Management of dentine hypersensitivity: efficacy of professionally and self‐administered agents

Abstract

West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of professionally and self-administered agents. J Clin Periodontol 2015; 42 (Suppl. 16): S256-S302. doi: 10.1111/jcpe.12336. Abstract Context:The gold standard treatment modality for dentine hypersensitivity has not yet been established. This review examines the effectiveness of self and professionally applied treatments for the reduction in pain from dentine hypersensitivity. Materials and Methods: Electronic (three databases) and hand searches were performed 14-21 July 2014 to identify randomized controlled trials for the treatment of dentine hypersensitivity. Results: This systematic review provided numerous treatment modalities for dentine hypersensitivity. Eleven agents and 105 Randomized Controlled Trials were robust enough to be included. The studies varied considerably in design, observation period, active agents, formulation of the whole agent, negative and positive controls and comparator products investigated. The stimuli used were predominantly airblast and tactile or thermal. Due to the heterogeneity between the studies and lack of direct comparison between agents there was insufficient data to undertake a meta-analysis to compare agents for meaningful conclusions. Best available evidence for each treatment agent has been documented as a narrative. Conclusions: Treatments including stannous fluoride, arginine, calcium sodium phosphosilicate and strontium toothpaste appear to be clinically effective for the treatment of dentine hypersensitivity compared to comparators and controls. There is limited evidence to confirm the relative effectiveness of individual professionally applied agents.

Influence of the Extended Use of Desensitizing Toothpastes on Dentin Bonding, Microhardness and Roughness

“…The latter describes the deposition of an obliterating material onto the dentin surface or within the dentinal tubules, resulting in a reduction of their respective diameters, diminishing the movement of the fluids and consequently decreasing mechanoreceptor stimulation (7,8) Several active ingredients have been used to manage DH, in both professional and home use (9). Although many products have been developed to obliterate dentinal tubules, the effects are usually temporary and DH returns when these tubule-occluding agents are removed, due to the erosion caused by daily dietetic challenges (7,8).…”

Eficacia de la Arginina al 8% y Nitrato Potásico al 5% en el tratamiento de la hipersensibilidad dentinaria. Ensayo clínico aleatorio.

“…(8,11,16) Las sales de potasio, por su parte, se han utilizado e investigado durante muchos años como agentes activos en el tratamiento de la HSD. A pesar de existir evidencia que pone en duda su real eficacia, (10) existen algunos ensayos clínicos que han demostrado que los dentífricos con Nitrato de Potasio al 5% son clínicamente eficaces en el tratamiento de la HSD.…”

“…(8) Si bien los dentífricos en base a nitrato de potasio demostraron ser inicialmente efectivos en la reducción de la HSD, (9) estudios recientes cuestionan su real eficacia. (10) Un nuevo compuesto, la arginina, ha emergido como un agente potencialmente eficaz para la HSD en estudios clínicos.…”

Dentine Hypersensitivity: Review of a Common Oral Health Problem

“…Although previous systematic reviews have recommended arginine-containing toothpastes for treatment of DH [50,51]. West et al [49] and Yang et al [54] in more recent reviews of clinical trials and Idon et al [55] in a recent clinical trial did not find enough evidence to recommend the professionally applied formulation for treatment of DH over the other available agents.…”