Quality Resource Guide
l
Management of the Patient with Dentin Hypersensitivity
5
www.metdental.com
and the tooth is less sensitive to the stimuli.
24
While some clinical studies showed that dentifrice
containing potassium nitrate effectively reduces
dentin hypersensitivity,
22,23
other systematic reviews
failed to find sufficient evidence to support the
efficacy of potassium nitrate toothpaste.
18,24,25
A contemporary (2017) meta-analysis found sufficient
evidence to support its desensitizing effect.
26
Some
market products that contain potassium nitrate are
listed in
Table 1
.
2. Stannous Fluoride
Stannous fluoride is the only fluoride compound
that provides protection against many oral health
conditions. Research has demonstrated that it has
anti-plaque, anti-gingivitis, anti-sensitivity, and anti-
caries efficacy. It has also been shown to suppress
breath malodor.
27-30
Baig,
et. al
,
27
showed in an
in-situ study (2005), that stannous fluoride created a
smear layer that blocked dentinal tubules, resulting
in marked reduction of sensitivity. The outcome was
attributed to the fact that blocking the tubules leads
to limited fluid flow and prevention of the stimulation
of the mechanoreceptors.
Stannous fluoride has been delivered for some
time via various vehicles (mouth rinse, dentifrice,
gel). The American Dental Association granted
its Seal of Acceptance to non-aqueous stannous
fluoride gel formulations (Colgate® Gel-Kam, 0.4%
stable stannous fluoride) and Crest® Pro-Health
toothpaste) for therapeutic prevention of sensitivity
and caries.
7
In the past, the temporary extrinsic tooth staining
associated with the long-term use of the stabilized
stannous fluoride products was the primary limitation
to its usage. Due to advances in dentifrice technology,
the incorporation of sodium hexametaphosphate has
mitigated this undesirable staining effect.
31
Several researchers have reported a gradual
decrease
in
sensitivity
following
application
of stannous fluoride starting at two weeks after
initiation of treatment and continuing throughout a
16-week period.
32,33
It was also reported that an
application of 0.4% stannous fluoride gel resulted in
significantly less sensitivity in patients during a four
to eight-week period in a two-phase experimental
study. It was also found in two different randomized
controlled clinical trials that brushing twice daily
with stabilized stannous fluoride dentifrice provides
superior reduction of dentinal hypersensitivity
versus a marketed sodium fluoride dentifrice, and
a dentifrice containing 8.0% arginine, calcium
carbonate and sodium monofluorophosphate.
31, 34,35
Table 1
- Dentin Hypersensitivity Products
Delivery
Categories of Agents
Available Products
SELF-CARE
OTC Products
Professionally Prescribed Dentifrices
Potassium nitrate
•
Colgate Enamel Health Sensitivity Relief
•
Crest Sensi Namel
•
Sensodyne Pronamel Daily Protection
•
Arm & Hammer Sensitive Enamel
Stannous Fluoride
•
Colgate ® Gel-Kam
•
Crest® Pro-Health toothpaste
Calcium Sodium Phosphosilicate (NovaMin)
•
Sensodyne® Repair and Protect toothpaste
Arginine
•
Colgate Sensitive Pro-ReliefTM toothpaste
•
Colgate® Sensitive Pro ReliefTM mouthwash
Oxalate
•
Crest Sensi-Stop Strips
•
Listerine® Advance Defence Sensitive mouthwash
Potassium Nitrate
•
PreviDent® 5000 Sensitive
Hydroxyapatite
•
Cavex Bite&White ExSense
Calcium Sodium Phosphosilicate (NovaMin)
•
NUPRO NUSolutions paste®
•
Topex®ReNew paste
PROFESSIONAL CARE
Fluoride Varnish
Prophylaxis Pastes
•
Colgate® Sensitive Pro-Relief™ Desensitizing
Paste
•
NovaMin Sensodyne Prophylaxis® paste
Resin, adhesives
•
Gluma Desensitizer PowerGel
•
Clearfil ®Se Protect
•
Calm-It™ Desensitizer
Lasers
•
GaLAS, Nd:YAG, ErYAG, CO
2