Daily Application of a Toothpaste with Biomimetic Hydroxyapatite and Its Subjective Impact on Dentin Hypersensitivity, Tooth Smoothness, Tooth Whitening, Gum Bleeding, and Feeling of Freshness

Abstract

The aim of this observational study was to analyze the effect of a toothpaste with biomimetic zinc hydroxyapatite (HAP) on subjective parameters after a four-week home use. Patients with subjective dentin hypersensitivity were recruited at three dental practices in Germany and received a questionnaire with visual analogue scales and Likert scales both at baseline and follow-up. The questionnaire was specifically developed for this study and focused on questions about subjective parameters like dentin hypersensitivity, tooth surface texture, tooth color, and freshness after toothbrushing. Patients answered the questionnaire both at baseline and after a four-week home use (follow-up) of the HAP toothpaste. Data of 46 patients were analyzed by paired t-test and non-parametric Wilcoxon signed-rank test, respectively. Subjective parameters on dentin hypersensitivity were reduced after the four-week use of the HAP toothpaste (p < 0.001). Additionally, patients assessed their tooth surface as smoother (p < 0.001), tooth color as whiter (p = 0.003), and reported a stronger feeling of freshness after toothbrushing (p = 0.014) after four-week use of the HAP toothpaste compared to the previously used toothpaste. In conclusion, the tested toothpaste with biomimetic HAP is well-suited for individuals suffering from dentin hypersensitivity, because subjective symptoms on dentin hypersensitivity were reduced. Additionally, patients reported smoother and whiter teeth after using the HAP toothpaste.

In Vitro Whitening Effect of a Hydroxyapatite-Based Oral Care Gel

“…To date, only a few in vivo studies on the whitening effects of HAP been published. 6 9 29 In situ studies show an efficient reduction of bacterial colonization to enamel surfaces by using HAP-based mouth rinses. 18 23 30 This might be also an important factor for tooth whitening since stains are often incorporated into dental plaque.…”

Whitening Effects of a Novel Oral Care Gel with Biomimetic Hydroxyapatite: A 4-Week Observational Pilot Study

“…The following questions were answered by the patients at baseline and after 28 days (follow-up). Patients were asked to answer highly subjective questions by using the visual analogue scale (VAS) [ 17 , 36 ]. Note that the VAS did not contain any measuring units visible for the patients.…”

“…Particulate hydroxyapatite, Ca 5 (PO 4 ) 3 (OH), is a multifunctional biomimetic active ingredient used in preventive oral health care [ 1 , 2 , 3 , 4 , 5 , 6 ], and has a wide range of applications in this field. Specifically, it has been shown to remineralize both enamel and dentin, prevent caries [ 2 , 5 , 7 , 8 , 9 , 10 , 11 , 12 ], reduce bacterial colonization on teeth and dental surfaces [ 1 , 13 ], improve periodontal health [ 1 , 4 , 13 , 14 , 15 ], and improve symptoms associated with dentin hypersensitivity [ 3 , 16 , 17 ]. An important advantage of hydroxyapatite compared to other active ingredients in preventive oral health care is its high biocompatibility as it has no side effects when used in daily oral care [ 6 , 18 , 19 , 20 , 21 ].…”

“…Several in vitro and in situ studies have analyzed the interaction of biomimetic hydroxyapatite particles with enamel surfaces [ 1 , 24 , 25 , 26 ]. This interaction can lead to a tooth whitening effect [ 6 ], which has been shown in different in vitro [ 27 , 28 , 29 ] and in vivo studies [ 17 , 30 , 31 ]. Unlike peroxide-based products which may induce side effects (e.g., bleaching sensitivity and damage of the organic matrix of enamel and dentin), hydroxyapatite can be used on a daily basis without any adverse reactions, and even from persons under the age of 18 [ 22 ].…”

Characterization of a Toothpaste Containing Bioactive Hydroxyapatites and In Vitro Evaluation of Its Efficacy to Remineralize Enamel and to Occlude Dentinal Tubules

“…They identified different activities of HA in the oral cavity: (i) physical restoration, that is the attachment of HA particles to the tooth surface and cleaning properties; (ii) biochemical effect by releasing calcium and phosphate ions under acidic conditions forming an interface between HA particles and the enamel; and (iii) biological interaction of HA particles with microorganisms [ 3 ]. In addition, HA-based materials can desensitize exposed dentinal tubules by occluding them, thus forming a mineralized barrier [ 24 , 25 ].…”