Objectives <p>To evaluate and compare the 12-month clinical effectiveness of a surface pre-reacted glass-ionomer (S-PRG)–based resin varnish and a bioactive glass–based air-polishing system in the management of dentin hypersensitivity and their effects on tooth color.</p> Methods <p>This randomized clinical trial included 34 participants diagnosed with dentin hypersensitivity. Participants were randomly allocated (1:1) to receive either an S-PRG–based varnish or a bioactive glass–based air-polishing treatment. The primary outcome was pain intensity measured using the Visual Analog Scale (VAS), while the secondary outcome was tooth color change. Pain intensity was assessed in response to tactile, evaporative, and thermal stimuli using a 0–10 VAS. Tooth color change was evaluated using modified United States Public Health Service (USPHS) criteria. Assessments were performed at baseline, immediately post-treatment, and after 1, 6, and 12 months. Parametric VAS data were analyzed using independent t-tests for intergroup comparisons and repeated-measures ANOVA for intragroup comparisons. Categorical data were analyzed using the Mann–Whitney U test for intergroup comparisons and the Friedman test for intragroup comparisons. Statistical significance was set at <i>P</i> ≤ 0.05.</p> Results <p>The S-PRG–based resin varnish group demonstrated significantly lower VAS scores than the bioactive glass-based air-polishing system group immediately after treatment and throughout follow-up (<i>P</i> &lt; 0.05). At 12 months, the bioactive glass–based air-polishing system group showed a significant relapse in pain scores, whereas the S-PRG–based resin varnish group maintained sustained pain reduction across all stimuli (<i>P</i> &lt; 0.001). Immediately after treatment, the S-PRG–based resin varnish group exhibited temporary tooth color change, while no immediate color alteration was observed in the bioactive glass–based air polishing group. No significant differences in tooth color were seen between groups at 1, 6, or 12 months.</p> Conclusions <p>S-PRG–based resin varnish demonstrated greater sustained reduction in dentin hypersensitivity over the 12-month follow-up period compared with the bioactive glass–based air-polishing system and may represent a promising option for moderate-term symptom control.</p> Trial registration <p><a href="https://clinicaltrials.gov/">https://clinicaltrials.gov/</a>, NCT05981625, Registered 31 July 2023.</p>