Formulations of desensitizing toothpastes for dentin hypersensitivity: a scoping review

Abstract Objective: This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH). Methodology: In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815). Results: Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives. Conclusion: Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.

Giómeros fluidos en la eliminación de sensibilidad en molar permanente afectada con Hipomineralización Incisivo Molar (HIM). Reporte de caso / Fluid giomers in the elimination of sensitivity in permanent molar affected by Molar Incisor Hypomineralization (HIM). Case report

RESUMEN: El principal motivo de consulta de los pacientes afectados con hipomineralización incisivo molar grado B 3 II, según la Academia Europea de Odontología Pediátrica (EAPO) es la estética y sensibilidad, provocando dolor a los cambios térmicos y a la hora de realizar el cepillado dental, esto puede conllevar a una rápida progresión de caries dental, por disminuir el cepillado. En el presente caso se describe la reconstrucción y sellado de fosas profundas de la pieza 46 afectada con hipomineralización incisivo molar, mejorando la calidad de vida relacionada a la salud bucal del paciente y eliminando la sensibilidad en una sola cita.

ABSTRACT: The main reason for consultation of patients affected by molar incisor hypomineralization level B 3 II (EAPO) is aesthetics and sensitivity, causing pain with thermal changes, when consuming cold drinks and when brushing the teeth. This can lead to a rapid progression of tooth decay, by decreasing the brushing. In the present case, the reconstruction and sealing of deep pits of the tooth 46 affected by molar incisor hypomineralization are described, improving the quality of life related to the patient's oral health and eliminating sensitivity in a single appointment.

Factors associated with dentine hypersensitivity severity in Colombian dental patients / Factores asociados a la severidad de la hipersensibilidad dentinal en pacientes de odontología colombianos

Abstract: Introduction: the aim of this study was to determine the pre¬valence of dentine hypersensitivity (DH) and examine associated etiological factors related to the severity of DH in dental clinic patients treated at the School of Dentistry at Universidad Cooperativa de Colombia, Pasto, Colom¬bia. Materials and Methods: A cross-sectional study was designed in which three hundred and thirty three patients aged 15 to 44 years old were assessed for the presence and severity of DH. The dentine hypersensitivity diagnosis was based on self-reported sensitivity and a clinical examination. The ques¬tionnaire included socio-demographic information, data about oral health habits and acidic dietary intake. A descriptive analysis was performed and the association between DH severity and risk factors was determined using an ordinal logistic regression model. Results: Dentine hypersensitivity was detected in 88 out of 333 (26.4 percent) subjects (95 percent CI: 21.83-31.56). The pH of natural juices (OR=6.013; 95 percent CI: 0.995-36.319, p=0.051) and pH of alcohol beverages (OR= 7.800; 95 percent CI: 2.282-26.658, p=0.001) were signi¬ficantly associated with the severity of dentine hypersensitivity. Conclusions: The results indicated that the prevalence of dentine hypersensitivity in these patients was consistent with previous reports. Furthermore, the severity of DH was influenced by acidic diet. These results suggest that dental coun¬seling should be provided to all patients as well as to those with dentine hypersensitivity to prevent the occurrence of this oral health problem and the severity of symptoms.

Resumen: Introducción: el objetivo de este estudio fue determinar la prevalencia de hipersensibilidad dentina (HD) y examinar los factores etiológicos asociados relacionados a la severidad de la HD en pacientes de la clínica de la Facultad de Odontología de la Universidad Cooperativa de Colombia, Pasto, Colombia. Materiales y Métodos: Se diseñó un estudio transversal donde trescientos treinta y tres pacientes de edades entre 15-44 años de edad fueron evaluados para la presencia y severidad de HD. El diagnóstico de la hipersensibilidad dentinal fue basado en sensibilidad auto-reportada y un examen clínico. El cuestionario incluía información socio-demográfica, datos acerca de hábitos de salud oral e ingesta de dieta ácida. Un análisis descriptivo fue realizado y la asociación entre la severidad de la HD y los factores fue determinada usando un modelo de regresión logística ordinal. Resultados: La hipersensibilidad dentinal fue detectada en 88 de 333 (26,4 por ciento) sujetos (IC 95 por ciento: 21,83-31,56). El pH de los jugos naturales (OR=6,013; IC 95 por ciento: 0,995-36,319, p=0,051) y el pH de las bebidas alcohólicas (OR=7,800; IC 95 por ciento: 2,282- 26,658, p=0,001) fueron asociadas significativamente con la severidad de la hipersensibilidad dentinal. Conclusiones: Los resultados indican que la prevalencia de HD en estos pacientes fue concordante con previos reportes. Además, la severidad de la HD fue influenciada por la dieta acida. Estos resultados sugieren que el consejo odontológico debería ser provisto a todos los pacientes, al igual a aquellos con HD tanto para prevenir la ocurrencia de este problema de salud oral como la severidad de los síntomas.

Eficácia e sensibilidade dental resultante do clareamento dental de consultório com 6% H2O2/TiO_N. Estudo clínico randomizado controlado / Efficacy and tooth sensitivity resulting of 6% H2O2/TiO_N in office dental bleaching. A randomized controlled clinical trial

Este trabalho comparou a eficácia e a sensibilidade dental resultante do uso de um agente clareador composto por 6% peróxido de hidrogênio contendo nanopartículas de dióxido de titânio dopado por nitrogênio (PH6) com um clareador tradicional composto por 35% peróxido de hidrogênio (PH35); ambos fotocatalisados por luz híbrida composta de LED/Laser. Participaram deste estudo clínico controlado, randomizado, com triplo cegamento e amostras pareadas, 48 voluntários, maiores de 18 e menores de 28 anos, distribuídos aleatoriamente em 2 grupos experimentais: PH6 (teste) e PH35 (controle). Foram realizadas 2 sessões clínicas de clareamento com intervalo de 7 dias entre elas. Em cada sessão foram realizadas 2 aplicações consecutivas do clareador. Em cada uma delas, o gel clareador foi aplicado por 12 minutos, sendo fotocatalisado de forma intermitente por metade deste tempo. A eficácia (E) foi determinada pela variação de cor (ΔE), registrada por espectroscopia de refletância avaliada nos tempos T0 (baseline), após a 1ª. sessão de clareamento (T1) e após a 2ª. sessão (T2). A sensibilidade dental (S) foi caracterizada segundo Ocorrência (OS), Intensidade (IS), Tipo (TS) e Duração (DS). A eficácia foi analisada por ANOVA de medidas repetidas e teste post hoc de Bonferroni e a sensibilidade dental foi analisada de forma descritiva e 20 inferencial por meio do teste de Qui-Quadrado (α=0,05). Os testes apontaram valores de ΔE significativamente maiores para PH35 no T2. Para PH6, o clareamento foi o mesmo nos dois momentos. PH35 apresentou maior ocorrência de sensibilidade que PH6. Intensidade e duração da sensibilidade foram maiores para o grupo PH35. O tipo de sensibilidade mais citado pelos voluntários foi em choque. Em pacientes com idade entre 18 e 28 anos de idade, PH35 promoveu maior clareamento e maior sensibilidade dental que PH6. PH6 deve ser a opção de escolha para clareamento dental de consultório.

This study compared the efficacy and tooth sensitivity resulting from use of a bleaching agent composed of 6% hydrogen peroxide containing nanoparticles of nitrogen-doped titanium dioxide (PH6) with a traditional bleaching agent containing 35% hydrogen peroxide (PH35); both agents were activated by a hybrid LED/Laser light. 48 volunteers between 18 and 28 years of age participated in this randomized, controlled, triple-blinded clinical study with paired samples. They were randomly divided in 2 groups: PH6 (test) and PH35 (control). Two clinical sessions were performed with an interval of 7 days between them. In each session, two consecutive applications of the bleaching agent were performed. In each of them, the bleaching agent was applied for 12 minutes, activated intermittently for half of the duration. Efficacy (E) was determined by color alteration (ΔE), recorded with reflectance spectroscopy. It was assessed at T0 (baseline), after the 1st. bleaching session (T1) and after the 2nd. session (T2). Tooth sensitivity (S) was characterized according to Occurrence (OS), Intensity (IS), Type (TS) and Duration (DS). Efficacy was analyzed by repeated measures ANOVA and post hoc Bonferroni test and tooth sensitivity was analyzed descriptively and inferentially by means of chi-squared test (α=0.05). The tests showed significantly higher values of ΔE for PH35 in T2. For PH6, bleaching was the same in both sessions. PH35 showed a higher occurrence of sensitivity than PH6. Intensity and duration of sensitivity were greater for the PH35 group. The majority of volunteers classified the type of pain experienced in their sensitivity in the form of a "shock". For patients aged between 18 and 28 years old, PH35 promoted higher tooth bleaching and greater sensitivity than PH6. PH6 should be the option of choice for dental office bleaching

Root Dentine Sensitivity.

Background: Dentine hypersensitivity is one of the most painful, ubiquitous and least satisfactorily treated of all the chronic oral problems involving the teeth. Active Periodontal treatment appears to be one of the significant causes of hypersensitivity. Also, the role of plaque control in treatment of hypersensitivity is controversial. Thus the present study is aimed to study the degree to which a sample of patient developed Root Dentine Sensitivity (RDS) following nonsurgical periodontal treatment. Material & Methods: A total of 60 dental patients were evaluated for plaque scores and pain scoring using Scratch test and Air blast test. Visual Analogue Scale (VAS) was used for pain scoring. Oral hygiene instructions were given and non- surgical periodontal treatment was done quadrant wise over a period of 4 weeks. Results: The intensity of RDS given by VAS score and the percentage of teeth sensitive to both the test increased after scaling and root planing but gradually decreased when meticulous plaque control was maintained. Conclusion: Non- surgical periodontal treatment i.e. SRP and Oral hygiene maintenance may temporarily increase RDS, which reduces subsequently over a period of time with meticulous plaque control.

Sensibilidade dolorosa e efetividade do clareamento dental de consultório / Painful sensitivity and effectiveness determined by dental bleaching in- office

Vários aspectos da técnica de clareamento dental de consultório permanecem controversos. Neste trabalho foram estudadas a sensibilidade dolorosa e a efetividade determinadas por diferentes tratamentos clareadores. Participaram deste estudo 60 voluntários de ambos os gêneros, com idades variando de 18 a 25 anos que foram aleatoriamente distribuídos em 3 grupos. GI: peróxido de hidrogênio a 35% sem ativação por luz, GII: o mesmo peróxido ativado por dispositivo de luz conjugada LED/LASER e GIII: gel clareador a 15% contendo nanopartículas de óxido de titânio nitrogenado ativado por luz conjugada LED/LASER. A sensibilidade dos pacientes durante as sessões de clareamento foi avaliada utilizando uma escala VAS modificada. A alteração de cor determinada pelos protocolos de clareamento foi mensurada por espectroscopia de reflectância (Vita Easy Shade®,Vident, Brea, CA, USA). Os valores de ∆L (luminosidade), ∆E (variação de cor) e sensibilidade provocada pelos tratamentos (S) foram analisados por meio do método de equações de estimação generalizadas (GEE), comparações múltiplas ad Hoc de Bonferroni com significância de 5%. No estudo 1, realizado para avaliar a eficiência da utilização da luz conjugada LED/Laser, os voluntários de GI relataram maior freqüência e intensidade de sensibilidade provocada pelo tratamento clareador (37,6 ± 5,9% para GI contra 11,1 ± 3,3% de GII). O clareamento em GII foi mais eficiente que em GI (p>0,05). No estudo 2, a utilização do gel clareador H2O2 a 15% contendo TiO_N resultou em menor freqüência e intensidade de sensibilidade provocada que em GI (37,6 ± 6,1% para GI contra 11,9 ± 5,0% de GII) e maior eficiência de clareamento (p>0,05). Concluiu-se que o método de fototermo catalisação com luz conjugada LED/Laser utilizada em conjunto com agente clareadores do tipo processo oxidativo avançado homogêneo (POAHo), permite tanto a redução da sensibilidade provocada como do tempo de tratamento e que o agente de menor concentração reduz a sensibilidade provocada, aumentando a segurança do clareamento dental, com a mesma eficiência do agente tradicional

Several aspects of in-office dental bleaching remain controversial. In this study, we studied the painful sensitivity and effectiveness determined using different bleaching techniques. The study included 60 volunteers of both genres, with ages ranging from 18 to 25 years who were randomly divided into 3 groups. GI: hydrogen peroxide 35% without activation by light, GII: the same peroxide-activated device LED / Laser and GIII: 15% whitening gel containing nanoparticles of titanium oxide nitrogen activated by coupled light LED / Laser. The sensitivity of the patients during the bleaching treatments was evaluated using a modified VAS scale. The color change determined by the protocols of bleaching was measured by reflectance spectroscopy (Vita Easy Shade ®, Seer, Brea, CA, USA). The values of ΔL (brightness), ΔE (color variation) and sensitivity caused by the treatments (S) were analyzed by the method of generalized estimating equations (GEE), multiple comparisons with Bonferroni ad hoc 5% significance. In study 1, conducted to evaluate the efficacy of use of coupled light LED/Laser, GI volunteers reported a higher frequency and intensity of sensitivity caused by bleaching treatment (37.6 ± 5.9% for GI against 11.1 ± 3.3% of GII). The Bleaching was more efficient in GII than GI (p> 0.05). In study 2, the use of gel co 15% H2O2 containing TiO_N resulted in a lower frequency and intensity of sensitivity caused in GI (37.6 ± 6.1% for GI vs. 11.9 ± 5.0% of GII) and greater efficiency of bleaching (p> 0.05). It was concluded that the method of catalyzing photothermo reaction with coupled light LED/Laser used in conjunction with bleaching agent type homogenous advanced oxidation process (POAHo) allows both the reduction of sensitivity caused as time of treatment and the agent of lower concentration reduces sensitivity, increasing safety of tooth whitening, with the same efficiency as the traditional agent

The clinical evaluation of Nd:YAG laser in the treatment of dentine hypersensitivity / 实用口腔医学杂志

Objective: To investigate the effects of Nd:YAG laser in the treatment of dentine hypersensitivity. Methods:270 teeth in 153 patients were equally divided into two groups at random. The teeth in the experimental group were treated with Nd:YAG laser at 265.5 J/cm 2 (0.75 W and 10 Hz for 2 min) for 3 times with the interval of 1 week, those in the control group were treated with Gluma desensitizer for 3 times with the interval of 2 d. Results:The effective rate of the experimental and control groups was 92.59% and 49.62% respectively (P