Does dentine hypersensitivity increase after scaling, and how is it managed?

Dentin hypersensitivity (DH) is a recognised consequence of non-surgical periodontal therapy, including scaling and root planing (SRP), which exposes dentinal tubules through removal of deposits and disruption of the smear layer ^[1][2]. All desensitizing treatment modalities tested post-SRP have shown meaningful reductions in sensitivity compared to untreated controls ^[1][2].

For in-office management after SRP, several agents have demonstrated efficacy. Bioactive glass (BAG), Nd:YAG laser, fluoride varnish, bioactive ceramic solution, universal self-etching adhesive, and PRG filler-based varnish have all been shown to reduce DH scores over follow-up periods of up to 8 weeks ^[2][3]. When BAG and Nd:YAG laser were combined in sequence, with BAG applied before laser irradiation, the most pronounced and sustained reduction in VAS scores was observed across the study period ^[2].

For home-use management, agents including arginine, casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), Novamin, potassium nitrate, propolis, and strontium chloride-containing toothpastes have all shown statistically significant improvements compared to baseline ^[4][5]. CPP-ACP demonstrated the greatest reduction in DH symptoms by week 8 across multiple measurement scales ^[5].

A consensus panel has emphasised that a structured clinical decision tree, moving from diagnosis through staged treatment selection to prognosis, should guide management of DH, with elimination of etiological causes as the first step before applying desensitizing therapies ^[6][7]. The overall certainty of evidence supporting specific agents post-SRP remains low to very low, so clinical judgement remains essential when selecting a protocol ^[1].