Data sharing practices in collaborative human genomic research in low- and middle-income countries: A systematic review protocol.

INTRODUCTION: The practice of creating large databases has become increasingly common by combining research participants' data into larger repositories. Funders now require that data sharing be considered in newly funded research project, unless there are justifiable reasons not to do so. Access to genomic data brings along a host of ethical concerns as well as fairness and equity in the conduct of collaborative research between researchers from high- income and low-and middle-income countries. MATERIALS AND METHODS: This systematic review protocol will be developed in line with PRISMA -guidelines which refers to Open Science Framework, registered in PROSPERO (https://www.crd.york.ac.uk/prospero/) record CRD42022297984 and published in a peer reviewed journal. Data sources will include PubMed, google scholar, EMBASE, Web of science and MEDLINE. Both published and grey literature will be searched. Subject matter experts including bioethicists, principal investigators of genomic research projects and research administrators will be contacted. After de-duplication, titles and abstracts will be screened for eligibility. Data extraction will be undertaken using a piloted form designed in EPPI-Reviewer software before conducting risk of bias assessments by a pair of reviewers, acting independently. Any discrepancies will be resolved by consensus. Analysis will be done using a structured narrative synthesis and where feasible metanalysis. This review will attempt to highlight the context of data sharing practices in the global North-South and South-South collaborative human genomic research in low- and middle-income countries. This review will enhance the body of evidence on ethical, legal and social implications of data sharing in international collaborative genomic research setting criteria for data sharing. The full report will be shared with relevant stakeholders including universities, civil society, funders, and departments of genomic research to ensure an adequate reach in low-and middle-income countries (LMICs).

Oral healthcare provision at long-term care facilities in eThekwini: Perspectives of coordinators.

BACKGROUND: The prevalence and impact of oral disease among long-term institutionalised residents highlight the need for a scale-up of preventive and promotional oral health services that include oral health education and training for caregiving staff. However, opportunities to improve oral healthcare services are met with challenges. AIM: This study was undertaken to establish coordinator perspectives on oral health provision. SETTING: Seven long-term care facilities in the eThekwini district, South Africa. METHODS: An in-depth exploratory study was conducted with 14 purposively selected coordinators (managers and nurses). Semi-structured interviews were conducted and focused on coordinators' experience and perspectives on oral healthcare. Data were analysed using thematic analysis. RESULTS: The following themes emerged from the study: A lack of comprehensive oral health care practices, inadequate support from the dental sector, insufficient oral health prioritisation, limited funding for oral health, and challenges associated with coronavirus disease (COVID-19). All respondents reported that no oral health initiatives existed. Plans for oral health training workshops presented with coordination and funding challenges. Oral health screening initiatives have ceased since COVID-19. CONCLUSION: The study findings indicated that prioritisation of oral health services was inadequate. There is a need for continual oral health in-service training for caregivers and support from coordinators in guiding the implementation of oral health training programmes.Contribution: It is envisaged that the findings of this study will bring about greater coordinator involvement and collaboration with the public and private dental sectors to improve oral healthcare at long-term care facilities.

Caregivers' knowledge, attitudes, and oral health practices at long-term care facilities in KwaZulu-Natal.

Background: Vulnerable individuals residing at long-term care facilities require special oral health consideration. Examining concepts of oral health and hygiene practices of caregivers becomes essential for understanding the quality of oral health services provided to residents. Aim: This study explored the oral health-related knowledge, attitudes and practices (KAP) of caregivers. Setting: Long-term care facilities in the eThekwini District, KwaZulu-Natal. Methods: A cross-sectional study was conducted at seven long-term care facilities among 188 caregivers who completed a self-administered questionnaire. Data were collated and analysed using the Statistical Package for the Social Sciences (SPSS) version 24. Inferential techniques included an analysis of variance (ANOVA) test. A p-value ≤ 0.05 was considered to be statistically significant. Results: Participants reported that dentures do not to be cleaned (n = 139; 73.9%). Participants (n = 70; 37.2%) reported that some medications have oral side effects. Most participants (n = 173; 92%) were optimistic about improving their oral health knowledge and skills. Participants (n = 108; 57.4%) only reported flossing when they had food trapped between their teeth. Few participants (n = 30; 16%) reported visiting the dentist every 6 months. Conclusion: Participants had a positive attitude to improve their oral health-related knowledge and practices. However, the study showed that there is a need to scale-up oral health education and training activities for caregivers. Contribution: It is envisaged that findings of this study will demonstrate the importance of oral health-related knowledge among caregivers in providing better oral health care through improved attitudes and practices.

Research-Related Stakeholders' Perspectives on Sociocultural Considerations in Biobanking Practice in South Africa.

Background: Biobanking practice continues to proliferate in South Africa, yet little is known about how stakeholders engage with social, cultural, and religious considerations in this area of research. This study was undertaken to establish the perspectives of South African stakeholders (researchers, biobankers, clinicians, and research committee members) on sociocultural considerations in biobanking research. Methods: This in-depth exploratory study used semistructured face-to-face or Skype interviews with 25 purposively selected stakeholders involved in the biobanking-related practice. The study sample comprised biobankers, clinicians, researchers, postgraduate students in biobanking research, and research ethics committee members in South Africa. The interview focused on social and cultural challenges facing the biobanking practice in the country. Further probes included stakeholder perspectives on ownership and custodianship of stored biosamples. Thematic analysis was used to analyze the collected data. Results and Discussion: Several themes arose from the data analysis. These included respondents' perceptions of poor understanding of biobanking among research participants and communities; inconsistency in defining ownership and custodianship of biosamples; variability in respondents' understanding of cultural, religious, and social implications of biobanking; the notion of distrust; and building trust in biobanking. There were also inconsistencies in respondents' recognition of social, cultural, and/or religious influences on participant decision-making in biobanking research. Respondents highlighted that a general climate of distrust existed in the biobanking practice in South Africa. Conclusion: There is a need for greater stakeholder awareness of sociocultural considerations in biobanking practice in South Africa. One possible way to achieve this could be through the availability of training programs aimed at improving stakeholder understanding of the sociocultural context for biobanking practice in addition to greater efforts at community engagement with respect to all biobanking activities and research.

Public healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use in Pietermaritzburg, KwaZulu-Natal.

Background: There is limited published evidence on health workers' perspectives on trends in oral antibiotic prescription for dental conditions in the public health sector. Aim: This study set to determine healthcare practitioners' knowledge, attitudes and practices related to oral antibiotic prescriptions for dental use. Setting: This included two public hospitals in Pietermaritzburg. Methods: This was a cross-sectional study using quantitative data. Purposive sampling was used to select medical and dental practitioners from Institution A and B (n = 122). A self-administered questionnaire was developed using open and close-ended questions. Data were collected and analysed using the Statistical Package for Social Sciences (IBM SPSS version 25R). Results: The response rate for the study was 72.1%. The majority of study participants (n = 72, 81.8%) indicated awareness of an antibiotic stewardship programme in their respective institutions. However, a significant number (n = 42; 47.7%) of participants were unsure of whether this programme was active. Most participants (n = 80, 90.9%) indicated the need for improving oral antibiotic prescription for dental conditions. Participants indicated prescription of antibiotics for orofacial swellings (n = 52; 59.0%) and dental pain related to irreversible pulpitis (n = 29; 32.9%), reversible pulpitis (n = 33; 37.5%) and dental fillings (n = 15; 17.0%). Antibiotics were also prescribed for pericoronitis (n = 58; 65.9%), periodontitis (n = 57; 64.7%) and impacted teeth (n = 21; 23.8%). All dental practitioners (n = 14) supported the need for antibiotic cover for pericoronitis and periodontitis. Conclusion: The results indicated inconsistencies in healthcare practitioners' reported knowledge, attitudes and practices related to antibiotic prescription patterns. Contribution: This study highlights the need for clear evidence-based guidelines for antibiotic prescription for dental conditions.

Self-Directed Learning During the COVID-19 Pandemic: Perspectives of South African Final-Year Health Professions Students.

PURPOSE: Self-directed learning (SDL) has been advocated for effective training of final-year health professions students. COVID-19 challenges conventional teaching, learning, and assessment in the clinical environment. This study aimed to identify and explore enablers and barriers to SDL among final-year health professions students training during the COVID-19 pandemic. METHODS: Adopting the SWOT (strengths, weaknesses, opportunities and threats) framework, this study explored the clinical learning and training experiences of final-year health professions students during the pandemic. A survey was conducted via online platforms. Data from 155 respondents were thematically analyzed. RESULTS: Personal attributes such as reflection, self-determination, motivation, resilience, and positive learning behaviors and skills were identified as SDL enablers. Collaborative learning networks and online learning platforms facilitate learning needs and goals. Fear and anxiety, untrusted learning sites, uncertainty about graduation, financial issues and challenges in the learning environments were the major themes related to barriers to SDL. CONCLUSION: The importance of SDL as a skill for uncertain times warrants further investigation in the training of future healthcare professionals. Inclusive planning and engagement with final-year health professions students to address identified stressors, as well as the creation of shared platforms where students are part of the decision-making processes for clinical learning and training are recommended. Responsive curricula that optimize unpredictable disruptions in clinical training are needed to equip students to diagnose their own learning needs and implement appropriate learning strategies.

Challenges to biobanking in LMICs during COVID-19: time to reconceptualise research ethics guidance for pandemics and public health emergencies?

Biobanking can promote valuable health research that may lead to significant societal benefits. However, collecting, storing and sharing human samples and data for research purposes present numerous ethical challenges. These challenges are exacerbated when the biobanking efforts aim to facilitate research on public health emergencies and include the sharing of samples and data between low/middle-income countries (LMICs) and high-income countries (HICs). In this article, we explore ethical challenges for COVID-19 biobanking, offering examples from two past infectious disease outbreaks in LMICs where biobanking activities contributed to the perpetuation of global inequities. We focus on how the ethical imperative to promote the common good during public health emergencies can conflict with protecting the interests of biobank participants. We discuss how conducting biobank research under a waiver of informed consent during public health emergencies is ethically permissible, provided guidance is in place to prevent biopiracy and exploitation of vulnerable communities. We also highlight the need for biobank collaborations between LMICs and HICs to promote capacity building and benefit sharing. Finally, we offer guidance to promote the ethical oversight of biobanks and biobank research during the COVID-19 pandemic or other future public health emergencies.

Online Training as a Means to Improve the Understanding of Ethical, Legal, and Social Aspects of Biobanking Research: Stakeholder Perspectives from South Africa.

Introduction: The proliferation of biobanking activities demand a review of current training opportunities for service providers and researchers, specifically related to the ethical, legal, and social issues (ELSI) of biobanking research. Such information could be useful for planning and developing an educational course. However, it is equally important to explore the platform for offering such a course. Aim and Objectives: This study explored stakeholder perspectives on training needs in biobanking research and the use of an online training platform for such educational purposes. Methods: An exploratory study design using qualitative data was used. The study sample comprised selected stakeholders (n = 25) including biobankers, clinicians, researchers, postgraduate students, and research ethics committee members. Semi-structured in-person or Skype interviews were conducted and all ethical considerations were upheld. The interview focused on participants' perspectives on the accessibility and applicability of current available courses, and advantages and disadvantages of online biobanking courses. Data were analyzed using thematic analysis. Results and Discussion: The following themes arose from data analysis: inadequate availability of online courses, and advantages and disadvantages of online courses and opportunities for a successful training course. There was general consensus regarding the limited availability of context-specific training opportunities on the ELSI of biobanking. The majority of participants were previously self-taught and therefore relied on existing literature and collaborations with international biobanking groups for ongoing learning. Some respondents indicated that the costs of such available training courses were exorbitant. Some respondents also felt that available courses were not tailored to the specific needs of a diverse audience in biobanking. Apart from access, respondents reported possible challenges with internet connectivity and availability of data. Conclusion: Respondents expressed a need for affordable and focused online educational opportunities in biobanking, but highlighted that these courses need to be contextualized and integrated into other learning activities.

Stakeholder perspectives on the ethico-legal dimensions of biobanking in South Africa.

BACKGROUND: Biobanking provides exciting opportunities for research on stored biospecimens. However, these opportunities to advance medical science are fraught with challenges including ethical and legal dilemmas. This study was undertaken to establish perspectives of South African stakeholders on the ethico-legal dimensions of biobanking. METHODS: An in-depth exploratory study was conducted with 25 purposively selected biobankers, clinicians, researchers, postgraduate students in biobanking research, and research ethics committee (REC) members in South Africa. Potential study participants were recruited through known hubs for biobanking in the country, online searches and the snowball sampling technique. A semi-structured face-to-face or Skype interview was arranged. Data was analysed using thematic analysis. RESULTS: The emergent themes included: inconsistency in understanding consent models, disconnect between biobank researchers and biosample donors, inadequate processes to support re-consenting minors, inconsistent governance processes for biobanking research; challenges with sample and data sharing, and suboptimal strategies for benefit sharing and return of results. Biobanking practice in general appeared to be inconsistent and fragmented. While the need for consent in research is explicitly outlined in legislative documents, some respondents were unclear on the type of consent model to apply in biosample collection. They also reported inconsistencies in research participants' understanding of consent. Furthermore, these respondents' own understanding of consent and consent models were dependent on where they were positioned in biobanking practice (roles occupied). Respondents were unsure about the process to follow to re-consent child participants once the age of majority (≥ 18 years) was reached. It was not surprising that consent was identified as one of the major ethical challenges in biobanking practice. In certain settings, some respondents reported suboptimal governance processes for sample collection. Participants were generally unsure about how to operationalise benefit sharing and how to approach the idea of returning results to research participants and biobank donors. CONCLUSION: The study findings indicated inconsistencies in stakeholder understanding of ethico-legal considerations related to biobanking in South Africa. A need for ongoing ethics capacity development among stakeholders was identified. Improving understanding of the ethics of biobanking could be facilitated by acknowledging the disconnect created by biosamples in the relationship between biobank researchers and donors.

Evaluating the Abrasivity of a Nanosized Eggshell-Titanium Dioxide on Tooth Enamel Using Atomic Force Microscopy.

OBJECTIVES: This study aimed to evaluate nanosized eggshell-titanium dioxide (EB@TiO2) abrasiveness in comparison with calcium carbonate and hydrated silica-containing toothpaste. MATERIAL AND METHODS: Thirty-five bovine tooth enamels were prepared, and specimens randomly assigned to a sample group of five (n = 7), namely, Colgate regular, Colgate pro-relief, Sensodyne rapid relief, Sensodyne repair, and EB@TiO2. Half of the enamel surface was brushed with each respective sample group, while the other half was covered with a tap. STATISTICAL ANALYSIS: The mean roughness value (Ra) of the brushed and covered halves were measured using an atomic force microscope (AFM). To assess the surface morphology and changes, a scanning electron microscope (SEM) was performed. Using pair sample test and ANOVA, the Ra for the entire specimens were analyzed. A Bonferroni correction was used to identify the mean differences among the five groups (α=.05). RESULTS: The findings from this analysis show that all the tested toothpaste abraded the enamel significantly (p < 0.05). The abrasive value contained in toothpaste comprising calcium carbonate was lower than the silica toothpaste hydrated. CONCLUSION: Overall, Colgate regular had the lowest toothpaste abrasivity, followed by EB@TiO2, while Sensodyne rapid relief had the most enamel wear. The prominent feature of this study suggests that EB@TiO2 is suitable for oral use, as its abrasivity is comparable with calcium carbonate-containing toothpaste.

A Dental Communication Board as an Oral Care Tool for Children with Autism Spectrum Disorder.

Children with autism spectrum disorder (ASD) sometimes display an inability for information sharing through functional verbal communication. This may interfere with professional oral care. These children tend to process visual information more efficiently than auditory information. Picture schedules can briefly suffice as visual cues serving a vital function in helping children with ASD to function in a particular setting such as an oral care environment. A visual communication implement such as a dental communication board was developed in this study to allow for a facilitated communication process between the patient with ASD and the oral care professional. This study entailed two main phases, namely the selection of symbols for the construction of a dental communication board and the small scale testing of the board in a clinical setting. This study incorporated a combination of a quantitative non-experimental descriptive survey combined with a concurrent mixed method survey design which retrieved data for both close-ended and open-ended questions from the same respondent. A quantitative survey questionnaire at a structured dental seminar presentation was employed for the first phase, and a combination of a quantitative and qualitative questionnaire was employed for the second phase of this study. Documented responses were collated and analyzed using frequency and thematic analysis. The most frequently selected symbols were retrieved after a frequency analysis and displayed on a color coded background to distinguish the various categories on the dental communication board. The thematic analysis resulted in the emergence of three main themes, namely the strengths of the board; weakness of the board and suggestions. This study anticipates the incorporation of a dental communication board as a visual mode using graphic symbols to augment expressive and receptive language in an oral care environment to facilitate professional oral care for children with ASD.

The Application of the Logistic Equation Model to Predict the Remineralization Characteristics of Desensitizing Paste.

OBJECTIVES: A mathematical model making using of the Verhulst logistic equation was developed to predict the remineralization behaviors of desensitizing paste. METHODS: The input parameter used for the model was obtained experimentally by brushing twenty-one simulated dentin specimens for seven days with three sample groups, namely, EB@TiO2, Colgate Pro-relief, and Sensodyne repair (n = 7). A field emission scanning electron microscope (FESEM) and ImageJ software were used to observe and measure the % occluded ratio of the dentin surface. The model fittings for the three sample groups were carried out using the built-in MATLAB least-squares fitting routine fmincon in the optimization toolbox. RESULTS: The results suggest that the experimental parameter were in agreement with the model. It was found that the logistic equation model can make a future prediction of the remineralization pattern for EB@TiO2 and Colgate Pro-relief. It was, however, found that the trajectory for the Sensodyne repair was a bit complex, thus making the prediction difficult. CONCLUSIONS: Overall, the salient feature of this study suggests that the logistic equation could be used to predict the remineralization behavior of desensitizing paste in the management of sensitive tooth.

Remineralization Potential of a Modified Eggshell-Titanium Composite-Scanning Electron Microscope Study.

OBJECTIVES: This article reports the remineralization potential of a modified eggshell-titanium dioxide (EB-TiO2) composite in the management of DH. MATERIALS AND METHODS: The prepared composite was further characterized using different techniques such as Fourier-transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), transmission electron microscopy (TEM), and field scanning electron microscopy (FSEM) to establish the modification. Forty freshly extracted bovine anterior teeth were used to evaluate the dentin tubule remineralization potential of EB-TiO2. Each tooth was sectioned mesiodistally to obtain dentin blocks. The dentin blocks were subsequently agitated in 4% wt. citric acid for 2 minutes to simulate sensitive tooth. Each dentin block was randomly assigned to five groups, namely Group 1: untreated, Group 2: EB alone, Group 3: EB-TiO2 treated, and Group 4: Colgate Sensitive, and Group 5: Sensodyne treated (n = 8) that were then subjected to remineralization protocol. RESULTS: Both the XRD and FTIR images confirm the surface medication of EB-TiO2. The TEM revealed a nonhomogeneous structure with an average particle size of 65 nm. FSEM further was used to observe the remineralization capabilities of the samples. The FSEM image of the dentin specimens treated with EB-TiO2 shows complete remineralization of the dentin tubules, which remain intact postacidic exposure. CONCLUSIONS: This study confirmed that EB-TiO2 composite effectively remineralizes dentin tubules. More so, the composite could be a cheaper and more efficient therapy material in the management of DH.

Corrigendum to "An In Situ Evaluation of the Protective Effect of Nano Eggshell/Titanium Dioxide against Erosive Acids".

[This corrects the article DOI: 10.1155/2018/4216415.].

A novel application of nano eggshell/titanium dioxide composite on occluding dentine tubules: an in vitro study.

To synthesize Nano eggshell-titanium-dioxide (EB@TiO2) biocomposite and to evaluate its effectiveness in occluding opened dentine tubules. EB@TiO2 was synthesized and characterized using X-ray diffraction (XRD), and Transmission Electron Microscope (TEM). Sixteen simulated bovine dentine discs were prepared and randomly assigned into four groups according to the following treatment (n = 4): Group 1: No treatment; Group 2: eggshell powder; Group 3: EB@TiO2; Group 4: Sensodyne. These were then agitated in a solution of 1g powder and 40mL water for 3hours. Thereafter, each dentine discs from the respective groups were post-treated for 5 min with 2wt% citric acid to test their acid resistant characteristics. Scanning Electron Microscope (SEM) was used to observe the effectiveness of occluded dentine pre-and post-treatment. The cytotoxicity of the synthesized EB@TiO2 was tested using NIH 3T3 assay. ANOVA was used to evaluate the mean values of the occluded area ratio and the data of MTS assay. This was followed by a multi-comparison test with Bonferroni correction (α = .05). The XRD confirmed that EB@TiO2 was successfully modified through ball-milling. The TEM revealed the presence of both spherical and irregular particle shape powders. The SEM result showed that EB@TiO2 could effectively occlude open dentine tubules. Equally, the result demonstrated that EB@TiO2 exhibited the highest acid resistant stability post-treatment. NIH 3T3 assay identified that EB@TiO2 had little effect on the NIH 3T3 cell line even at the highest concentration of 100µg/ml. This study suggests that the application of EB@TiO2 effectively occluded dentine tubules and the occlusion showed a high acid resistant stability.

Evaluating the buffering and acid-resistant properties of eggshell-titanium dioxide composite against erosive acids.

OBJECTIVE:: This paper reports on the buffering and acid-resistant properties of a modified eggshell-titanium composite against citric acid attack. MATERIALS AND METHODS:: Eggshell-titanium EB-TiO2 was prepared by ball-milling eggshell powder and titanium dioxide. Fourier Transform Infrared Spectroscopy (FTIR), X-ray Diffraction (XRD), and Transmission Electron Microscopy (TEM) were used to characterize EB-TiO2. The buffering property against citric acid at pH values of 2, 4, and 5 was measured using a pH meter. Five brands of toothpaste (Colgate, Colgate Sensitive, Aquafresh, Oralwise, and Sensodyne) were used to assess the acid-resistant properties of EB-TiO2. Enamel models were simulated by dissolving each brand of toothpaste with eggshell (control) and EB-TiO2. The samples were exposed to citric acid of pH 2. The average slope (kPa/s) was measured using a pressure sensor. An analysis of variance was used to analyze the kPa/s values (α =.05). RESULTS:: The FTIR and XRD analyses suggest the surface modification of EB-TiO2. The TEM image revealed spherical-shaped particles in EB-TiO2. The pH test results showed that the buffering properties of eggshell and EB-TiO2 were comparable. Significant differences were observed in the acid resistance properties of the samples exposed to citric acids ( P < .05). The Colgate toothpaste infused with eggshell powder had the highest mean kPa/s values, whereas Sensodyne infused with EB-TiO2 had the lowest kPa/s values. CONCLUSION:: The salient features of this study indicate that modification of eggshell with titanium dioxide does not affect its carbonate buffering properties. Connecting the kPa/s values to acid-resistant properties, EB-TiO2 effectively reduces erosive attacks when added to toothpaste.

A conceptual framework to guide public oral health planning in Limpopo province.

BACKGROUND: There is limited understanding of the complexities surrounding public oral health service delivery in South Africa and the resulting impact on oral health outcomes. AIM: This study aimed to identify the strengths and challenges in oral health decision-making within the public health sector and to propose a conceptual framework to guide oral health service delivery in the province. SETTING: This study was performed in the Limpopo province. METHODS: National and provincial health policy documents were reviewed to identify statements on oral health service delivery. A face-to-face, semi-structured interview was conducted with the Limpopo Provincial Manager of Department of Health, Oral Health Services. Data were collected on oral health policies and the organisational structure of public oral health services. A self-administered questionnaire was completed by five district managers of public oral health services to obtain data on the delivery of public oral health services in Limpopo province. RESULTS: The results indicated that oral healthcare was not explicitly mentioned, included or referred to in the examined health policy documents. The interviews indicated that public oral health services do not have a dedicated budget and were not considered a priority. The questionnaire results revealed challenges in infrastructure, human resources and perceived marginalisation from the healthcare services. Participants agreed that there was a need for oral health to be clearly expressed and prioritised in health policy statements. CONCLUSION: This study proposed a framework that incorporated the identified core components that influenced oral health services provision in Limpopo province.

Evaluation of the Occluding Characteristics of Nanosized Eggshell/Titanium Dioxide with or without Saliva.

OBJECTIVES: The study reports on the effectiveness of a ball-milled nanosized titanium dioxide composite (EB@TiO2) for DH management in comparison with commercial desensitizing paste with and without saliva. MATERIALS AND METHODS: Forty-nine dentine specimens were prepared from extracted bovine anterior teeth. Twenty-one of the specimens were brushed with three desensitizing toothpaste for 7 days, namely: Group 1; EB@TiO2, Group 2; Colgate Pro-relief; and Group 3; Sensodyne repair (n = 7). Twenty-four specimens were brushed with the toothpaste for 7 days and stored in artificial saliva (control) after brushing. Each specimen was subsequently posttreated in citric acid solution to test its stability in acidic condition. Field scanning electron microscope was used to evaluate the effectiveness of the dentine tubules occlusion. The biocompatibility of the composite was tested using BHK21 cell line. STATISTICAL ANALYSIS: One-way analysis of variance was used to analyze the percentage occluded area ratio values for all specimens (α = 0.05). Independent t-test was further used to evaluate the occlusion differences with saliva and without saliva. RESULTS AND CONCLUSIONS: The number of dentine tubules decreased significantly after 7 days of brushing. Overall, the occlusion observe for EB@TiO2 were significantly better than for Colgate Pro-relief and Sensodyne repair (p < 0.05). BHK21 assay suggested that composite had no significant effect on the BHK21 cell line. This study demonstrated that the composite effectively occluded open dentine tubules within 7 days of brushing.