Randomised clinical studies investigating immediate and short-term efficacy of an occluding toothpaste in providing dentine hypersensitivity relief

Abstract

Background Dentine hypersensitivity (DH) can occur after gum recession or enamel loss and may impact quality of life. Treatments include toothpastes that decrease DH by occluding dentine tubules. One effective occluding ingredient used in toothpastes is stannous fluoride (SnF 2 ), but this can be unstable in aqueous formulation. These three studies aimed to characterise the short-term effects of an experimental, anhydrous SnF 2 dentifrice on DH. Methods Three examiner-blind, parallel-group studies evaluated DH in participants with the condition after a single brushing and after 3d brushing with an experimental anhydrous 0.454% SnF 2 /polyphosphate toothpaste (Test) or a toothpaste containing 0.76% sodium monofluorophosphate (Control). Test treatment participants brushed two pre-identified sensitive teeth first, then their remaining dentition for ≥1 min (‘focused brushing’). Control treatment participants brushed their whole dentition for ≥1 min. DH was measured after single brushing and after 3d twice-daily use, via evaporative (air) (Schiff Sensitivity Scale) and tactile (Yeaple probe) stimuli and analysed using an ANCOVA model. Results In all studies, after 3d treatment, the Test toothpaste/brushing regimen significantly reduced DH compared to the Control regimen by both evaporative and tactile stimuli assessment ( p < 0.0001 for all). The Test regimen also significantly reduced DH from baseline at both time-points by both measures in all studies (p < 0.0001 for all). Mean Schiff sensitivity score differences (95% confidence intervals) between Test and Control regimens after 3d were: Study 1: − 0.45 (− 0.577, − 0.319); Study 2: − 0.40 (− 0.505, − 0.300); Study 3: − 1.31 (− 1.500, − 1.128). Mean tactile score differences were: Study 1: 11.30 (7.927, 14.662); Study 2: 3.57 (2.531, 4.614); Study 3: 24.54 (20.349, 28.736). After single use, in Studies 2 and 3, the Test toothpaste/brushing regimen significantly reduced DH versus Control by both measures ( p < 0.001 for all); in Study 1, treatment differences were not significant. Toothpastes were generally well-tolerated. Conclusions Taken together, these studies indicated focused brushing with an experimental anhydrous 0.454% SnF 2 /polyphosphate toothpaste reduces DH compared to brushing with a conventional toothpaste after single use, with greater reduction after 3d. Trial registration Registrations at ClinicalTrials.gov : Study 1: NCT02832375 (registered 26.July.2016); Study 2: NCT02731833 (registered 26.April.2016); Study 3: NCT02923895 (registered 5.October.2016).

The effect of iontophoresis delivery of fluoride in stannous fluoride desensitizing toothpaste on dentin permeability in human extracted teeth

“…Therefore, increased frequency of treatment caused more surface precipitation and greater tubule occlusion, leading to a greater reduction in HD and a greater benefit for dentin hypersensitivity relief. Randomized clinical studies of Creeth et al 25 also indicated that dentin hypersensitivity reduced after single brushing with 0.454% SnF 2 toothpaste and significantly greater reduced after 3 days twice-daily use. However, after 7 days, SnF 2 with-iontophoresis group showed deeper dentinal tubule occlusion than SnF 2 without-iontophoresis group.…”

Stannous Fluoride Effects on Enamel: A Systematic Review

“…They did not notice any differences in microbiome diversity. Creeth et al [ 41 ] investigated in a short-term clinical study, how a stannous fluoride toothpaste could reduce DH compared to brushing with a conventional toothpaste after single use. This toothpaste, effectively, reduced DH on evaporative and tactile stimuli after a three-day treatment.…”

“…Luo et al [ 35 ], comparing stannous fluoride group with potassium nitrate and placebo, affirmed that the use of potassium nitrate could alleviate tooth sensitivity during and after in-office bleaching. Creeth et al [ 41 ] demonstrated how brushing with an experimental anhydrous 0.454% SnF 2 polyphosphate toothpaste reduced DH with a single use and better in three days use.…”

Acidic Monetite Complex Paste with Bleaching Property for In-depth Occlusion of Dentinal Tubules

“…7,8 Based on this theory, the main strategy to treat DH is to reduce dentin permeability by blocking/occluding dentinal tubules. [9][10][11] Current materials for dentinal tubule occlusion include sodium fluoride/stannous fluoride, [12][13][14] strontium chloride/acetate, 15,16 potassium oxalate, [17][18][19] arginine, 20,21 calcium phosphate and its composites, [22][23][24][25][26][27][28][29][30][31] bioglass and silicates, [32][33][34][35][36][37][38][39][40][41][42][43] laser, 44,45 gallic acid (tannin)/Fe 3+ complex, 47,48 amyloid-like aggregation coating, 49 and selfassembly peptide. 51 Although some of these demonstrate clinical effectiveness in tooth desensitization, no treatment regimen presently exhibits long-lasting efficiency in treating DH.…”