The only way to seal exposed dentin at home is by using a desensitizing toothpaste that can occlude open dentinal tubules. Simply brush with said toothpaste for two minutes twice a day and it will cover up all of the tubules.
However not all toothpastes that desensitize teeth can elicit this effect because some of them work via a different mechanism. That means you do need to choose the right one if you want one that can specifically seal the exposed dentin.
It is beneficial for you to know how to do all of this at home because you can alleviate sensitive teeth from the comfort of your own home. Although a more permanent solution would be to have it treated by your dentist but of course that does cost more and is also not a home remedy.
Table of Contents:
How does dentin become exposed
The dentin is not supposed to be exposed because it is not the outermost layer of the tooth. That title belongs to the enamel which is meant to be a barrier that protects the inner contents of the tooth, dentin and pulp.
However if the enamel becomes missing, the dentin layer which is underneath will become exposed. Therefore what can cause it is whatever will make the enamel "disappear".
Causes for dentinal exposure:
Aggressive brushing. If you brush overzealously you can potentially abrade away the enamel or even cause the gums to recede. Both will result in dentinal exposure.
Hard toothbrush. Softer toothbrushes are very soft and gentle on your teeth and gums. They are not likely to cause any damage but a hard one can cause a lot of unintended consequences such as gum recession or enamel abrasions.
Acid erosion. If you eat too acidic foods, you can either erode away the enamel or dissolve the smear plugs which are natural dentin seals. Both will lead to sensitivity.
Missing restoration. If you've had a cavity before, a dental restoration would have been used to cover over and replace the missing tooth structure. If the restoration falls out, the dentin will be exposed. These restorations can be fillings, crowns, or veneers.
Grinding or clenching. If you are stressed out and suffer from grinding or clenching your teeth, you can potentially wear away your enamel in your sleep. Once the enamel is gone the dentin will be left open.
Desensitizing toothpastes can seal exposed dentin
Some desensitizing agents in sensitive toothpastes can seal exposed dentin, particularly the ones that work by occluding open dentinal tubules. The general mechanism via how they work is by forming a complex and then inserting itself into the orifices of the patent tubules. In other words, it uses itself as a plug to clog up all of the exposed orifices.
How to seal exposed dentin with desensitizing toothpaste:
Wet your mouth and toothbrush.
Apply sensitive toothpaste to toothbrush.
Brush for at least two minutes. Three minutes would be even more helpful.
Rinse out and avoid snacking as much as possible.
Repeat these steps after every meal if possible.
Benefits from sealing the dentin:
Decrease teeth sensitivity to cold, hot, sour, spicy, acidic and etc.
Eat and drink without discomfort.
No more pain from sucking in cold air.
Restore your teeth to how they should be.
Stannous fluoride
Stannous fluoride (SnF2) is the only type of fluoride that can occlude open dentinal tubules which makes it a good desensitizer. Technically it is not the fluoride which elicits this effect but the tin (Sn) which is used to stabilize it.
A study from the Journal of the American Dental Association, found that a stannous fluoride toothpaste occluded the tubules by forming a tin complex. This complex consisted of tin, zinc, phosphate, and silicon which are found in the mouth.
Essentially this tin complex inserted itself into all of the open orifices thus effectively sealing the tubules. The study also found that stannous fluoride occluded 82% of the open tubules vs the placebo's 35%. This also resulted in a decrease in dentin hypersensitivity.
Examples of SnF2 toothpastes:
Colgate total
Sensodyne rapid relief
Crest pro-health
We just want you to be aware that stannous fluoride toothpastes do cost more than other types of fluoride such as sodium fluoride and sodium monofluorophosphate. There is a price premium for it!
Hydroxyapatite
The synthetic enamel paste, nano-hydroxyapatite based toothpastes can occlude dentinal tubules since it is highly biocompatible and biomimetic. It has such an affinity because our enamel is made of 97% hydroxyapatite while the dentin has 70%.
Since it is the same exact substance, when you brush with this toothpaste it will literally insert itself into the exposed tubules. If you brush with enough of it and often enough, it will eventually seal off the openings and even form an extra layer over the tooth.
The schematic diagram above shows how the hydroxyapatite uses itself to form a plug to get rid of the tubules' patency. It does a wonderful job since it has a high affinity for tooth structure and is naturally attracted to it.
Examples of nano-hydroxyapatite toothpastes:
Twice oral wellness toothpaste
Wellnesse whitening toothpaste
Davids nano-hydroxyapatite toothpaste
Risewell mineral toothpaste
Boka Nano toothpaste
Bite fresh mint toothpaste bits
Dr Jen super paste
Arginine
Arginine based toothpastes can occlude dentinal tubules and decrease teeth sensitivity. In the SEM photographs below, you can see how the exposed tubular holes look significantly more closed after brushing with it.
We won't go too much into detail about this particular desensitizing agent because it is not commonly available in the US market. Colgate pro-relief which was an arginine toothpaste, used to be available for purchase in the US but has since been discontinued.
It was truly a shame because a lot of our patients had great results for it. The good news is that it is still available overseas such as in Europe and Asia but that makes it more difficult for those in the US since you have to get it shipped internationally.
Strontium chloride
Strontium chloride is the last dentinal occlusion desensitizing agent on our list. Studies have shown it to be effective in reducing sensitivity by clogging up all of the patent orifices.
Unfortunately we don't have many examples for this toothpaste since it isn't readily available in US toothpastes. The original 1961 sensodyne formulation did contain strontium chloride but they don't seem to use it any more. As of right now, sensodyne works by using stannous fluoride and potassium nitrate to desensitize teeth.
Desensitizer that does NOT seal dentinal tubules
Potassium nitrate is the odd ball desensitizer in toothpaste which does NOT seal exposed dentinal tubules. The way it reduces sensitivity is by depolarizing the nerve and rendering it unexcitable. It floods the nerve cells with potassium which distorts the concentration gradient, thus preventing an action potential from firing.
While studies have shown that it is effective in reducing sensitivity, unfortunately it does so by leaving the dentin exposed. In other words, it does not seal it nor occlude it. The patency of the tubules remain the same despite brushing with this toothpaste.
Is there an all natural way to do it?
There is technically an all natural way to seal up all of those exposed dentin and that is to consume a lot of foods with calcium oxalate in them.
nuts
peanuts
rhubarb
spinach
wheat bran
Spinach is particularly high in calcium oxalate and you've probably experienced it yourself when you ate a lot of it. Have you ever had "spinach teeth" which is that chalky gritty feeling that you get from eating a lot of spinach? That grittiness is actually the calcium oxalate forming a layer over your teeth, which effectively seals dentinal tubules.
Unfortunately this isn't the most practical solution because you can't be eating spinach every single day. You do need nutritional variety in your diet so that you don't become malnutritioned.
Another downside to having foods with too much calcium oxalate is the increase in risk of getting kidney stones. Therefore it is not recommended to try to do this by eating an obscene amount of spinach.
Calcium oxalate desensitizer
We're not sure if it was spinach teeth which inspired this but there is a professional desensitizing agent with oxalate in it. KoR whitening makes one and they call it the KoR complete desensitizer.
This solution is actually given out as part of their take home whitening kit. You're supposed to apply it on your teeth prior to whitening them every night. It helps to reduce the whitening sensitivity because it seals all of the exposed dentin thus preventing the bleaching gel from irritating your nerves.
The photo above shows the tubular occlusion when you use this oxalate based product. It literally forms a plug with calcium oxalate thus decreasing the tubular patency.
The safety data sheet (SDS) shown above for the KoR desensitizer is evidence that it is composed of oxalic acid. The point which we're trying to make is that it is very similar to eating spinach.
Limitations to sealing dentin with toothpaste
Despite the convenience of being able to occlude exposed dentin at home with mere toothpaste, it is not a permanent solution. All of these desensitizers will occlude the tubules but the effects are not permanent.
Whenever you eat low pH foods, it will slowly dissolve or dislodge these desensitizing agents. In other words, by the time you finish eating breakfast, lunch, and dinner your teeth will start to feel sensitive again.
In order to replenish the desensitizing effect you need to keep brushing with the sensitive toothpastes. As you brush, you will replenish all of the lost occlusion agents. Basically what happens throughout the day is that you seal the tubules in the morning when you brush. Then you start losing some of the effects throughout the day after every meal. Then at night time before you go to sleep you brush again to reseal them.
Therefore it is a constant battle to keep your teeth sensitivity free. What this also implies is that if you stopped using sensitive toothpastes, you will lose all of its effects. It only works while you're consistently brushing with it.
Last resort - Have your dentist do it for you
If you don't want to have to brush with sensitivity toothpastes for the rest of your life, you can seek out a more permanent solution with your dentist. There are multiple ways that your dentist can seal the exposed dentin for you.
Dental treatments to decrease dentin exposure:
Dental bonding. Bonding a tooth colored composite filling over the exposed parts can eliminate the symptoms. The longevity would be similar to that of other fillings.
Crowns or veneers. A less conservative treatment for sealing the dentin is by covering the entire tooth with porcelain. This can be in the form of a crown which covers the tooth 360 degrees or a veneer which covers its 180 degrees.
Gum grafting. The gum specialist (periodontist) can try to regrow some of your gums. This is effective for the receded gums that are causing the dentin to be exposed.
Night guard. This oral appliance that you wear at night doesn't get rid of exposed dentin but helps to prevent further formation of it. Teeth grinding can wear through the enamel and cause it to become exposed. The night guard will prevent that from happening.
All of these treatments do not need to be replenished on a daily basis unlike using toothpaste. Once you get it, it should last for a very long time. The only downside is that some of the treatments are more invasive and they do cost significantly more than toothpaste.
Takeaway
Exposed dentin can be successfully sealed at home by using a desensitizing toothpaste on a daily basis. They work because the desensitizers will insert themselves into the patent dentinal tubules thus sealing it off completely.
After using it for a while you'll notice a decrease in tooth sensitivity. You'll be able to return to eating all of the foods that you enjoy. The advantage is in its convenience and also its inexpensive pricing. The disadvantage is that it is not a permanent solution because you do have to continually use the product. Once you stop using it, it will stop working.
Dr David Chen likes to refer to sensitive toothpastes as a prison life time sentence because you basically have to use it for life! Once you start using it, you literally can't stop if you want to retain its benefits.
