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      The Efficacy of Strontium and Potassium Toothpastes in Treating Dentine Hypersensitivity: A Systematic Review

      review-article
      Author(s): 1 , 2 , *
      Publication date (Electronic):
      Journal: International Journal of Dentistry
      Publisher: Hindawi Publishing Corporation

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          Abstract

          Objectives. The aim of the present paper was to review the published literature in order to identify all relevant studies for inclusion and to determine whether there was any evidence of the efficacy of strontium and potassium toothpastes in the treatment of dentine hypersensitivity (DH). Methods. Following a review of 94 relevant papers both from searching electronic databases (PUBMED) and hand searching of relevant written journals, 13 studies were identified, and 7 papers (1 for strontium-based toothpastes and 6 for potassium-based toothpastes) were finally accepted for inclusion. The main outcome measures were the methodology and assessment used by Investigators in studies designed to evaluate DH. Results. The results of the present paper would indicate that the reported efficacy of both strontium- and potassium-based toothpastes in relieving DH is questionable. Conclusions. The results from the present paper would appear to support the conclusions of previous investigators that there is only minimal evidence for the efficacy of both strontium- and potassium-based toothpastes in relieving symptoms of DH.

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          Guidelines for the design and conduct of clinical trials on dentine hypersensitivity.

          R Orchardson, L Gangarosa, Sari M. Närhi … (1997)
          Clinical trials on dentine hypersensitivity have been numerous and protocols varied. To date there is little consensus as to the conduct of studies on this poorly-understood yet common and painful dental condition. A committee of interested persons from academia and industry was convened to discuss the subject of clinical trials on dentine hypersensitivity and a consensus report is presented. A double-blind randomized parallel groups design is recommended, although cross-over designs may be used for the preliminary screening of agents. Subjects may have multiple sites scored. Sample size will be determined by estimating the variability in the study population, the effect to be detected and the power of the statistical test to be used. Subject selection is based on a clinical diagnosis of dentine hypersensitivity, excluding those with conflicting characteristics such as currently-active medical or dental therapy. The vestibular surfaces of incisors, cuspids and bicuspids are preferred as sites to be tested. A range of sensitivity levels should be included. Tactile, cold and evaporative air stimuli should be applied. Negative and benchmark controls should be incorporated. Most trials should last 8 weeks. Sensitivity may be assessed either in terms of the stimulus intensity required to evoke pain or the subjective evaluation of pain produced by a stimulus using a visual analog or other appropriate scale. The subject's overall assessment may be determined by questionnaire. Outcomes should be expressed in terms of clinically significant changes in symptoms. Follow-up evaluation is required to determine the persistence of changes. At least 2 independent trials should be conducted before a product receives approval.
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            Consensus-based recommendations for the diagnosis and management of dentin hypersensitivity.

            (2003)
            These consensus recommendations for the diagnosis and management of dentin hypersensitivity were developed by a broadly constituted board of dentists and dental hygienists drawn from general dental practice, specialist practice, academia and research from across Canada, joined by 2 international dentists with subject matter expertise. The need for consensus recommendations was made evident by the lack of clear and robust evidence in the dental literature, as well as confusion about diagnosis and management demonstrated by an educational needs assessment survey. High prevalence of the condition, underdiagnosis and widespread availability of noninvasive, efficacious and inexpensive preventive treatment further underscored the need for direction. This paper outlines the key elements of the scientific basis for the causes, diagnosis and management of dentin hypersensitivity; where such evidence is deficient, the document relies on the compound experience of the board. A simple algorithm was developed to guide clinicians through the diagnostic process and assist them in determining appropriate case management. Finally, the board makes a series of recommendations to raise awareness, to improve dental education, to develop symbols for charting, to develop an index for case assessment and for further research.
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              Managing dentin hypersensitivity.

              Robin Orchardson, Linda D Gillam (2006)
              The objective of this review is to inform practitioners about dentin hypersensitivity (DH) and its management. This clinical information is described in the context of the underlying biology. The authors used MEDLINE to find relevant English-language literature published in the period 1999 to 2005. They used combinations of the search terms "dentin*," "tooth," "teeth," "hypersensit*," "desensiti*" and "desensitiz*." They read abstracts and then full articles to identify studies describing etiology, prevalence, clinical features, controlled clinical trials of treatments and relevant laboratory research on mechanisms of action. The prevalence of DH varies widely, depending on the mode of investigation. Potassium-containing toothpastes are the most widely used at-home treatments. Most in-office treatments employ some form of "barrier," either a topical solution or gel or an adhesive restorative material. The reported efficacy of these treatments varies, with some having no better efficacy than the control treatments. Possible reasons for this variability are discussed. A flowchart summarizes the various treatment strategies. DH is diagnosed after elimination of other possible causes of the pain. Desensitizing treatment should be delivered systematically, beginning with prevention and at-home treatments. The latter may be supplemented with in-office modalities.
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                Author and article information

                Journal
                Journal ID (nlm-ta): Int J Dent
                Journal ID (iso-abbrev): Int J Dent
                Journal ID (publisher-id): IJD
                Title: International Journal of Dentistry
                Publisher: Hindawi Publishing Corporation
                ISSN (Print): 1687-8728
                ISSN (Electronic): 1687-8736
                Publication date (Print): 2013
                Publication date (Electronic): 8 April 2013
                Volume: 2013
                Electronic Location Identifier: 573258
                Affiliations
                1Dental Institute, Kings College London, Floor 18, Tower Wing, Guys Hospital, London SE1 9RT, UK
                2Centre for Adult Oral Health, Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University, London E1 2AD, UK
                Author notes

                Academic Editor: Dimitris N. Tatakis

                Article
                DOI: 10.1155/2013/573258
                PMC ID: 3638644
                PubMed ID: 23653647
                SO-VID: f36cc5e1-8f58-4ad1-97b0-bfd07ad220d2
                Copyright © Copyright © 2013 B. F. A. Karim and D. G. Gillam.
                License:

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 18 October 2012
                Date revision received : 27 January 2013
                Date accepted : 25 February 2013
                Categories
                Subject: Review Article

                ScienceOpen disciplines: Dentistry
                Data availability:
                ScienceOpen disciplines: Dentistry

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