Increased Fluorohydroxyapatite across Dentin after Fluoride Iontophoresis.

Due to the multiple factors contributing to dentin demineralization and hypersensitivity among individuals, the effectiveness of the available treatments in the long term remains unclear. A recent study reported a simple strategy to potentially mimic natural remineralization with increased crystallization on the enamel caries using fluoride iontophoresis. Such an effect is also ideal for accomplishing dentin biomineralization and structural strength. This study aimed to investigate structural and compositional characteristics and permeability changes after fluoride iontophoresis with different polarities, cathodal iontophoresis (CIP), anodal iontophoresis (AIP), and the control without iontophoresis for the treatment of etched dentin under simulated pulpal pressure. The 24 premolars were divided into 3 groups: CIP, AIP, and topical application of 5% sodium fluoride (NaF) for 40 s. Relative to before treatment, iontophoresis with both polarities significantly decreased the permeability with a visible increase in occluding tubules containing crystal formation and growth throughout the dentin structure and depth. The CIP not only restored the etched dentin surface into a sound condition but also reinforced the dentin across the structure and depth by the synergistic effects of remineralization, increasing crystal formation and transformation toward the more crystalline structure of fluorohydroxyapatite. Following topical treatment, X-ray diffraction analysis and Raman spectra revealed a significant reduction in the crystal size and crystallinity associated with the raised B-type carbonate substitution into the hydroxyapatite compared with that in the sound dentin. The result was the first to reveal the ideal strategy to rapidly restore the etched dentin surface into a sound condition, including reinforcing the dentin across the structure and depth by the synergistic effects of decreasing permeability, increasing crystal formation, and transformation toward the more crystalline structure of fluorohydroxyapatite using the 5% NaF applied with the DC cathode iontophoresis. The technique is noninvasive and simple and deserves further development for clinical application.

Postoperative instructions for silver diamine fluoride therapy: A scoping review of current evidence and practice.

OBJECTIVES: Silver diamine fluoride (SDF) has gained popularity in dentistry as an anti-hypersensitive and anti-caries agent. This study aims to review the postoperative instructions for SDF therapy and examine the evidence supporting these instructions in treating dentine hypersensitivity and caries control. DATA AND SOURCES: Two independent reviewers searched three electronic databases (EMBASE, PubMed, and Web of Science) to identify clinical studies that used SDF to treat dentine hypersensitivity and dental caries. Additionally, they searched Google Chrome for information from manufacturers, the department of health, national dental organisations, authoritative dental organisations, and universities regarding SDF therapy for these conditions. Data on postoperative instructions were extracted, and their impact on the treatment of dentine hypersensitivity and caries control was investigated. STUDY SELECTION: This review included 74 clinical studies, 11 sets of instructions from SDF manufacturers, and six recommendations from national dental organisations, departments of health and universities. Amongst the included records, 50 clinical studies, two manufacturers, and one department of health mentioned postoperative instructions for SDF therapy. The recommendations varied, from suggesting no specific instructions, immediate rinsing, refraining from eating or drinking for 30 to 60 min, and even avoiding brushing until the next day after SDF therapy. Notably, no clinical studies reported the effects of these postoperative instructions on the SDF treatment of dentine hypersensitivity or dental caries. CONCLUSIONS: This scoping review highlights the presence of inconsistent postoperative instructions for SDF therapy in the treatment of dentine hypersensitivity and caries control. Furthermore, there is a lack of evidence supporting the effectiveness of these instructions. CLINICAL SIGNIFICANCE: No evidence supports the postoperative instructions for SDF therapy for managing dentine hypersensitivity and dental caries. Studies are necessary to provide guidance for clinicians using SDF in their clinical practice.

Clinical evidence for silver diamine fluoride to reduce dentine hypersensitivity: A systematic review.

OBJECTIVE: To assess the clinical evidence for silver diamine fluoride (SDF) to reduce dentine hypersensitivity in adults. METHODS: Two independent researchers searched the English literature in five databases (Scopus, PubMed, Web of Science, EMBASE and the Cochrane Library) up to 15th July 2023 for clinical trials investigating the desensitising effect of professionally applied SDF to manage dentine hypersensitivity in adults aged 18 or above at any follow-up period. The primary outcome was the change in dentine hypersensitivity between baseline and follow-up visits after SDF application regarding any validated pain outcome measures. The Cochrane guidelines were used for the risk of bias assessment. RESULTS: Three hundred and thirty-one studies were identified, and four of them were finally included. Three of the included studies were rated as having a 'low risk' of bias. The SDF solution reduced dentine hypersensitivity in adults. The percentage reduction in dentine hypersensitivity ranged from 23 % to 56 % after a single application of SDF solution. Moreover, the SDF solution was more effective than potassium nitrate, potassium oxalate and glutaraldehyde plus hydroxyethyl methacrylate in reducing dentine hypersensitivity. Meta-analysis indicated a more significant reduction in visual analogue scales (1-10) by 1.35 (95 % CI:0.9-1.8; p<0.00001) after receiving the SDF application than controls. CONCLUSION: The included clinical trials showed that SDF solution reduced dentine hypersensitivity in adults. However, clinical trials are few, and their protocol varied from one another. Further well-designed clinical trials should be conducted to provide more evidence on its use to manage dentine hypersensitivity. CLINICAL SIGNIFICANCE: SDF is cleared as desensitizing agents by the US Food and Drug Administration to manage dentine hypersensitivity, which induces pain, limits food choice, and impacts the quality of life. Evidence from this systematic review informs clinicians and provides researchers insight for future research on SDF use for dentine hypersensitivity. THE INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS (PROSPERO) REGISTRATION NUMBER: CRD42023462613.

Molar-Incisor Hypomineralisation: Severity, caries and hypersensitivity.

OBJECTIVES: To investigate distribution of affected teeth and severity of molar-incisor hypomineralisation (MIH) in 8-9-year-old children. A second aim was to study association between severity of MIH and hypersensitivity, caries, and affection of incisors and second primary molars (SPM). METHODS: A total of 3013 children in one age cohort participated in a cross-sectional study, of which 851 children were diagnosed with MIH. A majority of these children were re-examined and MIH diagnosis based on the European Academy of Paediatric Dentistry criteria was confirmed in 538 children. The re-examinations were undertaken at the local clinics by one calibrated dentist. Data were tested with bivariate logistic regression analysis. Results were reported using frequencies, proportions, odds ratios (OR) and confidence intervals (CI). RESULTS: Almost half of the children with MIH (46.8 %) had at least one severely affected molar. Incisors were affected in 51.9 % of children with MIH, and the prevalence was higher in children with severe affection (57.4 %, p < 0.01). Among children with MIH, second primary molars were affected in 29.6 %, hypersensitivity in at least one first permanent molar was reported by 25.8 and 30.8 % had caries extending to dentine. Children classified with severe MIH were more likely to suffer from hypersensitivity (OR 5.62, 95 % CI 3.61-8.74) and dentine caries (OR 10.32, 95 % CI 6.46-16.50) than children with mild MIH. CONCLUSION: Prevalence of hypomineralised incisors and SPM were high in the studied children with MIH. Children with severe MIH had higher probability of incisor affection, dentin caries and hypersensitivity. CLINICAL SIGNIFICANCE: This study highlights the importance of understanding the association between MIH, caries and hypersensitivity, especially in children with severe MIH. These children need extensive and individualized care in the dental services to prevent caries and pain.

In-depth occlusion of dentine tubules via the application of (poly-L-aspartic acid)­strontium and phosphate/fluoride to treat dentine hypersensitivity.

Dentine hypersensitivity (DH) is a common oral health issue and occlusion of the exposed dentinal tubules (DTs) is regarded as the most effective therapeutic treatment nowadays. However, it is still difficult to develop easy and effective strategies for deep occlusion of DTs. In this study, we develop a strategy for occluding DTs deeply and compactly via simple application of occlusion media including (poly-L-aspartic acid)­strontium (PAsp­strontium) and phosphate/fluoride. The bonding of strontium ions to poly-L-aspartic acid formed a positively charged PAsp­strontium complexes. After application of 15 min each, the PAsp­strontium and phosphate/fluoride rapidly penetrated into the DTs in turn via the electrostatic interaction, then occluded the DTs with crystals up to a depth of 150 µm. The occlusion within DTs was resistant to abrasive and acidic challenges. The occlusion media performed better than commercial desensitizers Duraphat and Gluma. Moreover, this strategy possessed sufficient biocompatible and excellent performance in vivo. The application of occlusion media would shed light on in the management of DH.

Why don't dental teams routinely discuss dentine hypersensitivity during consultations? A qualitative study informed by the Theoretical Domains Framework.

AIM: Although dentine hypersensitivity is widespread, can cause substantial pain and impact quality of life, it is not routinely discussed during dental consultations. This qualitative study aimed to develop an understanding of the barriers and facilitators to these discussions. MATERIALS AND METHODS: Using the Theoretical Domains Framework to shape the topic guide, N = 7 online focus groups were organized with a total N = 40 participants comprising experienced dentists, dental foundation trainees and dental care professionals. Inductive and deductive thematic analyses of the anonymized, transcribed focus group conversations were undertaken. RESULTS: An attitude-behaviour gap was observed in dental teams' accounts. Although they saw it as part of their professional role to routinely discuss sensitivity, and believed that such conversations were 'an easy win', in practice they experienced several behavioural barriers that hindered these conversations from taking place. These included competing priorities, a perceived lack of seriousness and assessment of dentine hypersensitivity and practical issues such as time. CONCLUSIONS: Systemic (e.g., lack of time and training, professional culture) and behavioural (e.g., dental teams' belief that conversations should take place only with patients likely to be adherent) barriers to dentine hypersensitivity conversations explain why these conversations do not routinely take place.

Effect of Commercially Available Nano-Hydroxyapatite Containing Desensitizing Toothpaste and Mouthwash on Dentinal Tubular Occlusion: A SEM Analysis.

The aim of this in vitro study was to evaluate and compare the dentinal tubule occlusion using nano-hydroxyapatite (n-HAP) containing toothpaste and mouthwash under a scanning electron microscope. The specimens were randomly divided into two groups with five specimens each: group 1-toothpaste group and group 2-mouthwash group. The percentage of the occluded dentinal tubules was assessed at the baseline, 7th, 14th, 21st, and 28th days under a scanning electron microscope. The toothpaste group showed a higher percentage of occluded dentinal tubules as compared to the mouthwash group at the 7th, 14th, 21st, and 28th days, respectively. It can be concluded that brushing twice daily with n-HAP containing toothpaste for duration of 28 days produced good dentinal tubule occlusion.

The prevalence and predictive factors of dentine hypersensitivity among adults in Turkey.

AIM: This study sought to determine the prevalence of dentine hypersensitivity (DH) among adults in Turkey. Also, to ascertain the association between DH and both etiological predictors and demographic patient characteristics. MATERIAL METHOD: Using a questionnaire and thermal and evaporative tests, 259 women and 209 men in the age range of 18 to 72 were analyzed. Individually, a clinical evaluation of DH signs was conducted. The DMFT index, gingival index, and gingival bleeding were reported for each subject. The gingival recession and tooth wear of sensitive teeth were also evaluated. Pearson Chi-square test was used to compare categorical data. Logistic Regression Analysis was used to examine the risk factors of DH. Data with dependent categorical variables were compared using the McNemar-Browker test. The significance level was p < 0.05. RESULTS: The average age of the population was 35.6 years. In the present study, a total of 12,048 teeth were analyzed. 1755 had thermal hypersensitivity (14.57%), while 470 experienced evaporative hypersensitivity (3.9%). The incisors were the teeth most impacted by DH, whereas the molars were the least affected. Exposure to cold air and sweet foods, gingival recession, and the presence of noncarious cervical lesions were all strongly linked to DH (Logistic regression analysis, p < 0.05). The cold stimulus increases sensitivity more than the evaporation stimulus. CONCLUSION: Significant risk factors for both thermal and evaporative DH include cold air, consumption of sweet food, presence of noncarious cervical lesions, and gingival recession. More epidemiological research in this area is still required to fully characterize the risk factors and implement the most effective preventive interventions.

Efficacy of a toothpaste containing paeonol, potassium nitrate, and strontium chloride on dentine hypersensitivity: A double-blind randomized controlled trial in Chinese adults.

Objective: The purpose of this randomized controlled trial was to compare the efficacy of a toothpaste containing paeonol, potassium nitrate, and strontium chloride with control toothpaste on dentine hypersensitivity (DH). Methods: DH patients who had at least two sensitive teeth and did not use desensitization toothpaste in the past 3 months were randomly allocated to either test or control group. The toothpaste containing paeonol, potassium nitrate, and strontium chloride was used in the test group, while the placebo toothpaste used in control group. The outcome measures included Yeaple probe score and Schiff Index score at 4 and 8 weeks. The patients, personnel and assessors were blinded to the allocation. The differences in Yeaple probe score and Schiff Index score between groups were analyzed with ANOVA. Results: 91 eligible subjects were randomized. 88 of them completed 8-week follow-up and were analyzed (45 in the test group and 43 in the control group). In both groups, the Yeaple probe score showed an upward trend, while the Schiff sensitivity score showed a downward trend. At week 8, the Yeaple probe score had increased by 30.22 g in the test group, and the Schiff Index score had decreased by 0.89. Compared with the control group, the Yeaple probe score in the test group increased by 286.85% from baseline, and the Schiff Index score decreased by 42.96%, showing a statistically significant difference. Five cases of adverse events were observed. Conclusion: The toothpaste containing paeonol, potassium nitrate, and strontium chloride was effective against DH. Clinical significance: This combination of paeonol, potassium nitrate and strontium chloride could be a novel functional ingredient choice for anti-hypersensitivity products in future. Registration: The trial was registered in the Chinese Clinical Trial Registry (ChiCTR2000041417).

Occlusion of dentinal tubules on periodontally involved teeth by dentifrice containing stannous fluoride and sodium fluoride.

PURPOSE: This study examined the occlusion effect of a dentifrice containing stannous fluoride (SnF2) and sodium fluoride (NaF) on periodontally involved teeth in comparison with healthy teeth using scanning electron microscopy (SEM) in comparison with a dentifrice containing NaF alone. METHODS: Sixty dentine samples obtained from single-rooted premolars, 15 of them extracted for orthodontic reasons (Group H) and 15 because of periodontal destruction (Group P), were included in the study. Each group of specimens was further divided into subgroups: HC and PC (control), H1 and P1 (treated with SnF2 and NaF), and H2 and P2 (treated with NaF). The samples were brushed twice a day for 7 days, kept in artificial saliva, and examined by SEM. The diameters of open tubules and the numbers of tubules were assessed at ×2,000 magnification. RESULTS: The H and P groups showed similar diameters of open tubules. The numbers of open tubules in Groups H1, P1, H2, and P2 were significantly lower than in Groups HC and PC (P < 0.001), and consistent with the percentages of occluded tubules. Group P1 had the highest percentage of occluded tubules. CONCLUSIONS: Although both dentifrices were found to successfully occlude dentinal tubules, the dentifrice containing SnF2 and NaF provided the highest degree of occlusion in periodontally involved teeth.

Efficacy of 810 nm and 650 nm Diode Laser Alone and in Combination With Sodium Fluoride Gel in Treating Dentin Hypersensitivity: A Split-Mouth Randomized Clinical Study.

Introduction Dentin hypersensitivity has been defined as a short, sharp pain caused by exposing naked dentin to external stimuli such as evaporation, heat, cold, osmotic liquids, and tactile effects. None of the available treatments has been considered the gold standard in treating dentin hypersensitivity. The use of laser has recently become more popular, and it is a promising treatment method in this field. The study aimed to compare the effectiveness of both 810 nm and 650 nm diode lasers in treating dentin hypersensitivity. Materials and methods This study was conducted on six patients who were referred to the Department of Oral Medicine, Faculty of Dental Medicine, Damascus University (4 females and 2 males) with 108 teeth suffering from generalized dentin hypersensitivity and were randomly divided into two groups. Group 1 consisted of three patients with 50 teeth treated with an 810 nm diode laser; it was divided by the split-mouth design into two subgroups. The first subgroup was treated by the application of the laser alone toward the target area with 1-watt power, continuous mode, and a total application time of 90 seconds, and the second subgroup was treated by applying sodium fluoride gel for one minute, then the laser was applied with the same settings as the first subgroup. Group 2 consisted of three patients with 58 teeth treated with a 650 nm diode laser; it was divided by the split-mouth design into two subgroups. The first subgroup was treated by the application of the laser alone toward the target area with 200 m watt power, continuous mode, and a total application time of 120 seconds, and the second subgroup was treated by applying sodium fluoride gel for one minute and then applying the laser with the same settings as the first subgroup. The pain was evaluated using a numeric rating scale (NRS) of 100 degrees before and immediately after treatment, and then after three to six and nine months by applying an air stream from a dental chair syringe at a distance of 0.5 cm from the target area. Results This study showed that both types of lasers were effective in treating pain caused by dentinal hypersensitivity. The average values ​​of pain reduction on the NRS showed the superiority of the 810 nm diode laser over the 650 nm after treatment and at all time points of pain assessment. No statistically significant differences were detected between applying laser alone and applying it combined with sodium fluoride gel in pain reduction values. Conclusions The application of an 810 nm diode laser either alone or in combination with sodium fluoride gel in treating dentin hypersensitivity is effective and better than the application of a 650 nm diode laser either alone or in combination with sodium fluoride gel. In addition, applying a 650 nm diode laser either alone or in combination with sodium fluoride gel has slight effectiveness in treating dentine hypersensitivity, and it is believed that a single treatment session with a 650 nm diode laser was not enough to obtain the required pain reduction.

Comparative efficacy of self-administered dentifrices for the management of dentine hypersensitivity - A systematic review and network meta-analysis.

OBJECTIVES: This systematic review with network meta-analysis synthesises available randomised controlled trials evidence concerning efficacy of self-administered dentifrices for management of dentine hypersensitivity (DH) pain. STUDY SELECTION: Following systematic review registration (CRD42019154064), three data bases (MEDLINE, Embase, CENTRAL) were searched to December 2022 for parallel randomised controlled trials conducted in adults diagnosed with DH, using at least two recognised stimuli, assessing the short-term efficacy of home-use dentifrice treatment in reducing pain. Thirty-two studies and 4,638 participants were included. A Network meta-analysis (NMA) approach was used to compare relative effectiveness between interventions. CONCLUSIONS: Twice daily application of self-applied dentifrice containing formulations of stannous, potassium +/- stannous, or arginine can be recommended for the reduction of dentine hypersensitivity pain. There is a need for standardised methodology guideline development to improve the conduct, analysis and reporting of DH clinical studies. CLINICAL RELEVANCE: This is the first comprehensive NMA to be performed, that follows guidelines for conduct of DH trials to determine the efficacy of self-applied dentifrices for the management of dentine hypersensitivity. Indirect comparisons can be made between formulations that have not been compared to one another in randomised controlled trials.

Clinical trials evaluating desensitising agents. Some design and analysis issues.

INTRODUCTION: The purpose of this short communication is to draw attention to an efficient design for trials to evaluate desensitising agents, and an appropriate statistical analysis. METHODS: Two recent sensitivity trials conducted by the Bristol Dental School Clinical Trials Group are reviewed. RESULTS: The methodology used was effective to establish efficacy of the products evaluated. CONCLUSIONS: This methodology is recommended for wider use. CLINICAL SIGNIFICANCE: Effective clinical trial methodology enables establishment of efficacy of desensitising products leading to patient benefit.

Clinical efficacy of hydroxyapatite toothpaste containing Polyol Germanium Complex (PGC) with threonine in the treatment of dentine hypersensitivity.

Introduction: This study aims to evaluate the clinical efficacy of a hydroxyapatite toothpaste containing a Polyol Germanium Complex with threonine in treating dentine hypersensitivity. The study also seeks to monitor the quality of life of the treated dentine hypersensitivity sufferers. Materials and methods: This study is a randomized clinical trial with a total of 120 patients with dentine hypersensitivity. All participants were divided into three groups: patients assigned to the GARDA SILK toothpaste; patients receiving the conventional fluoride toothpaste for comparison purposes, and patients asked to brush their teeth without toothpaste. The modified Quigley-Heine Plaque Index was assessed at the baseline and after treatment. Sensitivity was assessed at baseline, 3, 7 and 14 days using the air stimulus (Schiff Index). The impact of dentine hypersensitivity on the quality of life was assessed before and after the treatment with the Russian version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ). Results: After 14 days of treatment, the mean Plaque Index scores in Groups 1 and 2 did not exceed 1 and averaged 0.72 ± 0.249 and 0.86 ± 0.213, respectively. In Group 3, the mean Plaque Index was significantly higher (1.04 ± 0.070, p < 0.05). The mean Schiff sensitivity scores in Group 1 decreased to 2.45 ± 0.42 at 3 days, 1.84 ± 0.26 at 7 days, and 1.02 ± 0.34 at 14 days. Group 2 exhibited smaller reductions in the Schiff index at all time points. In this group, Schiff scores dropped to 2.67 ± 0.28 after 3 days, 2.34 ± 0.44 after 7 days, and 1.93 ± 0.36 after 14 days. Conclusion: The GARDA SILK hydroxyapatite toothpaste with a threonine-containing Polyol Germanium Complex (PGC) is effective in maintaining good oral hygiene, reducing dentine hypersensitivity, and improving the quality of life of dentine hypersensitivity sufferers.

Biomimetic remineralization of human dentine via a "bottom-up" approach inspired by nacre formation.

Nacre exhibited noticeable similarities in fundamental material buildup and biological characteristics with tooth hard tissue, so the present study aims to achieve bionic dentine remineralization by duplicating nacre's "bottom-up" assembly concept. Inspired by nacre's mineralization mechanism, the present project starts to synthesize a "seawater-like" mineralizing precursor medium, then monitor its in vitro dentinal tubules occlusion effect, acid-resistant stability, the "fingerprint" dynamic components change in real time on in vitro sensitive tooth model as well as its in vitro cellular biological response towards human dental pulp stem cells. For the further exploration, a single-layer fibrillar collagen model was established to simulate the exposed collagen of demineralized dentine to appraise its intrafibrillar mineralization effect. The results demonstrated that the application of "seawater-like" mineralizing precursor medium effectively occluded dentinal tubules, reduced dentine permeability, increased surface microhardness, provided certain acid-resistant stability and possessed favorable in-vitro biocompatibility. In addition, the dynamic procedure of hierarchical intrafibrillar nanocrystalline assembly was observed, which offered a clue to uncover its remineralizing mechanism. It is attainable to realize the biomimetic remineralization of human dentine via the "bottom-up" concept inspired by nacre structure duplication, suggesting great potential for providing dentists a therapeutic strategy to counter dentine hypersensitivity in the future.

Phototherapy Using Er,Cr:YSGG Laser as a Definitive Treatment for Dentin Hypersensitivity: A Systematic Review.

Purpose: To assess the efficacy of Er,Cr:YSGG lasers in reducing dentine hypersensitivity (DH). Methods: Electronic literature were searched through various databases (MEDLINE, SCOPUS, ProQuest, LILACS and EBSCO) up to March 2022 for articles addressing the following focused question: "In patients with dentine hypersensitivity, does an Er,Cr:YSGG laser provide a better outcome in terms of pain reduction than other dentine desensitizer agents?". The literature was searched using combinations of the following medical subject heading (MeSH) terms and keywords: (laser OR phototherapy OR Er,Cr:YSGG laser) AND (dentine hypersensitivity OR dentine sensitivity OR dental sensitivity). Results: A total of 486 studies were found, of which 7 randomized controlled trials were included in the review. The Er,Cr:YSGG laser wavelengths, power density and duration of irradiation used in the studies were 2780 nanometers, 0.25-0.5 watts and 20-60 seconds, respectively. The follow-up assessments were conducted ranging from immediately to 3 months after treatment. All studies showed that the Er,Cr:YSGG laser was effective in alleviating DH. Conclusion: This systematic review suggests that the application of an Er,Cr:YSSG laser is effective in alleviating DH and may have limited adverse effects if adequate parameters are followed.

Are there associations between the occurrence of dental fluorosis and the experience of dentine hypersensitivity? A cross-sectional study.

Objectives: Associations between the occurrence of dentine hypersensitivity (DH) and dental fluorosis (DF) have been suggested. Testing this association requires studies among populations with both conditions. This study aimed to determine the association between DF and the experience of DH among a population endemic for DF. Methods: This was a cross-sectional study conducted in 2021 over 6 months among 428 adult patients. Participants' demographics were collected, followed by verbal screening for DH and oral examinations. Clinical assessment for DH was carried out by tactile and evaporative methods. The presence and severity of DF were also assessed using the Thylstrup and Fejerskov Index. Data analysis included Chi-square and correlation statistics to assess the presence and strength of associations. Results: The overall prevalence of DH was 31.1%. A higher proportion (41.1%, P < 0.001) of participants with DF had DH than those without DF. The association between DH and DF was minimal but statistically significant (r = 0.174, P < 0.001). Among those with DF, the prevalence of DH was highest in participants with severe fluorosis (50%, P = 0.740). The proportion of sensitive teeth to the teeth examined was significantly higher (P < 0.0001) for participants with DF (289/4167, 6.9%) than participants without DF (267/6758, 4%). This proportion was also highest for severe DF (20/254, 7.9%, P = 0.572) than the mild and moderate forms. Conclusion: DH was more prevalent among individuals with DF. The prevalence of DH was not dependent on the severity of DF.

Cross-cultural adaptation of the Arabic version of the DHEQ-15.

OBJECTIVES: Many patients who suffer from Dentine Hypersensitivity (DH) often go undiagnosed because they do not consider DH as serious problem that requires treatment. The use of patient-reported outcome measures can help in diagnosis and management of DH problems. The aim of the present study was to adapt cross-culturally the original English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Arabic-speaking countries. METHODS: An Arabic version of DHEQ-15 was first developed by forward-backward translation and piloted among a group of dental patients. A cross-sectional study design was then used to test the psychometric properties of the Arabic DHEQ-15 in a wider convenience sample of Libyan dental patients diagnosed with DH. Confirmatory factor analysis was used to test the three-dimensional distribution of the subscales. The significance level of all statistical tests was set at p ≤ 0.05. RESULTS: The Arabic DHEQ-15 demonstrated good face and content validity. A total of 462 participants aged, on average, 39.2 ± 12.9 years took part in the psychometric testing of the Arabic DHEQ-15. The overall Cronbach's alpha of the questionnaire was 0.91, and overall Interclass correlation coefficient (ICC) for test-retest repeatability was 0.914. Participants with more severe DH had a significantly higher DHEQ-15 score than those with less severe DH (p < 0.001). Those who reported better global rating of their oral health had lower scores on the Arabic DHEQ-15 (p < 0.001). Confirmatory factor analysis confirmed three subscales of the Arabic DHEQ-15. CONCLUSIONS: The Arabic DHEQ-15 has been developed and further testing has demonstrated acceptable levels of psychometric properties in an Arabic population. The Arabic DHEQ-15 is a reliable measure of the quality-of-life impact of DH for use with Arabic-speaking populations.

A comparative study on the effect of propolis and dentine bonding agent in treating dentine hypersensitivity.

OBJECTIVE: To find out if there is a difference in the efficacy of propolis and seventh-generation dentine bonding agent in reducing dentine hypersensitivity. METHODS: The randomised, single-blind study was conducted at the Department of Periodontology, Dow International Dental College, Dow University of Health Sciences, Karachi, from December 2018 to November 2019, and comprised patients with complaint of dentine hypersensitivity who were divided in group A which received 30% ethanolic extract of propolis, and group B which received dentine bonding agent. Recordings of dentine hypersensitivity were obtained at baseline, before and after the application of experimental agents, and on days 7, 15 and 30. The response was measured using the Schiff Cold Air Sensitivity Scale. Data was analysed using SPSS 20. RESULTS: Of the 52 patients, 19 (36.5%) were males and 33 (63.5%) were females. The overall mean age was 29.9 ± 6.5 years. Majority of the subjects were students i.e. 16 (30.8%) and housewives i.e. 11 (21.2%), while drivers, teachers, businessmen etc. constituted of 25 (48%) subjects. Significant reduction of dentine hypersensitivity was observed in both groups (p<0.05). Intergroup comparison showed non-significant differences (p>0.05). CONCLUSIONS: Propolis and dentine bonding agent had significant effect in reducing dentine hypersensitivity. The difference between the two was not significant.

Efficacy of near infrared dental lasers on dentinal hypersensitivity: a meta-analysis of randomized controlled clinical trials.

Conventional therapies have aimed to try to help individuals suffering with dentine hypersensitivity (DH/DHS). A relatively new approach, laser therapy claims to be beneficial while having immediate and long-lasting effect. Therefore, our analysis aims to explore the immediate and 1-month efficacy of near-infrared laser (NIR) therapy in treating dentinal hypersensitivity. A systematic literature search conducted in databases, and analysis was undertaken utilizing a meta-analysis approach. Randomized controlled clinical trials comparing near-infrared lasers and placebo/no treatment in patients (> 18 years) were included. The risk of bias for included studies was assessed using Cochrane RoB tool (for randomized studies). Random effects meta-analyses model of standardized mean differences and 95% confidence intervals were performed using RevMan 5.4 software. A comprehensive electronic and manual search yielded a total of 1081 potential articles. Following the implementation of the inclusion and exclusion criteria, a total of 6 studies were included in the analysis. Near-infrared laser therapy led to statistical significant reduction in immediate and 1-month follow-up VAS (visual analog scale) scores compared to placebo/no treatment (p < 0.05). Statistical heterogeneity across the studies was high (I2-96%). The findings suggest that near-infrared laser therapy does have a significant immediate effect in reducing dentine hypersensitivity compared to placebo/no treatment. Furthermore, this effect is not diminished and endured at 1-month follow-up.