New review suggests that most dentine hypersensitivity treatments provide some benefit

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Dentine hypersensitivity  – is a short sharp pain that arises from exposed dentine typically in response to thermal stimuli.  The aim of this review and network meta-analysis was to compare the effectiveness of different in-surgery treatments for dentine hypersensitivity.

The databases Medline, Science Direct, ISI web of science, Ovid, and Cochrane Central Register of Controlled Trials were searched and the references of previous reviews checked. There were no language restrictions. The search and data extractions were conducted independently in duplicate. Three authors performed quality assessments independently. Disagreements were resolved by discussion. Active treatments were considered in 5 main groups; physical occlusion of dentinal tubules; chemical occlusion of dentinal tubules; nerve desensitization; photobiomodulating action (Laser therapy); and combined treatments. Network meta-analysis, was undertaken using the Bayesian hierarchical random-effects modelling

  • 40 trials were included in the meta-analysis with the overall results showing that most active treatments had better outcomes than placebo although there was no significant difference between the 5 active treatment groups.

The authors concluded

The results from network meta-analysis showed that most active treatment options including physical occlusion, chemical occlusion, laser therapy, and combined therapy had significantly better treatment outcome than placebo. The comparisons of the five active treatment groups showed no significant differences.

Comment

There have been other reviews of treatments for dentine hypersensitivity on the 11th June 2012 we featured a review by Cunha-Cruz.  That review focuses on just the use of Oxalates while a Cochrane review by Poulsen et al (2006) looked at potassium containing toothpastes. Neither of those two reviews suggested significant treatment benefits.  However, a review by He et al that we featured on the 25th June 2012 suggested a slight benefit from laser treatment. The review authors highlight issues with the quality of the trials and this issue has also been raised in the other reviews. The challenge of a gold standard test for dentine hypersensitivity also presents a challenge for researches and reviewers. The results of the previous reviews and the quality issues mean the conclusions of this review should be considered in this light.

Links

Po-Yen Lin, Ya-Wen Cheng, Chia-Yi Chu,  Kuo-Liong Chien, Chun-Pin Lin, Yu-Kang Tu, In-Office Treatment for Dentin Hypersensitivity: A Systematic Review and Network Meta-Analysis DOI: 10.1111/jcpe.12011     Journal of Clinical Periodontology – Accepted article.

Dental Elf   11th June 2012

Dental Elf   25th June 2012

 

 

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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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