels |
Older ingredient, less common now |
|
Sodium fluoride (standard fluoride) |
Strengthens enamel and slows decay; mild help with sensitivity |
Should be in every toothpaste regardless; the NIDCR explains why |
Any of the first four, in a fluoride toothpaste, is a reasonable choice. Potassium nitrate and stannous fluoride have the longest track record, and many pastes now combine a nerve calming ingredient with a channel blocking one. The ADA’s toothpaste guide explains what else is in a tube, and the ADA Seal of Acceptance on the box means the manufacturer’s sensitivity claim was reviewed against evidence rather than marketing.
What to avoid
Abrasion is the enemy of a sensitive tooth. Toothpastes are rated for how much they scour, and whitening pastes and some “deep clean” pastes sit at the high end; they polish stain off enamel by wearing a little of it away, and on an exposed root surface they wear dentin much faster. A sensitive patient using a whitening paste with a hard brush is doing the one thing that guarantees the problem gets worse. Choose a paste marked low abrasion or made for sensitivity, use a soft brush, and hold it lightly. Charcoal pastes are abrasive and rarely contain fluoride, and the ADA does not recommend them. Very acidic mouth rinses and constant sipping of sparkling water, sports drinks or citrus soften enamel and dentin; keep them to mealtimes and rinse with water afterward.
How to use it so it works
Sensitivity toothpaste is not a painkiller and does not act in one brushing. Use it twice a day, every day, in place of your regular paste. Brush for two minutes with a soft brush, angling the bristles at the gumline where roots are exposed, and after brushing spit but do not rinse, so the active ingredient stays on the teeth. Some patients also dab a little paste on a specific sensitive spot with a fingertip at night and leave it. Expect improvement in two to four weeks, and expect the sensitivity to creep back if you stop; the ingredients work by maintaining a block, not by repairing the tooth. Flossing daily and a professional cleaning every six months keep the gumline healthy, which stops recession advancing.
Reading a label in the aisle
Turn the box over and look for the drug facts panel, which every toothpaste sold in the United States with an anti sensitivity or anti cavity claim must carry. The active ingredients are listed first with their percentages: potassium nitrate at five percent, or stannous fluoride, or sodium fluoride, or a combination. If potassium nitrate or stannous fluoride is not there, the paste is not a sensitivity paste no matter what the front says. Then check for the ADA Seal on the front or side. Then check the inactive ingredients for the abrasive, usually hydrated silica or calcium carbonate; a paste marketed for sensitivity uses a gentler grade, while a whitening paste uses more of it. Flavor, foaming agent and sweetener make no difference to sensitivity and are a matter of taste.
When toothpaste is not the answer
A toothpaste treats the symptom of exposed dentin. It does not fix a cavity, a cracked tooth, a leaking filling or gum disease, and it does not stop grinding. See a dentist rather than trying a new tube if the sensitivity started suddenly, affects one tooth, lingers for more than a few seconds after the cold is gone, comes with pain on biting, or is accompanied by a visible chip, a dark spot or gums that bleed. Those point to a cause that needs treatment. For sensitivity that toothpaste helps but does not resolve, Park Falls Dental can apply a stronger fluoride varnish or a desensitizing agent in the office, bond over an exposed root, or, for extensive recession, refer for a gum graft. Sensitivity after whitening is expected and short lived, and using a potassium nitrate paste for two weeks before a whitening session reduces it. The practice’s general dentistry page covers the examinations that find the cause.
Park Falls Dental
Park Falls Dental has cared for Ukiah families for more than thirty years from its office at 1252 Airport Park Boulevard, Suite D-1, open Monday to Friday from 8:00 am to 5:00 pm. Dr. Samar Samuel, DDS, a Howard University graduate, joined the practice in 2016. The practice accepts Delta Dental, Ameritas and United Concordia and offers CareCredit financing; see the insurance page. New patients call 707-723-0974 or schedule online.
Frequently asked questions
What is the best toothpaste for sensitive teeth?
One that contains potassium nitrate or stannous fluoride, includes fluoride, is low abrasion, and carries the ADA Seal. Brand matters much less than those four things.
How long does sensitivity toothpaste take to work?
Two to four weeks of twice daily use for most people. Stannous fluoride pastes sometimes work faster.
Can I use whitening toothpaste if my teeth are sensitive?
It is best avoided. Most whitening pastes are abrasive and make sensitivity worse. Whiten under a dentist’s supervision instead, using a sensitivity paste beforehand.
Does sensitivity toothpaste repair enamel?
No. It blocks the channels in dentin or calms the nerve. Fluoride in the paste strengthens enamel, but worn enamel does not grow back.
Should I rinse after brushing with sensitivity toothpaste?
Spit, but do not rinse. Leaving a film of paste on the teeth gives the active ingredient more time to work.
Is stannous fluoride better than potassium nitrate?
They work differently and both have good evidence. Stannous fluoride also helps gums and decay; potassium nitrate is gentler on staining. Many people do well with either, and some pastes combine them.
Why are my teeth sensitive only to cold?
Cold moves the fluid in exposed dentin most sharply. Cold only sensitivity that fades quickly is usually exposed dentin; sensitivity to heat, or pain that lingers, can mean the nerve is inflamed and needs an examination.
Can gum recession be fixed?
Receded gum tissue does not grow back, but its progress can be stopped with gentle brushing and healthy gums, and a periodontist can graft tissue over exposed roots.
Are charcoal toothpastes good for sensitive teeth?
No. They are abrasive, usually lack fluoride, and the ADA does not recommend them.
When should I see a dentist about sensitive teeth?
If it started suddenly, affects one tooth, lingers after the trigger is gone, hurts on biting, or comes with a chip, dark spot or bleeding gums.
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Sensitive teeth that toothpaste is not fixing? Book an examination with Dr. Samar Samuel at Park Falls Dental, 1252 Airport Park Boulevard, Suite D-1, Ukiah, CA. New patients call 707-723-0974 or schedule an appointment.