The industrial strength fluoride treatment does actually help with sensitivity caused by receding gums. I had the treatment a month ago when I was at the dentist. They're using a new type -- it's swabbed onto the teeth and spreads over the teeth, then dries and, after about 30 minutes, falls off. It feels weird, but it's been helpful. And, my insurance covers it.
My dentist has never tried to upsell me on anything. She did mention that she thinks it would be a good thing for me to have two implants done to replace the two upper rear molars I'm missing, but she's not pressured me about it.
She also asked if I had a night guard (I'm a big teeth grinder). I said yes. She asked if my previous dentist (same practice, he retired last year) had done it. Told her no, I made my own via the OTC drug store route. That would have been a perfect opportunity for her to launch into a spiel about how a custom made, $3,000, dentist provided night guard is so much better, but she didn't. She just said to use it regularly (I do).