The Efficacy of Selected Desensitizing OTC Products: A Systematic Review.

Licensed by the Creative Commons Attribution LicenseObjectives. The aim of the present study was to review the published literature in order to identify relevant studies for inclusion and to determine whether there was any evidence on the clinical effectiveness of selected desensitizing toothpastes, calcium sodium phosphosilicate (CSPS), amorphous calcium phosphate (ACP), nanohydroxyapatite, and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) on reducing dentine hypersensitivity (DH). Materials and Methods. Following a review of 593 papers identified from searching both electronic databases (PUBMED) and hand searching of relevant written journals, only 5 papers were accepted for inclusion. Results. Analysis of the included studies (3 CSPS and 2 ACP) would suggest that there may be some benefit for patients using these products for reducing DH. No direct comparative studies were available to assess all these products under the same conditions neither were there any comparative randomised controlled studies that compared at least two of these products in determining their effectiveness in treating DH. Conclusions. Due to the small number of included studies, there are limited clinical data to support any claims of clinical efficacy of these OTC products. Further studies are therefore required to determine the efficacy of these products in well-controlled RCT studies with a larger sample size

In Vitro Ability of a Novel Nanohydroxyapatite Oral Rinse to Occlude Dentine Tubules.

Objectives. The aim of the study was to investigate the ability of a novel nanohydroxyapatite (nHA) desensitizing oral rinse to occlude dentine tubules compared to selected commercially available desensitizing oral rinses. Methods. 25 caries-free extracted molars were sectioned into 1 mm thick dentine discs. The dentine discs (n = 25) were etched with 6% citric acid for 2 minutes and rinsed with distilled water, prior to a 30-second application of test and control oral rinses. Evaluation was by (1) Scanning Electron Microscopy (SEM) of the dentine surface and (2) fluid flow measurements through a dentine disc. Results. Most of the oral rinses failed to adequately cover the dentine surface apart from the nHa oral rinse. However the hydroxyapatite, 1.4% potassium oxalate, and arginine/PVM/MA copolymer oral rinses, appeared to be relatively more effective than the nHA test and negative control rinses (potassium nitrate) in relation to a reduction in fluid flow measurements. Conclusions. Although the novel nHA oral rinse demonstrated the ability to occlude the dentine tubules and reduce the fluid flow measurements, some of the other oral rinses appeared to demonstrate a statistically significant reduction in fluid flow through the dentine disc, in particular the arginine/PVM/MA copolymer oral rinse

The efficacy of strontium and potassium toothpastes in treating dentine hypersensitivity: a systematic review.

Objectives. The aim of the present paper was to review the published literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence of the efficacy of strontium and potassium toothpastes in the treatment of dentine hypersensitivity (DH). Methods. Following a review of 94 relevant papers both from searching electronic databases (PUBMED) and hand searching of relevant written journals, 13 studies were identified, and 7 papers (1 for strontium-based toothpastes and 6 for potassium-based toothpastes) were finally accepted for inclusion. The main outcome measures were the methodology and assessment used by Investigators in studies designed to evaluate DH. Results. The results of the present paper would indicate that the reported efficacy of both strontium- and potassium-based toothpastes in relieving DH is questionable. Conclusions. The results from the present paper would appear to support the conclusions of previous investigators that there is only minimal evidence for the efficacy of both strontium- and potassium-based toothpastes in relieving symptoms of DH

The Impact of Removable Partial Dentures on the Health of Oral Tissues: A Systematic Review

Objectives: The aim of the present study was to review the available literature data to identify relevant studies for inclusion and to verify whether there is evidence to support the hypothesis that the insertion of an RPD into the oral cavity has a deterioration effect on the oral health status. Materials and methods: 570 articles were identified, from searching both electronic databases (e.g., PUBMED) and manual searching of relevant written journals using an agreed search protocol up to 31st December 2011. The extraction of data for inclusion was conducted by two independent reviewers. The main outcomes of intervention involved both methodology and assessment tools applied by investigators to assess the effect of a RPD in terms of plaque accumulation, caries incidence, and gingival tissue (inflammation). Results: 401 articles were excluded following an initial screening; 169 articles were included for the further review. At a second round screening, 163 articles were also rejected and six (Randomised Clinical Trials [RCTs]) articles were eventually accepted for inclusion. Based on the results, there was some scientific evidence supporting the hypothesis that RPDs placement may increase plaque accumulation and gingival inflammation. The importance of an established prevention program for RPD wearers (including good plaque control and OHI) either prior to or during treatment was emphasised by all investigators in the included studies. Among the limitations, however when evaluating the data, was the lack of homogeneity between the included studies (e.g., study design and duration, calibration details, clinical parameters to be evaluated, reporting of dropout rates and treatment intervention). Conclusion: The conclusion from this present review would indicate that there were insufficient RCTs to adequately address the original research question, although a number of suggestions may be recommended. There was no doubt from the evidence presented in the published literature that in the absence of good oral hygiene measures a RPD may promote accumulation of the plaque which may in turn lead to gingival inflammation. Furthermore, there also appears to be a higher risk of dental caries (particularly root caries) in RPD wearers in the absence of good oral hygiene measures. The importance of an integrated prosthodontics maintenance programme with regular recall visits including both oral and denture hygiene care of a RPD cannot be under-estimated and should be adopted as a gold standard in general dental practice

Knowledge of UK Dental Undergraduates and Dentists in Treating Dentine Hypersensitivity

Aim: The purpose of the present questionnaire-based study was to evaluate the knowledge and understanding of UK based dental undergraduates and qualified dentists in treating Dentine Hypersensitivity (DH). Methods: 120 questionnaires were handed out to 4th and 5th year dental students and Staff at the Dental Hospital in London UK as part of a collaborative study with the Faculdade de Odontologia de Bauru, University of Sao Paulo, Brazil. The questionnaire consisted of 22 questions, which included both open and closed questions. Results: 91 questionnaires (75.8% response rate) were returned; of the 91 respondents (38M; 52F, 1 missing value) 53 were dentists (61%) and 34 were dental students (39%) (4 missing values). 37.5% of students indicated that 10% of patients suffered from DH whereas 18.9% of dentists indicated that 25% of patients suffered from DH. Both dentists (22.6%) and 27.5% of students indicated that DH lasted >12 weeks. 18.9% of dentists considered that DH was a serious problem for patients although 32.5% of students were not sure. Dentists (66%) and students (62.5%) indicated that DH had a major impact on the quality of life (QOL) with 51.1% (dentists) and 56.3% (students) indicating that it was moderate in nature. Conclusion: The results of the present pilot study would suggest that in terms of knowledge and understanding of DH (e.g., hydrodynamic theory) both dentists (90.5%) and students (76.9%) were comparable although in the assessment and subsequent management of DH the results indicated that dentists were more confident than the student

Quantification of Tooth Wear by Selected Desensitizing Polishing Pastes Using White Light Profilometry

Objectives: To analyse tooth wear using white light non-contact profilometry following the polishing of the tooth surface with selected polishing pastes. Methods: Three polishing pastes containing a range of particles sizes and different coarseness (extra-fine, medium, course) were compared with commercially available prophylaxis pastes (Nupro with Novamin® and Nupro with Fluoride) as controls. Particle size distribution was analysed using a using particle size analyser and quantified using Masterizer software. Teeth were in 70% ethanol prior to evaluation. 25 extracted human premolar teeth were distributed in five groups (n=5), and the teeth were mounted in a silicone putty matrix leaving an exposed buccal surface. White light profilometry with Proscan 2000 software was used to scan each tooth surface before and after polishing. Scantron ProForm software was used to superimpose images and measure surface loss and analyse the difference between the two surfaces-scans by the Proscan 2000 software. Results: Particle size analysis indicated that all samples consisted of a wide distribution of particles’ sizes (DX 10, 50, and 90). The course polishing paste had the largest DX 90 whereas Nupro with Fluoride had the lowest DX 90. The extra-fine pumice had the lowest DX 90, although this paste had larger values for DX 10 and DX 50 compared to the medium paste. The volume tooth loss analysis demonstrated that the course pumice had the most tooth surface loss compared to the extra-fine pumice which had the least amount of tooth surface loss. The average volume loss per group was 0.808, 0.022, 0.014, 0.022, 0.026 (course, medium, extra-fine, Nupro with Fluoride, and Nupro with Novamin®) respectively. Conclusions: The results indicated that the larger the DX 90 within the paste, the more tooth surface loss occurred due to the abrasivity of the paste. There was however minimal or no significant difference in the amount of tooth loss between the control polishing pastes

Prevalence of Moderate to Severe Periodontitis in an 18–19th Century Sample—St. Bride’s Lower Churchyard (London, UK)

The aim of the study was to determine the prevalence of moderate to severe periodontitis in 18–19th century skulls in the St Bride’s Lower Churchyard in London, UK. Materials and methods: A total of 105 adult skulls (66 M: F 39) from the Museum of London collection were examined for evidence of dental disease. The primary method was to measure the presence of moderate to severe periodontitis. Other dental pathologies were recorded such as tooth wear, calculus, and caries. Results: Overall, the prevalence of moderate to severe periodontitis in the sample was 21–24%. Males were observed to be more susceptible to periodontal disease than females. The severity of bone loss in the skull collection also increased with age. There was no significant difference in the amount of calculus deposition when comparing either age or sex. A total of 14% of the individuals in the sample showed signs of smoking. Conclusion: The results of the study indicated that the prevalence of moderate to severe periodontitis in an 18–19th century skull sample was 21–24%, which was higher than in previous studies. This may be due to the lack of basic personal mouth care and professional dental treatment as well as known risk factors such as smoking, stress, low socioeconomic status, and malnutrition

Comparison of Two Tricalcium Phosphate Varnishes and a Comparator Fluoride Varnish on Tubular Occlusion

Objectives The aim of the present study involved comparing the tubular occluding properties of three varnishes, two Clinpro™ varnishes and a Colgate® Duraphat® Varnish. Method Nine caries-free premolar dentine discs were prepared and treated with the three varnishes and subsequently observed under SEM at 0o and 90o angle to assess their ability to cover the dentine surface. The tubule occluding properties were measured using a modified Pashley cell hydraulic conductance model. A further 9 caries-free extracted molars were sectioned into 500μ thick dentine discs. The fluid flow rate was assessed after a) immersing the discs in 6% citric acid for 2 minutes, b) treating the dentine disc with the experimental varnishes and c) subjecting the treated discs to an acid challenge (6% citric acid for 2 minutes). Results SEM investigation showed uniform occlusion of the dentinal tubules, with varying depths of penetration. Hydraulic conductance tests showed no statistically significant differences in the fluid flow rate (expressed as percentages) when all the three varnishes were compared at different stages of treatment (p = 0.33). However, after subjecting the discs to an acid challenge, there was a statistically significant increase in the fluid flow rate with the Colgate® Duraphat® Varnish treated discs, whereas the ClinproTM White Varnish and Clinpro™ XT Varnish discs showed no statistically significant differences (p = 0.99 and p= 0.83 respectively). Conclusions All the tested varnishes (Colgate® Duraphat® Varnish, ClinproTM White Varnish and ClinproTM XT varnish) were effective in blocking the dentinal tubules as demonstrated in this in vitro study. However, the tricalcium phosphate varnishes (ClinproTM) were more resistant to an in vitro acid challenge compared to the sodium fluoride varnish (Colgate® Duraphat®)

Dentine Tubule Occlusion by Novel Bioactive Glass-Based Toothpastes.

There are numerous over-the-counter (OTC) and professionally applied (in-office) products and techniques currently available for the treatment of dentine hypersensitivity (DH), but more recently, the use of bioactive glasses in toothpaste formulations have been advocated as a possible solution to managing DH. Aim. The aim of the present study, therefore, was to compare several bioactive glass formulations to investigate their effectiveness in an established in vitro model. Materials and Methods. A 45S5 glass was synthesized in the laboratory together with several other glass formulations: (1) a mixed glass (fluoride and chloride), (2) BioMinF, (3) a chloride glass, and (4) an amorphous chloride glass. The glass powders were formulated into five different toothpaste formulations. Dentine discs were sectioned from extracted human teeth and prepared for the investigation by removing the cutting debris (smear layer) following sectioning using a 6% citric acid solution for 2 minutes. Each disc was halved to provide test and control halves for comparison following the brushing of the five toothpaste formulations onto the test halves for each toothpaste group. Following the toothpaste application, the test discs were immersed in either artificial saliva or exposed to an acid challenge. Results. The dentine samples were analyzed using scanning electron microscopy (SEM), and observation of the SEM images indicated that there was good surface coverage following artificial saliva immersion. Furthermore, although the acid challenge removed the hydroxyapatite layer on the dentine surface for most of the samples, except for the amorphous chloride glass, there was evidence of tubular occlusion in the dentine tubules. Conclusions. The conclusions from the study would suggest that the inclusion of bioactive glass into a toothpaste formulation may be an effective approach to treat DH