Beyond the Relief of Pain: Dentin Hypersensitivity and Oral Health-Related Quality of Life

A Real-World Study on the Quality of Life of Consumers with Dentine Hypersensitivity and the Benefits of Hypersensitivity Toothpaste Use

Dentine hypersensitivity (DH) causes pain from exposed dentine, triggered by external stimuli. Limited evidence exists on its impact on quality of life (QoL), the effectiveness of hypersensitivity toothpaste (HT) and the dental behaviors of DH sufferers. This study therefore aimed to generate evidence to address these evidence gaps and validate the existing science behind the effectiveness of HT. An observational retrospective cross-sectional survey was conducted in Indonesia, which included the Dentine Hypersensitivity Experience Questionnaire-15 (DHEQ-15), items related to the perceived effectiveness of HT and self-reported dental health behaviors. A total of 511 respondents completed the survey. The mean (standard deviation) DHEQ score of participants was 82.44 (14.41), showing the substantial impact of DH on QoL. Nearly all HT users (97.7%) reported relief from DH, with additional benefits like long-lasting fresh breath (96.4%) and cleaner teeth (97.1%), with regular HT users experiencing greater benefits such as improvements in DH (R-HT users [4.65 (0.55)] vs. E-HT users [4.46 (0.65)], p < 0.01). Compared to HT users, mainstream toothpaste (MT) users were significantly less likely to brush their teeth at least three times a day (HT users [41.9%], MT users [18.7%], p < 0.05) and to have had a dental check-up within the past year (HT users [82.5%], MT users [47.3%], p < 0.05). This study found that DH significantly impacts QoL, and that HT effectively relieves DH symptoms, particularly for regular users, who also show better dental health behaviors than users of mainstream toothpaste. The preliminary results indicate that educating users about dental products, like hypersensitivity toothpaste, can improve oral health behaviors and outcomes.

Evaluation and comparison of the effects of a new paste containing 8% L-Arginine and CaCO3 plus KNO3 on dentinal tubules occlusion and dental sensitivity: a randomized, triple blinded clinical trial study

BACKGROUND

Dentin hypersensitivity, often occurring after dental treatments or from erosive lesions, is a prevalent patient complaint. This study introduces a paste combining 8% L-arginine, calcium carbonate, and potassium nitrate to evaluate its impact on dentinal tubules occlusion, dentin permeability, and tooth sensitivity.

METHODS

Dentin surfaces from 24 third molars (thickness: 2 mm) were divided into two groups of 12. One received the experimental paste, while the other received a placebo without desensitizer. Permeability and sealing ability were assessed through scanning electron microscopy (SEM) and dentin permeability measurement. The pastes' effects on hypersensitivity were then examined in a triple-blind, randomized parallel-armed clinical trial with 16 eligible patients. Sensitivity to cold, touch, and spontaneous stimuli was recorded using the VAS scale at various intervals post-treatment. Statistical analysis was conducted using Shapiro-Wilk, Mann-Whitney U, Friedman, and Wilcoxon tests (α = 0.05).

RESULTS

The permeability test demonstrated a significant reduction in dentin permeability in the experimental group (P = 0.002) compared to the control (P = 0.178). SEM images revealed most dentinal tubules in the intervention samples to be occluded. Clinically, both groups showed a significant decrease in the three types of evaluated sensitivity throughout the study. However, no significant difference in sensitivities between the two groups was observed, with the exception of cold sensitivity at three months post-treatment (P = 0.054).

CONCLUSION

The innovative desensitizing paste featuring 8% L-arginine, calcium carbonate, and potassium nitrate effectively occluded dentinal tubules and reduced dentin permeability. It mitigated immediate and prolonged dentin hypersensitivity to various stimuli, supporting its potential role in managing dentin hypersensitivity.

TRIAL REGISTRATION

http://irct.ir : IRCT20220829055822N1, September 9th, 2022.

Efficacy of a stannous fluoride dentifrice for relieving dentinal hypersensitivity in Chinese population: an 8-week randomized clinical trial

OBJECTIVES

To compare the effectiveness of using a 0.454% stannous fluoride-containing dentifrice twice daily in relieving dentinal hypersensitivity (DH) in a Chinese population.

MATERIALS AND METHODS

This was a single-centre, randomized, controlled, examiner-blind, three-treatment-arm, parallel-group study in participants with clinically diagnosed DH. Subjects who met inclusion criteria (n = 197) were randomly allocated into 3 groups: test group (n = 66)-using a 0.454% stannous fluoride-containing dentifrice twice daily; positive control group (n = 64)-using a 5.0% calcium sodium phosphosilicate-containing dentifrice twice daily; negative control group (n = 67)-using a 1150 ppm of NaF dentifrice twice daily. Status of DH was assessed at week 4 and week 8 by the same independent examiner. Changes from baseline in Schiff sensitivity score, tactile threshold and Dentine Hypersensitivity Experience Questionnaire (DHEQ) score were analysed using analysis of covariance models. The DHEQ evaluated subject-perceived oral health-related quality of life (OHRQoL).

RESULTS

Statistically significant improvements in mean Schiff scores (p < 0.0001 for all products at Weeks 4 and 8), tactile threshold (p < 0.0001 for test and negative control at Weeks 4 and 8: Week 4 p = 0.0040 and Week 8 p < 0.0001 for positive control) and all DHEQ scores (p < 0.01 for all groups) were observed. No statistically significant differences were observed in the adjusted mean between all dentifrices at both timepoints, potentially driven by a placebo effect. Forty-two treatment-emergent adverse events (TEAEs) were reported (n = 32 subjects), with 2 serious AEs (n = 1) in the test group. TEAEs were not considered treatment-related.

CONCLUSIONS

All groups demonstrated statistically significant improvements in Schiff score, tactile threshold and OHRQoL. However, due to a possible placebo effect in the negative control, there were no statistically significant differences between the dentifrices.

CLINICAL RELEVANCE

This study adds to the growing research exploring why the placebo effect is a common phenomenon in DH studies.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT04950465.

Evaluation of the effects of 980 and 810-nm high-level diode lasers in treating dentin hypersensitivity: A double-blinded randomized clinical trial

Background

Dentin hypersensitivity is a prevalent problem, manifested as a short sharp pain. Researchers have used different lasers to treat this condition. The present study aimed to evaluate the effect of 980 and 810-nm high-level diode lasers on dentin hypersensitivity to determine proper laser parameters for clinical applications.

Materials and Methods

In this double-blinded randomized clinical trial, seven patients with 60 teeth affected by dentin hypersensitivity were selected for the present double-blind, randomized clinical trial. The patients' teeth were randomly matched and assigned to three groups: Group 1: 980-nm diode laser; Group 2: 810-nm diode laser; and Group 3: Control, which received only the guiding beam. The laser parameters were 1-W power, continuous wave mode, a distance of 1 mm, no contact, a 45° irradiation angle, and a 30-s exposure time using to-and-fro movements. The treatment consisted of two sessions with a 1-week interval. Pain severity was determined with the visual analog scale (VAS) at all the study intervals using a dry ice spray. The data were analyzed with SPSS version 20 using one-way ANOVA, repeated measures ANOVA, and least significant difference tests. Significance level was set at α = 0.05.

Results

The changes in VAS were significant only in the first stage (P = 0.046). The mean VAS scores decreased over time in the 810-nm and 980 laser groups. A comparison of VAS changes relative to the baseline revealed significant changes in VAS scores at all the time intervals with both lasers. The two 810 and 980-nm laser groups did not exhibit any significant differences for 2 months postoperatively (P = 0.098).

Conclusion

The application of 810 and 980-nm diode lasers at 1-W power and an exposure time of 30 s was effective in decreasing pain in patients with dentin hypersensitivity, with no significant difference between these two lasers.

Patient-reported outcome measures in individuals with amelogenesis imperfecta: a systematic review

PURPOSE

Amelogenesis imperfecta (AI) is a hereditary condition which affects the composition and structure of enamel in terms of hypoplasia and/or hypomineralization. The condition severely affects patients facing such difficulties as hypersensibility, loss of tooth substance and poor aesthetics. The objective is to perform a systematic review of patient-reported outcome measures (PROMs) in patients with amelogenesis imperfecta.

METHODS

Inclusion criteria were articles written in English, including PROMs from patients with amelogenesis imperfecta. The databases PubMed, Scopus and Web of Science were searched on April 27, 2022, and eligible articles were screened. Exclusion criteria were articles based on proxy reports and single case reports.

RESULTS

405 studies were screened in terms of title and abstract, with 31 articles eligible for full-text screening, resulting in a total of 11 articles eligible for inclusion, (articles including 4-82 patients). The content was analyzed, resulting in the outcome divided into seven domains: Oral Health-Related Quality of Life (OHRQoL), Dental fear, Esthetics, Psychosocial factors, Function, Dental hypersensitivity, and Treatment outcome.

CONCLUSION

The limited quantity of research on PROMS from patients with AI indicates a significant impact of OHRQoL and daily life. A large variety of approaches have been presented in the articles. Patients report concerns of esthetics, hypersensitivity, function, and a general impact on well-being and social interaction. This highlights the importance for the need of early dental treatment.

PROSPERO REGISTRATION NUMBER

256875.

Combination of two desensitizing protocols to control dentin hypersensitivity in non-carious lesions: a randomized, double-blind clinical trial

OBJECTIVES

This study evaluated the effect of photobiomodulation (PBM) combined with 8% strontium acetate (SA8%) in the treatment of dentin hypersensitivity (DH) in non-carious lesions and analyzed the risk factors with the patient's quality of life.

METHODS

Eighty teeth with DH were randomly allocated into four treatment groups (n = 20): G1, PBM imitation + toothpaste with no active ingredient; G2, PBM imitation + toothpaste with SA8%; G3, PBM + toothpaste without the active ingredient; and G4, PBM + toothpaste with SA8%. Participants were provided with a questionnaire on the experience of dentin hypersensitivity (QEDH) to assess the impact of desensitizing treatment on health-related quality of life (HRQL). Friedman and Kruskal-Wallis tests were used for intra- and intergroup comparisons, and Wilcoxon and Mann-Whitney tests were used to analyze HRQL. All analyses used significance levels of 5%.

RESULTS

Intergroup comparisons revealed a significant difference (p < 0.05); G4 had the best response in terms of HD reduction in G4 compared to the other groups on the 7th day of assessment (T3). Only G4 showed a statistically significant difference (p < 0.05) in the reduction of EDH for intragroup analysis.

CONCLUSION

The combination of therapies was more effective in reducing DH than the isolated use of these strategies.

CLINICAL RELEVANCE

The combination of therapies is effective in the treatment of DH.

Efficacy of near infrared dental lasers on dentinal hypersensitivity: a meta-analysis of randomized controlled clinical trials

Conventional therapies have aimed to try to help individuals suffering with dentine hypersensitivity (DH/DHS). A relatively new approach, laser therapy claims to be beneficial while having immediate and long-lasting effect. Therefore, our analysis aims to explore the immediate and 1-month efficacy of near-infrared laser (NIR) therapy in treating dentinal hypersensitivity. A systematic literature search conducted in databases, and analysis was undertaken utilizing a meta-analysis approach. Randomized controlled clinical trials comparing near-infrared lasers and placebo/no treatment in patients (> 18 years) were included. The risk of bias for included studies was assessed using Cochrane RoB tool (for randomized studies). Random effects meta-analyses model of standardized mean differences and 95% confidence intervals were performed using RevMan 5.4 software. A comprehensive electronic and manual search yielded a total of 1081 potential articles. Following the implementation of the inclusion and exclusion criteria, a total of 6 studies were included in the analysis. Near-infrared laser therapy led to statistical significant reduction in immediate and 1-month follow-up VAS (visual analog scale) scores compared to placebo/no treatment (p < 0.05). Statistical heterogeneity across the studies was high (I²-96%). The findings suggest that near-infrared laser therapy does have a significant immediate effect in reducing dentine hypersensitivity compared to placebo/no treatment. Furthermore, this effect is not diminished and endured at 1-month follow-up.

Evaluating the efficacy of desensitizing dentifrices on dentinal hypersensitivity management: A scanning electron microscopic analysis

Introduction

Dentin hypersensitivity (DH) adversely affects quality of life by impairing the ability to eat and drink certain foods, therefore, should be addressed promptly with a contingency plan that includes initial treatment with a noninvasive prophylactic home care approach, followed by in-office treatment if desired result is not achieved.

Aim

The purpose of this study was to evaluate the effectiveness of four different pastes containing 5% NovaMin (Sensodyne Repair and Protect^®), Propolis (Phytoshield Propolis^®), 5% potassium nitrate (Sensodyne^®), and 8% arginine (Colgate Sensitive Pro Relief^®) based toothpastes in the treatment of DH.

Materials and Methods

One hundred dentin slices were cut from the crown section of molars. Etching with 37% orthophosphoric acid was done to open the tubules. Scanning electron microscope (SEM) study was done to ensure that the tubules are opened. The dentin specimens were divided into four groups: Group 1 -5% NovaMin, Group 2 - Propolis, Group 3 - 5% potassium nitrate, and Group 4 - 8% arginine. Samples were brushed for 2 min twice daily with a soft toothbrush for 15 days and were stored in distilled water. The samples were rinsed under running water to remove the toothpaste. The SEM was performed to check the obliteration of tubules.

Results

5% NovaMin group showed more completely occluded dentinal tubules when compared to other groups. The differences among all the groups were statistically significant (P ≤ 0.05).

Conclusion

In the present study, all materials, NovaMin, Propolis, potassium nitrate, and arginine, were effective in occluding dentinal tubules but NovaMin appeared most proficient in occluding tubules, followed by arginine, potassium nitrate, and Propolis. Topical NovaMin is an upcoming agent demonstrating desensitization and remineralization properties.