Comparative Desensitizing Effect of a Toothpaste & Mouthwash- Containing Potassium Nitrate: An In Vivo & In Vitro Scanning Electron Microscopic Study

Abstract

Potassium Nitrate has been used as a desensitizing agent to treat dentinal hypersensitivity for quite a long time. The effectiveness of a potassium nitrate is evaluated many times in the form of toothpaste. There hasn't been much study done to evaluate the desensitizing efficacy of potassium nitrate used in the form of mouthwash. Aim of our study was to compare the desensitizing effect of a tooth paste & mouthwash-both containing Potassium Nitrate.Material & Methods: Thirty patients were assessed using evaporative stimuli and thermal stimuli and tactile stimuli and response was evaluated using Visual Analogue Scale at baseline and after 1 month. The patients were divided into two groups; Group I: fifteen patients who used toothpaste containing 5% potassium nitrate, sodium fluoride, xylitol; Group II: Fifteen patients who used mouthwash containing 3% potassium nitrate, sodium fluoride, xylitol. A total of ten extracted human teeth were collected. Horizontal ground section was done in all the teeth. In five ground section of teeth potassium nitrate containing tooth paste were applied and in five ground sections were shaken vigorously in potassium nitrate mouth rinse. All the ground sections were taken for scanning electron microscopic evaluation. Result:The results of all the stimulus assessment methods indicated that potassium nitrate toothpaste as well as mouthwash showed statistically significant decrease in the sensitivity score on a Visual Analogue Scale compare to baseline. But, there were no statistically significant differences between the groups, although both were effective in the treatment of hypersensitivity toothpaste showed slightly better result. Scanning electron microscopic analysis result showed that there were partial to complete occlusion of dentinal tubules in toothpaste group. However, no such tubule occlusion effect found in mouthwash group. Conclusion:Both toothpaste and mouthwash containing potassium nitrate are effective in reducing dentinal hypersensitivity. However toothpaste was having slightly better result.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity

“… Elias-Boneta et al in 2013 in a randomized, double-blinded, parallel single-center clinical study concluded that mouth rinse containing arginine provided a superior reduction in DH compared to potassium nitrate and a negative control mouthwash after 2 weeks[ 154 ] Sharda et al, 2018 compared effectiveness of a desensitizing dentifrice and mouthwash containing calcium sodium phosphosilicate on DH and found the mouthwash to be as effective as the toothpaste in reducing DH and with a fair remineralization potential[ 155 ] Sen et al, 2018 also compared effectiveness of a desensitizing dentifrice and mouthwash containing potassium nitrate on DH and found the mouthwash to be as effective as the toothpaste in reducing DH[ 156 ] Sharma et al determined the efficacy in relieving dentinal sensitivity of 4 weeks’ treatment with an alcohol-free mouth rinse comprising 1.4% potassium oxalate compared with negative and positive controls. The findings revealed a decreased sensitivity by 110% in the positive-control subjects versus negative-control subjects ( P < 0.001), and no serious treatment-related oral adverse events were seen in any of the study subjects.…”

“…Sen et al, 2018 also compared effectiveness of a desensitizing dentifrice and mouthwash containing potassium nitrate on DH and found the mouthwash to be as effective as the toothpaste in reducing DH[ 156 ]…”

“…Mechanism of action of desensitizing mouthwashes is summarized in Table 4 . [ 147 154 155 156 157 ] Based on the above-mentioned studies, the following patient-related instructions and recommendations to the clinicians have been devised:…”

Evaluation of the Efficacy of LASER, Desensitizing Agents, and their Combined Effect on Dentinal Hypersensitivity in Bicuspids: In Vitro Study

“…However, macroscopically, the normal tooth and a hypersensitive tooth have the same dentin, but the difference lies in the symptoms, which suggest minor inflammation of pulp. [ 5 ]…”

Comparative evaluation of the effectiveness of three commercially available desensitizing mouthwash on dentinal tubule occlusion: An in vitro scanning electron microscopic study

“…The occlusion of dentinal tubules is caused by the use of physical or chemical substances externally on denuded surfaces, which creates an artificial layer on the outer surface of dentinal tubules by depositing an obliterating material on the dentin surface and reducing the diameter of tubules, blocking dentinal fluid diffusion, and resulting in a decrease in DH. [ 4 ] Various agents are used for treating DH, including lasers, desensitizing dentifrices, mouthwash formulations, dentin sealing agents, periodontal soft tissue grafting, etc. However, no treatment modality has been regarded as the gold standard treatment of dental hypersensitivity.…”