Teeth Sensitivity
Teeth Sensitivity
Teeth Sensitivity
Updated 8/5/23
I have not found a comprehensive list or review of chemicals for teeth sensitivity, so I am attempting to provide one here. This is needed because there are many ingredients that are effective for this condition and they all work differently. But labeling is often unclear and composition changes even for what appears to be the same product. As a result, sometimes you are using the same brand or product year to year, but a totally different active ingredient. Amazon and other retailers make this even worse with terrible descriptions and search engines. Availability and labeling is also different in every geography.
I would divide all these chemicals into three categories:
(1) Remineralizing products
(2) Tubule blocking products
(3) Numbing products
To summarize my findings, I would suggest using ALL of the following products:
Toothpastes:
-BioMin with Sodium Fluoride TUBULE BLOCKER. Non-whitening.
-Colgate Total Plaque Pro-Release with Zinc Arginine and Stannous Fluoride, Whitening. TUBULE BLOCKER (can substitute Colgate Sensitive Plus with Arginine Bicarbonate (non-whitening) to avoid Stannous Fluoride if concerned with staining)
-Dr. Jen’s Super Paste with Hydroxyapatite and Sodium Fluoride REMINERALIZER non-whitening
-Sensodyne with Potassium Nitrate (not with NovaMin, because BioMin is better for that purpose, though see below on whitening comments) and Sodium Fluoride, whitening NUMBING
Mouthwashes:
-Colgate Sensitive Pro Relief with Arginine and Sodium Fluoride TUBULE BLOCKER
-PerioMed with Stannous Flouride (but only if not concerned with staining) TUBULE BLOCKER
-Listerine Sensitive Advanced Defence with Dipotassium Oxalate Monohydrate and Sodium Fluoride TUBULE BLOCKER
-Dr. Brite Sensitivity Relief Mouthwash with Hydroxyapatite REMINERALIZING
-Sensodyne with Potassium Nitrate and Sodium Fluoride NUMBING
The designations in caps above represent the category of the main ingredient.
I do not know the effect of using multiple products at once. If you are concerned about that then maybe alternate every week or so. But I would always make sure a Sodium Fluoride product is in the mix.
Please provide any corrections or additions.
Disclaimer: I have no medical or dental training or training in biochemistry.
REMINERALIZING PRODUCTS
Sodium Fluoride
Description: The most common ingredient. Generally thought of as a cavity preventive, but also important for sensitivity. I am not totally clear on the biochemistry here, but Fluoride promotes “remineraliazation”.
Another description: “When administered at low topical doses, fluoride in both saliva and plaque and saliva prevent the demineralization of healthy tooth enamel while remineralizing teeth that have previously been demineralized. Sodium fluoride is absorbed by the surface of hydroxyapatite crystals on the teeth, which are necessary for mineralization. This renders the teeth more resistant to demineralization by changing the apatite crystal solubility. Sodium fluoride inhibits the demineralization of teeth in a pH-related manner.”
https://go.drugbank.com/drugs/DB09325#
Toothpaste and Mouthwash Products: Almost all toothpaste. Some mouthwashes. Just check ingredients to be sure and check the concentration level. Higher is better.
Note that Listerine does not have Fluoride. If you use Listerine, you should use it before brushing, not after.
Stannous Fluoride
Description: Similar to Sodium Flouride but also with an antibacterial effect. It works on sensitivity by forming a calcium barrier over the tooth. Seems generally better. It works faster and lasts longer. I am not clear on whether it should be considered a better version of Strontium Chloride or of Sodium Flouride, so I would never remove the latter from the mix. Stannous Flouride seems like a very good ingredient, but the problem is that it can stain teeth. The stains are not permanent and some manufacturers claim that newer formulations are less likely to stain. Some also have a whitening agent, which may counteract some of the staining effect.
Toothpaste Products: Crest Pro Health, Colgate Total, many others.
Mouthwash Products: PerioMed seems to be the most common. Not many major brands seem to have Stannous Flouride.
Hydroxyapatite
Description: Hydroxyapatite is naturally occurring in bone and teeth. Wikipedia explains this better than I can:
“Remineralisation of tooth enamel involves the reintroduction of mineral ions into demineralised enamel. Hydroxyapatite is the main mineral component of enamel in teeth. During demineralisation, calcium and phosphorus ions are drawn out from the hydroxyapatite. The mineral ions introduced during remineralisation restore the structure of the hydroxylapatite crystals. If fluoride ions are present during the remineralisation, through water fluoridation or the use of fluoride-containing toothpaste, the stronger and more acid-resistant fluorapatite crystals are formed instead of the hydroxylapatite crystals.”
Most of the products do not have Fluoride in them.
Toothpaste Products: ChatGPT (after some arguments and insults in both directions) tells me that these products have
Hydroxyapatite: Regenerate Enamel Science Advanced, Biorepair, Swissdent Extreme, ApaCare Repair.
But labeling (at least on Amazon) sucks. So I am not clear on whether ChatGPT is right.
I am more confident in these products:
-Boka Natural: https://tinyurl.com/29uc2mfz
-Sangi Apagard: https://tinyurl.com/3xkmz6jp
-David’s: https://tinyurl.com/5n6c823z
Those do not have Fluoride in them, unfortunately.
But this one has both Flouride and Hydroxyapatite: Dr. Jens Super Paste: https://tinyurl.com/3ks4sevv
Mouthwash Products: The only one I have found is Dr. Brite Sensitivity Relief Mouthwash. It does not have Fluoride. It does have Xylitol, which seems to be effective in preventing cavities.
TUBULE BLOCKING PRODUCTS
Strontium Chloride
Description: This was the original ingredient in Sensodyne (which Sensodyne has never made clear) but now seems very hard to find. Note that Strontium Acetate seems similar, or maybe a newer formula. Strontium Chloride works by blocking the tubules in the tooth that lead to the nerves. This is effective because the chemical is similar to calcium at a molecular level. I cannot find much information on Strontium Chloride staining. This is a good description of the biochemistry:
https://go.drugbank.com/drugs/DB13987
Toothpaste and Mouthwash Products: this is the only toothpaste I can find anywhere, and maybe a few other countries that do not ship to the US. No mouthwash.
https://www.sensodyne-me.com/en_AE/products/original-toothpaste.html
NovaMin
Description: NovaMin is a “bio-active glass” that was introduced in Europe about 15 years ago and then eventually to the US. “NovaMin consists of calcium sodium phosphosilicate which is the active ingredient that enables it to bind to the surface of the tooth to initiate the process of remineralization on the enamel. This occurs instantly on contact with saliva.” This sounds a little weird but it appears to be solid science.
Toothpaste Products: Fairly common but again you have to check the ingredients. SOME Sensodyne contains this instead of Potassium Nitrate, as usual with unclear labeling. I think NovaMin is more common in Sensodyne in Europe, while in the US and Canada they tend to use Potassium Nitrate. But both ingredients are available in both geographies.
Mouthwash Products: I cannot find any mouthwash with NovaMin.
Biomin
Description: BioMin is similar to NovaMin in being a bio-active glass that blocks tubules. This is what BioMin states as the difference between the two: “BioMin benefits from a larger proportion (approx. 50%) of particles that can enter the open tubule compared to NovaMin®’s approx 13%. BioMin’s smaller particles also deliver additional consumer benefits including a smoother ‘less gritty’ texture and a less abrasive toothpaste which reduces enamel wear.” They also link to various studies. BioMin is a newer product, and I cannot find a response from NovaMin. This leads me to the conclusion that BioMin is more effective. The only relative drawback with BioMin is that it is easier to find NovaMin formulations that are whitening, which I do not think BioMin has.
Toothpaste Products: I think only BioMin branded products. Dr. Collins appears to be a related brand name. Note that some of these (especially in the US) do not have Flouride in them, but some do.
https://www.ebay.com/itm/134610789673
Mouthwash Products: None that I can find.
Arginine and Zinc Arginine
Description: Arginine creates a plug in the tubules that lead to nerves. Not really clear how, but presumably by mimicking calcium at a molecular level like some of the other ingredients. Arginine seems well-reviewed by studies and it’s also natural body chemical. And yet there are not many products available. And…of course…they are badly labeled.
Zinc Arginine seems to be similar, but I cannot find any information on the difference between them. But generally when an article discusses Zinc Arginine it also highlights an antibacterial effect in the mouth. This effect seems well-supported by studies. Another formulation is Arginine Bicarbonate, which is often paired with Calcium Bicarbonate. Calcium Bicarbonate is supposed to increase hardness in teeth.
Toothpaste Products: Colgate Total Plaque Pro-Release. Widely available. But make sure it is exactly this product because, once again, labeling is unclear. Some of the “Total” products have Arginine and some do not.
Note that this product also has Stannous Flouride and Zinc. It does not have the toxic Triclosan that was in the original formula and pulled from shelves about ten years ago. Again….no change in label or advertising. Thanks guys.
Tom’s of Maine has a product but it does not have any Fluoride in it. The Arginine is in the form of Arginine Bicarbonate, a different formulation. It also has Xylitol and Calcium Carbonate, both of which seem to be effective in preventing cavities.
https://www.tomsofmaine.com/products/oral-care/rapid-relief-sensitive-toothpaste
Colgate Sensitive Plus also has Arginine Bicarbonate, which they call “PRO-ARGIN technology. It also has Calcium Carbonate and Fluoride too in the form of Sodium Monofluorophosphate.
https://www.colgate.com/en-in/products/toothpaste/colgate-sensitive-plus
Mouthwash Products: I have only found Colgate Sensitive Pro-Relief mouthwash, with Flouride. As usual, the labeling sucks. Here is Colgate’s (terrible) description of the product.
https://www.colgate.com/en-ca/products/mouthwash/colgate-sensitive-pro-relief-mouthwash#whereToBuy
Dipotassium Oxalate Monohydrate (DOM)
Description: This is another chemical that works by blocking tubules. Here is Listerine’s description: “This uniquely formulated tooth sensitivity mouthwash begins working immediately to help shield and protect sensitive areas of teeth. Its Crystal Block™ Technology works differently than most sensitivity toothpastes by physically blocking tooth sensitivity at its source.”
Toothpaste Products: None that I can find.
Mouthwash Products: Listerine Sensitive, which does not have Flouride unfortunately.
Listerine Sensitive Advanced Defence, which does have Flouride. This one specifies 1.4% DOM and the first one doesn’t say. Based on the spelling, I think this one is UK only, but Amazon US has it.
NUMBING PRODUCTS
Potassium Nitrate
Description: Potassium Nitrate seems to be the most common product marketed specifically for sensitivity. It is often found in Sensodyne and from what I can tell was the ingredient the first time they changed their formula (without telling anyone or properly labeling). It works by desensitizing nerve fibers. I think of this more as an anesthetic than even a temporary cure. https://go.drugbank.com/drugs/DB11090#
Though I have also seen credible sources that seem to allude to Potassium Nitrate’s tubule blocking properties. So honestly I am not sure. https://www.thejcdp.com/doi/JCDP/pdf/10.5005/jp-journals-10024-2754
Toothpaste Products: Lots of them, including Sensodyne. But you have to check the ingredients because they really try to obscure them without changing the label or marketing.
Mouthwash Products: The only one I can find is Sensodyne Mouthwash. It also has Sodium Fluoride.
Notes:
-It is possible to have too much Fluoride, so if you end up using all the active ingredients, maybe sub in some that do not have Fluoride.
-Amine Fluoride seems to have some effectiveness for sensitivity, but I have not included it above because information is very thin. Elmex has a version in Europe that has it.
-Potassium citrate is apparently an effective ingredient, but I have not found any products that contain it.
-I have seen reference to Regenerate Advanced Foaming Mouthwash as being effective at rebuilding enamel. But I cannot find any credible sources for this
-This is a pretty good source
https://www.dentaly.org/us/oral-hygiene/best-mouthwash/sensitive-mouthwash/