The In vitro Effectiveness of Oxalate Based Desensitizing Products on Tubular Occlusion

Abstract

Introduction: Dentine hypersensitivity (DH) is one of the most common clinically encountered conditions globally, affecting up to 74%. It has been described as a short, sharp pain resulting from changes in the fluid flow of exposed dentinal tubules, in response to physical and chemical stimuli. Objective: To compare the effectiveness of oxalate containing desensitizing products in reducing both dentine permeability and tubular occlusion vs. a control product using a recognized in vitro model. Methods: Three oxalate containing products were tested (Listerine® Advanced Defence Sensitive [LADS] mouth rinse, a 3% oxalate solution and an oxalate containing herbal toothpaste), vs. an artificial saliva control. The permeability of the acid-etched dentine discs was measured by hydraulic conductance (Lp). Dentine discs were examined using scanning electron microscopy and energy dispersive X-ray spectroscopy. After establishing the baseline permeability of the acid-etched dentine discs, discs (n=4) were randomly treated with the desensitizing products together with the addition of artificial saliva for 2 mins, followed by rinsing with distilled water (60 s). Permeability was measured at 30 s intervals for a total of 150 s. The occluded discs were acid challenged to assess tubular occlusion stability following the application of both the test and control products. Results: The oxalate containing desensitizing products in combination with artificial saliva significantly occluded the dentinal tubules by up to 65%, in comparison to the artificial saliva control that occluded ≤21% of the dentinal tubules. The occlusion associated with the oxalate containing desensitizing agents was substantially more stable in resisting an acid challenge compared to the control as determined by hydraulic conductance. Furthermore, the SEM images of the oxalate containing desensitising agents and control were consistent with the hydraulic conductance data. Of interest was that the oxalate containing herbal toothpaste deposited more precipitation on the surface than inside the tubules. The EDX analysis confirmed the presence of oxalates, calcium, and other ingredients of toothpaste. The results from the present study are in broad agreement with those of a previous study in that an oxalate containing mouth rinse provided a more stable tubular occlusion which was more resistant to an acid challenge compared to the other test products. Conclusion: Oxalate containing desensitizing agents were significantly more effective in occluding the dentinal tubules vs. an artificial saliva control. These results are of clinical significance as they demonstrate that oxalate containing desensitizing agents provide both significant and stable tubular occlusion of the open dentinal tubules following an acidic challenge

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