May 2010, Volume 6, Issue 5
Published by AEGIS Communications
An effective treatment for dentin hypersensitivity.
The diagnosis of dentin hypersensitivity often poses a challenge for the dental professional. The cause and description of the pain reported by the patient can vary and is often not adequate to make a definitive diagnosis. The dental professional often needs to perform a thorough examination, as well as additional tests, to determine why the pain is occurring and to rule out other possible causes of the pain (periodontal disease, caries, etc). Then, an appropriate treatment plan to address the problem can be implemented.
As a result of any number of factors, including abrasion or periodontal disease causing gingival recession, or erosion removing the surface of tooth enamel, the underlying dentin and dentin tubules can become exposed. An external stimulus, such as a change in external temperature, air movement, or physical stimulus, can cause the patient discomfort. The external stimulus is usually transitory, and the discomfort subsides shortly after the stimulus is removed.
Treatment and Prevention
The treatment and prevention of dentin hypersensitivity has focused on eliminating the ability of the causative agent to stimulate discomfort. This has resulted in the development of two major classes of products—agents that occlude dentin tubules and desensitizing agents that interfere with the transmission of nerve impulses.
Occluding agents act by physically covering or “plugging” the open, exposed dentin tubules, preventing the effect of thermal changes or physical stimuli caused by the movement of dentin fluid due to pressure changes. This might be considered a more “natural” treatment process, in a sense re-creating the missing cementum layer that previously covered the dentin tubules. These agents can be applied professionally in the office or by the patient using home-care products.
Desensitizing agents work by altering the levels of charged molecules in the dentin fluid. The most commonly used agent is potassium nitrate, usually delivered in a dentifrice that is applied daily by the patient during regular toothbrushing. The potassium ions must pass from the external dentin surface, through the dentin tubule to the pulp to reduce the excitation caused by fluid movement in the dentin tubules, and block the transmission of the stimulus from the odontoblastic process to the nerve in the pulp chamber. Most products require continued use over a 4- to 8-week period before significant relief may be realized. In addition, use of the product often needs to be continued to maintain the relief afforded by the potassium ions/salts.
Pro-Argin™ Technology Treats Hypersensitivity
In 2009, the Colgate-Palmolive Company introduced a new in-office treatment for dentin hypersensitivity called Colgate® Sensitive Pro-Relief™ desensitizing paste (Figure 1), based on the Pro-Argin technology. The Pro-Argin™ technology consists of arginine, a naturally occurring amino acid, and an insoluble calcium compound, in the form of calcium carbonate. These ingredients are delivered in a paste containing a mild abrasive system, and can be applied with a prophylaxis cup or a cotton-tipped applicator to teeth that exhibit dentin hypersensitivity. Mechanism of action studies have shown that this technology physically seals dentin tubules with a plug that contains arginine, calcium, and phosphate. This plug, which is resistant to normal pulpal pressures and to acid challenge, effectively reduces dentin fluid flow, and thereby reduces sensitivity.
Laboratory tests demonstrating the product’s mode of action, as well as clinical trials demonstrating relief of dentin hypersensitivity immediately and 4 weeks after a single application have been presented as evidence that the Pro-Argi technology provides instant and lasting relief of dentin hypersensitivity. The full range of research studies can be accessed on the Colgate Dental Professional Web site (http://www.colgateprofessional.com).
The paste is gentle to gingival tissues, does not elicit pain when applied, and has a pleasant mint flavor. The dental professional applies a small amount of paste to sensitive tooth surfaces with a slowly rotating soft prophy cup. It can also be spot-applied using a cotton-tipped applicator. Paste can also be applied to furcations and other hard-to-reach areas with a microbrush. The dental professional should carefully burnish the paste into all sensitive areas, focusing on the CEJ and exposed dentin.
Full-mouth or site-specific application of Colgate Sensitive Pro-Relief desensitizing paste results in immediate and lasting relief that lasts 4 weeks. Patients may achieve immediate relief with one application; however, patients with severe dentin hypersensitivity may require additional in-office treatments.
Clinicians encounter patients with dentin hypersensitivity on a regular basis. While every patient is different, dentin hypersensitivity is a condition that can be managed. The Colgate-Palmolive Company is pleased to present Colgate Sensitive Pro-Relief desensitizing paste with Pro-Argin technology as the newest treatment option for this problem.
About the Author
This article was written by Fotinos Panagakos, DMD, PhD, Director of Clinical Research Relations and Strategy, Colgate-Palmolive Company, Piscataway, New Jersey.
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