Dentin Hypersensitivity and Oxalates

Abstract

Treatment of dentin hypersensitivity with oxalates is common, but their efficacy remains unclear. Our objective was to systematically review clinical trials reporting an oxalate treatment compared to no treatment or placebo with a dentin hypersensitivity outcome. Risk-of-bias assessment and data extraction were performed independently by two reviewers. Standardized mean differences (SMD) were estimated using random-effects meta-analysis. Of 677 unique citations, 12 studies with high risk-of-bias were included. The summary SMD for 3% monohydrogen-monopotassium oxalate(n=8 studies) was −0.71 [95% Confidence Interval: −1.48, 0.06]. Other treatments, including 30% dipotassium oxalate (n=1), 30% dipotassium oxalate plus 3% monohydrogen monopotassium oxalate (n=3), 6% monohydrogen monopotassium oxalate (n=1), 6.8% ferric oxalate (n=1) and oxalate-containing resin (n=1), also were not statistically significant different from placebo treatments. With the possible exception of 3% monohydrogen monopotassium oxalate, available evidence currently does not support the recommendation of dentin hypersensitivity treatment with oxalates.

Evaluation of dentin hypersensitivity treatment with glass ionomer cements: A randomized clinical trial

“…2 Although current study did not compare Clinpro XT with a placebo control, another recent randomized clinical trial showed that resin-modified GIC was more effective than the placebo in reducing DH for up to 4 weeks. 2,29,31,32,33 Further, a split-mouth study design was adopted to eliminate the effects of individual conceptions of pain, pain perception, oral hygiene habits, dietary habits and psychosomatic factors. 14 Although the ultimate test of any treatment option is how well it works in clinical practice, the randomized, controlled and double-blind clinical trial is the gold standard for determining efficacy.…”

Effectiveness of various toothpastes on dentine tubule occlusion

“…47,67 However, a meta-analysis of the published papers regarding oxalates found little evidence regarding a positive clinical effect of oxalates. 48 No oxalate-containing toothpaste was tested in the present study. Comparison with the reference toothpaste (positive control).…”

“…47 However, a systematic review regarding the effectiveness of oxalates in the treatment of dentine hypersensitivity determined that that single treatments of oxalates had no effect on dentine hypersensitivity compared to placebos. 48 The mechanisms of the action of fluorides in desensitizing dentine hypersensitivity remain unclear. Although most toothpastes contain fluorides in some form, the incidence of dentine hypersensitivity remain high.…”

Current management of dentin hypersensitivity

“…Among these, oxalates have been used to precipitate and occlude the tubules. However, a systematic review recently revealed that with the possible exception of 3 % monohydrogen monopotassium oxalate, available evidence does not currently support the recommendation of dentin hypersensitivity treatment with oxalates [15]. …”