Clinical evaluation of the efficacy of a desensitizing paste containing 8% arginine and calcium carbonate for the in-office relief of dentin hypersensitivity associated with dental prophylaxis
Am J Dent . 2009;22(Special No. A):16A-20A.
Abstract
PURPOSE: To evaluate the clinical efficacy in reducing dentin hypersensitivity of a professional desensitizing paste containing 8% arginine and calcium carbonate relative to that of a commercially available pumice prophylaxis paste when applied pre-procedurally to a professional dental cleaning (dental prophylaxis). METHODS: This was a single-center, parallel group, double-blind, stratified clinical study, conducted in Langhorne , Pennsylvania . Adult male and female subjects who presented a tactile hypersensitivity score (Yeaple Probe) between 10 and 50 grams of force and an air blast hypersensitivity score of 2 or 3 (Schiff Cold Air Sensitivity Scale) were stratified according to their baseline hypersensitivity scores and randomly assigned within strata to one of two treatment groups. The two treatment groups were: (1) a Test paste, a desensitizing paste containing 8% arginine and calcium carbonate (Colgate-Palmolive Co); and (2) a Control paste, Nupro pumice prophylaxis paste (Dentsply Professional). Subjects had their assigned paste applied immediately before receiving a professional dental cleaning procedure. After the completion of the dental cleaning procedure, tactile and air blast dentin hypersensitivity examinations were again performed following the same methodology employed for the baseline hypersensitivity examinations. RESULTS: 45 subjects completed the study. At the final hypersensitivity examinations, conducted immediately after the completion of the dental cleaning procedure, subjects assigned to the test group exhibited statistically significant improvements from baseline with respect to baseline-adjusted mean tactile (132.1%) and air blast hypersensitivity scores (48.6%). Additionally, subjects assigned to the control group exhibited a statistically significant hypersensitivity improvement from baseline with respect to baseline-adjusted mean air blast hypersensitivity scores (13.9%). The hypersensitivity improvement from baseline indicated for the control group for mean tactile hypersensitivity scores (21.7%) was not statistically significant. At the final hypersensitivity examinations, statistically significant differences were indicated between the test group and the control group with respect to baseline-adjusted mean tactile (110.0%) and air blast hypersensitivity scores (41.9%).
Commentary
This research article presents a new desensitizing paste for in-office application to reduce postoperative dentin hypersensitivity after routine dental cleanings. The mode of action mimics the chemical reactivity of saliva in carrying calcium and phosphate ions for deposition on the dentin and root surfaces, gradually causing open dentinal tubule occlusion. The mix of 8% arginine and calcium carbonate work synergistically with the calcium and phosphate in the oral environment using a similar mode of action to that of saliva, but in a significantly more rapid deposition and effective clogging of the tubules. This results in the creation of a dentin plug that resists normal pulpal pressures and acid attack leading to a desensitizing effect. The study evaluated the effectiveness of the desensitizing paste as a sensitivity preventive applied before a dental prophylaxis. The authors used standardized methods for evaluating dentin hypersensitivity. This novel desensitizing formulation provided statistically significant reductions in dental hypersensitivity after the procedure when compared to the control. This very promising research may provide a commercially available product that dental professionals can use as a pretreatment and posttreatment regimen to allow our patients to be more comfortable. It has been reported that patients remember negative experiences from their dental visits and these negative experiences may influence their anticipation of discomfort during the next dental visit. The use of an 8% arginine and calcium carbonate desensitizing paste may reduce this problem.
