New study suggests better outcomes with arginine toothpaste and mouthwash regimen for dentine hypersensitivity treatment.

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Earlier this month (Dental Elf 18th Feb) we looked at a systematic review of the use of arginine toothpastes to reduce dentine hypersensitivity.   A new study is now available which compares arginine toothpaste, potassium nitrate toothpaste against a standard fluoride toothpaste.

Adult patients with at least two hypersensitive teeth were randomised to one of three treatment regimen. Involving brushing with the assigned soft-bristle toothbrush and toothpaste for 1 min twice a day (morning and evening) followed by rinsing with regimen’s mouthrinse.  The regimens were:-

Arginine toothpaste (8% arginine and 1450 ppm fluoride) and mouthwash (.8% arginine, PVM/MA copolymer, pyrophosphates, and 0.05% sodium fluoride with alcohol-free base).

Potassium toothpaste (5% potassium nitrate and 1450 ppm fluoride) and mouthwash (0.51% potassium chloride and 230ppm sodium fluoride, in an alcohol base)

Control toothpaste (1450 ppm fluoride) and arginine and potassium free mouthwash

Participants were not allowed an additional oral hygiene aids such a floss or interdental stimulators.

Tactile and air blast hypersensitivity were assessed at two, four and eight weeks, any adverse events noted.

  • 40 participants were randomised to each group and 118 completed the study
  • The Tactile hypersensitivity mean scores showed statistically significant improvement at two, four and eight ( p ≤0.001) weeks in the arginine regime; the potassium regime did not show significant ( p ≥0.05) improvement.
  • Air-Blast Hypersensitivity scores had a statistically significant decrease at two (p=0.006), four (p=0.006) and eight (p=0.002) weeks in arginine and potassium regimes ( p ≤0.05).
  • The most effective treatment proved to be arginine ( p ≤0.05) compared to the potassium regime.

The authors concluded.

Arginine regimen provided the greatest reduction in Tactile and Air-Blast dentine hypersensitivity compared to potassium and negative control regimens; and provides faster dentine hypersensitivity relief than potassium regimen.

Source of funding:- This study was sponsored by Colgate-Palmolive, New York, NY. Bernal Stewart, Fotinos Panagakos and William De Vizio are employees of the Colgate-Palmolive Company

Comment

This study suggests that a regimen involving both arginine toothpaste and mouthwash provides better and faster outcomes. It is worth noting that these are based on group mean scores.   A 2008 Cochrane review (Poulsen et al) of potassium containing toothpaste for dentine hypersensitivity which included 6 studies found no clear effect for potassium toothpastes. There is also little evidence to support oxalates  ( Dental Elf  June 11th 2013) although a review by Po-Yen et al suggested that most active treatment options provided some benefit ( Dental Elf 4th Sept 2012).

Links

Elias Boneta AR, Ramirez K, Naboa J, Mateo LR, Stewart B, Panagokos F, De Vizio W. Efficacy in reducing dentine hypersensitivity of a regimen using a toothpaste containing 8% arginine and calcium carbonate, a mouthwash containing 0.8% arginine, pyrophosphate and PVM/MA copolymer and a toothbrush compared to potassium and negative control regimens: An eight-week randomized clinical trial. J Dent. 2013 Feb 1. doi:pii: S0300-5712(12)00313-2. 10.1016/j.jdent.2012.11.011.  [Epub ahead of print] PubMed PMID: 23380274.

Poulsen S, Errboe M, Lescay Mevil Y, Glenny AM. Potassium containing toothpastes for dentine hypersensitivity. Cochrane Database of Systematic Reviews 2006, Issue 3. Art. No.: CD001476. DOI: 10.1002/14651858.CD001476.pub2.

Dental Elf 18th Feb 2013 – Limited evidence available for the effectiveness of the effectiveness of arginine containing toothpastes in managing dentine hypersensitivity

Dental Elf 4th Sept 2012 – New review suggests that most dentine hypersensitivity treatments provide some benefit

Dental Elf 11th June 2012 – Limited evidence for the use of oxalates for treating dentine hypersensitivity

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Derek Richards

Derek Richards is the Director of the Centre for Evidence-based Dentistry, Editor of the Evidence-based Dentistry Journal, Consultant in Dental Public Health with Forth Valley Health Board and Honorary Senior Lecturer at Dundee & Glasgow Dental Schools. He helped to establish both the Centre for Evidence-based Dentistry and the Evidence-based Dentistry Journal. He has been involved with teaching EBD and a wide range of evidence-based initiatives both nationally and internationally since 1994.

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