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SHORT COMMUNICATION
a
Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
b
School of Public Health, Chung Shan Medical University, Taichung, Taiwan
c
School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
KEYWORDS Abstract The prevalence of dentin hypersensitivity in Taiwan has been reported up to 38%.
arginine; The aim of this study was to evaluate the clinical efficacy of desensitizing toothpaste contain-
calcium carbonate; ing 8.0% arginine and calcium carbonate in treating dentin hypersensitivity. Forty-three partic-
dentin ipants with established two hypersensitive teeth were enrolled with informed consent. Air
hypersensitivity; blast sensitivity assessments were conducted at baseline and again after four and eight weeks
toothpaste of twice-daily product use. The use of desensitizing toothpaste was found to significantly
reduce dentin hypersensitivity (P < 0.001). The one-way analysis of variance analysis followed
by Tukey’s test indicated that this desensitizing toothpaste had a time-to-improvement distri-
bution (P < 0.05). Taken together, the toothpaste containing 8.0% arginine and calcium car-
bonate provides a significant reduction in dentin hypersensitivity.
Copyright ª 2013, Association for Dental Sciences of the Republic of China. Published by
Elsevier Taiwan LLC. All rights reserved.
Introduction
1991-7902/$36 Copyright ª 2013, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved.
http://dx.doi.org/10.1016/j.jds.2013.06.008
Efficacy of arginine/calcium carbonate toothpaste 445
treatment for dentin hypersensitivity may include muco- sensitive tooth, from a distance of 1 centimeter, using the
gingival surgery, pulpectomy, and application of resin, la- air component of a dental air/water syringe. Sensitivity was
sers, topical desensitizing agents, and desensitizing recorded in accordance with the air sensitivity scale
toothpaste. Desensitizing toothpaste is considered the described as follows5:
simplest and most cost-effective treatment for most
patients. 0 Z tooth/participant sensitivity does not respond to air
Arginine, an essential amino acid, has been identified as stimulation;
an ingredient with potential oral health benefits. Kleinberg3 1 Z tooth/participant responds to air stimulus, but does
demonstrated in an early work that the combination of not request discontinuation of stimulus;
arginine bicarbonate and calcium carbonate can be depos- 2 Z tooth/participant responds to air stimulus, and re-
ited on exposed dentin surfaces to physically block and seal quests discontinuation or moves from stimulus;
open dentin tubules. This concept has recently been devel- 3 Z tooth/participant responds to stimulus, considers
oped as toothpaste containing 8.0% arginine and calcium stimulus to be painful, and requests discontinuation of
carbonate by the Colgate-Palmolive Company (New York, NY, the stimulus.
USA). In vitro mechanism of action studies have shown that
this technology works by occluding dentin tubules.4 All prospective individuals who met the inclusion/
The objectives of this clinical study are to compare the exclusion criteria and signed an informed consent form
dentin hypersensitivity reduction efficacy of toothpaste received an air blast hypersensitivity evaluation, along with
containing 8.0% arginine and calcium carbonate (Colgate an oral soft and hard tissue assessment. For each individual
Sensitive Pro-Relief) with twice daily tooth brushing over an who qualified for participation in the study, two hyper-
8-week period. sensitive teeth that satisfied the air blast hypersensitivity
enrollment criteria were identified for evaluation
Materials and methods throughout the study. Participants who met the criteria
were provided with their assigned dentifrice (Colgate Sen-
sitive Pro-Relief toothpaste, containing 8.0% arginine and
Patient selection
calcium carbonate; Colgate-Palmolive Company) and a
soft-bristled adult toothbrush for home use twice per day.
This study was reviewed and approved by the Institutional Toothpaste was applied to the entire length of the brush.
Review Board, Chung Shan Medical University Hospital. Oral soft and hard tissue assessments, as well as air blast
Forty-three patients (18 males and 25 females with a mean sensitivity follow-up evaluations of baseline-designated
age of 44.6 12.0 years) with cervical exposed hypersen- study teeth, were conducted after 4 weeks and 8 weeks
sitive dentin of caries-free teeth were selected. Two hy- of product use. All examinations were performed by the
persensitive teeth had a qualifying dentin hypersensitivity same dental examiner, using the same procedures as
response to air blast stimuli applied for 1 second to the employed at baseline. Participants were also interviewed
cervical surface (gingivo-facial 1/3) as defined by a score of with respect to the presence of adverse events and the use
2 or 3 on the air blast sensitivity scale by Schiff et al.5 of concomitant medications.
Participants were required to be in good general health
without known allergies to the products being tested, and
able to read and understand the consent form and be
Statistical analysis
willing to sign it.
Exclusion criteria included: (1) gross oral pathology, Air blast sensitivity scores were analyzed using the Wil-
chronic disease, or history of allergy to test products; (2) coxon signed rank test. A P value 0.05 was taken to be
advanced periodontal disease or treatment for periodontal significant. For time-to-improvement distribution, com-
disease (including surgery) within the past 12 months; (3) parisons between means were analyzed by one-way anal-
sensitive teeth with mobility greater than one; (4) teeth ysis of variance (ANOVA) along with Tukey’s test at a
with extensive/defective restorations (including prosthetic P < 0.05 significance level.
crowns), suspected pulpitis, caries, cracked enamel, or used
as abutments for removable partial dentures; (5) current use Results
of anticonvulsants, antihistamines, antidepressants, seda-
tives, tranquilizers, anti-inflammatory drugs, or daily use of Throughout the study, there were no adverse events on the
analgesics; (6) participation in a desensitizing dentifrice oral soft or hard tissues of the oral cavity observed by the
study or regular use of a desensitizing dentifrice within the examiner or reported by the participants when questioned.
past 3 months; (7) current participation in any other clinical In the present study, 42 (97.7%) participants reported
study; (8) pregnant or lactating women; (9) allergies to reduced dentin hypersensitivity after using the desensitiz-
arginine, oral care products, personal care consumer prod- ing toothpaste containing 8.0% arginine and calcium car-
ucts, or their ingredients; (10) a medical condition that bonate after 8 weeks. The mean value of the air blast
prohibits not eating/drinking for 4 hours. sensitivity score at baseline was 2.6, whereas the mean
value of air blast sensitivity scores after the use of desen-
Air blast sensitivity assessment sitizing toothpaste at the end of the 4 week and 8 week
periods were 1 and 0.57, respectively (Table 1). The use of
Air blast sensitivity was assessed by directing a 1-second Colgate Sensitive Pro-Relief toothpaste was found to
blast of air onto the exposed buccal root surface of the significantly reduce dentin hypersensitivity (P < 0.001). As
446 H.-C. Hsu et al
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