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Desensitizing dentifrices
West NX, Sanz M, Lussi A, et al: Prevalence of dentine hypersensitivity and study of associated factors: A European population-based cross-sectional study. J Dent 41:841-851, 2013
Reprints available from NX West, Clinical Trials Unit, Dept of Oral and Dental Sciences, Univ of Bristol, UK; fax: þ44 117 3424404; e-mail: [email protected]; [email protected]
Desensitizing dentifrices Background.—Between 10% and 30% of most populations experience dentin hypersensitivity (DH). DH is caused by exposed patent, but otherwise clinically normal dentin and produces short sharp pain when exposed to stimuli such as hot or cold fluids or cold air. Gingival recession, attrition, and erosion are among the causes for the dentin exposure. The hydrodynamic theory of causation states that the pain of DH results when a trigger contacts open dentinal tubules and changes fluid movement within the tubules, which stimulate pulpal nerve impulses. Treatments to reduce DH pain have included the use of dentifrice formulations containing various substances. Among these formulations are 8% arginine and 1450 ppm sodium monofluorophosphate, 8% strontium acetate and 1040 ppm sodium fluoride, and a 30% microaggregation of zinc-carbonate hydroxyapatite nanocrystals (nano-CHA). The short-term efficacy of these three desensitizing dentifrices was measured. Methods.—The 85 individuals who completed the study were randomly assigned to group 1 (arginine), group 2 (strontium acetate), or group 3 (nano-CHA). All participants complained of DH on the facial surfaces of the teeth, but had good periodontal and physical health. They underwent scaling and polishing at least 7 days before beginning their participation and were instructed on correct brushing technique and instrument use. During the study, participants brushed their teeth twice a day for at least 1 minute and used no other dentifrice or desensitizing agent. Evaluations were carried out at baseline and after 3 days. Only teeth identified as hypersensitive were evaluated through tests including the air-blast test, cold water test, and tactile test. A 10-point visual analog scale (VAS) was used to document pain level, with 10 indicating excruciating pain or discomfort. In addition to the stimuli tests, participants were asked to personally rate their perceived sensitivity to hot or cold food and drink, air, tooth brushing, and sweet and sour food using the same 10-point scale. A subset of patients was followed for 8 weeks and retested. Results.—All participants had significant improvements in DH symptoms after 3 days compared to baseline values. The mean percentage of score reduction for all dentifrices, except the strontium acetate one, was more than 30% for all tests. In all but the subjective test, over half of
152
Dental Abstracts
the participants had a score reduction of at least one unit, representing a clinical response, and response rates for each dentifrice were around 80% for the air-blast and cold water tests. Among the subset of patients followed for 8 weeks, no significant differences were found for any test; all of the dentifrices were highly efficacious. A significant, but borderline, difference was noted between the nano-CHA dentifrice and the arginine dentifrice on the cold water test. The arginine dentifrice induced a significantly greater subjective improvement from baseline to day 3 compared to the strontium dentifrice. Patients using arginine and nano-CHA dentifrices had a significantly higher percentage of clinical responses than those using the strontium dentifrice. Discussion.—The levels of efficacy of these three dentifrices were comparable in the short term for the entire group and after 8 weeks in a smaller sample. The results are clinically relevant because home care with these agents achieved relief of DH pain within 3 days. The nano-CHA and arginine dentifrices were slightly better than the strontium dentifrice for cold-water stimulation.
Clinical Significance.—Patients having DH would be quite happy to achieve an 80% reduction in pain within 3 days of beginning use of a desensitizing dentifrice. The nano-CHA and arginine products were a bit better than the strontium agent in short-term tests, but no measurable differences were noted after 8 weeks.
Orsini G, Procaccini M, Manzoli L, et al: A 3-day randomized clinical trial to investigate the desensitizing properties of three dentifrices. J Periodontol 84:e65-e73, 2013 Reprints available from G Orsini, Dept of Clinical Sciences and Stomatology, Polytechnic Univ of Marche, Via Tronto 10, 60026 Ancona, Italy; fax: 39-071-2206221; e-mail: [email protected], [email protected]
Reprints available from NX West, Clinical Trials Unit, Dept of Oral and Dental Sciences, Univ of Bristol, UK; fax: þ44 117 3424404; e-mail: [email protected]; [email protected]
Desensitizing dentifrices Background.—Between 10% and 30% of most populations experience dentin hypersensitivity (DH). DH is caused by exposed patent, but otherwise clinically normal dentin and produces short sharp pain when exposed to stimuli such as hot or cold fluids or cold air. Gingival recession, attrition, and erosion are among the causes for the dentin exposure. The hydrodynamic theory of causation states that the pain of DH results when a trigger contacts open dentinal tubules and changes fluid movement within the tubules, which stimulate pulpal nerve impulses. Treatments to reduce DH pain have included the use of dentifrice formulations containing various substances. Among these formulations are 8% arginine and 1450 ppm sodium monofluorophosphate, 8% strontium acetate and 1040 ppm sodium fluoride, and a 30% microaggregation of zinc-carbonate hydroxyapatite nanocrystals (nano-CHA). The short-term efficacy of these three desensitizing dentifrices was measured. Methods.—The 85 individuals who completed the study were randomly assigned to group 1 (arginine), group 2 (strontium acetate), or group 3 (nano-CHA). All participants complained of DH on the facial surfaces of the teeth, but had good periodontal and physical health. They underwent scaling and polishing at least 7 days before beginning their participation and were instructed on correct brushing technique and instrument use. During the study, participants brushed their teeth twice a day for at least 1 minute and used no other dentifrice or desensitizing agent. Evaluations were carried out at baseline and after 3 days. Only teeth identified as hypersensitive were evaluated through tests including the air-blast test, cold water test, and tactile test. A 10-point visual analog scale (VAS) was used to document pain level, with 10 indicating excruciating pain or discomfort. In addition to the stimuli tests, participants were asked to personally rate their perceived sensitivity to hot or cold food and drink, air, tooth brushing, and sweet and sour food using the same 10-point scale. A subset of patients was followed for 8 weeks and retested. Results.—All participants had significant improvements in DH symptoms after 3 days compared to baseline values. The mean percentage of score reduction for all dentifrices, except the strontium acetate one, was more than 30% for all tests. In all but the subjective test, over half of
152
Dental Abstracts
the participants had a score reduction of at least one unit, representing a clinical response, and response rates for each dentifrice were around 80% for the air-blast and cold water tests. Among the subset of patients followed for 8 weeks, no significant differences were found for any test; all of the dentifrices were highly efficacious. A significant, but borderline, difference was noted between the nano-CHA dentifrice and the arginine dentifrice on the cold water test. The arginine dentifrice induced a significantly greater subjective improvement from baseline to day 3 compared to the strontium dentifrice. Patients using arginine and nano-CHA dentifrices had a significantly higher percentage of clinical responses than those using the strontium dentifrice. Discussion.—The levels of efficacy of these three dentifrices were comparable in the short term for the entire group and after 8 weeks in a smaller sample. The results are clinically relevant because home care with these agents achieved relief of DH pain within 3 days. The nano-CHA and arginine dentifrices were slightly better than the strontium dentifrice for cold-water stimulation.
Clinical Significance.—Patients having DH would be quite happy to achieve an 80% reduction in pain within 3 days of beginning use of a desensitizing dentifrice. The nano-CHA and arginine products were a bit better than the strontium agent in short-term tests, but no measurable differences were noted after 8 weeks.
Orsini G, Procaccini M, Manzoli L, et al: A 3-day randomized clinical trial to investigate the desensitizing properties of three dentifrices. J Periodontol 84:e65-e73, 2013 Reprints available from G Orsini, Dept of Clinical Sciences and Stomatology, Polytechnic Univ of Marche, Via Tronto 10, 60026 Ancona, Italy; fax: 39-071-2206221; e-mail: [email protected], [email protected]