Management of Dentine Hypersensitivity: Efficacy of Professionally and Self-Administered Agents

J Clin Periodontol 2015; 42 (Suppl. 16): S256S302 doi: 10.1111/jcpe.
12336
Management of dentine
hypersensitivity: efficacy of
professionally and
self-administered agents
Nicola X. West, Joon Seong and

Maria Davies
Periodontology, Clinical Trials Unit, Bristol
Dental School, Bristol, UK
West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of

professionally and self-administered agents. J Clin Periodontol 2015; 42 (Suppl.
16): S256S302. doi: 10.1111/jcpe.12336.
Abstract
Context: The gold standard treatment modality for dentine hypersensitivity has
not yet been established. This review examines the effectiveness of self and
professionally applied treatments for the reduction in pain from dentine
hypersensitivity.
Materials and Methods: Electronic (three databases) and hand searches were
performed 1421 July 2014 to identify randomized controlled trials for the
treatment of dentine hypersensitivity.
Results: This systematic review provided numerous treatment modalities for dentine hypersensitivity. Eleven agents and 105 Randomized Controlled Trials were
robust enough to be included. The studies varied considerably in design, observation period, active agents, formulation of the whole agent, negative and positive
controls and comparator products investigated. The stimuli used were predominantly airblast and tactile or thermal. Due to the heterogeneity between the studies and lack of direct comparison between agents there was insufficient data to
undertake a meta-analysis to compare agents for meaningful conclusions. Best
available evidence for each treatment agent has been documented as a narrative.
Conclusions: Treatments including stannous fluoride, arginine, calcium sodium
phosphosilicate and strontium toothpaste appear to be clinically effective for the
treatment of dentine hypersensitivity compared to comparators and controls.
There is limited evidence to confirm the relative effectiveness of individual
professionally applied agents.
Dentine hypersensitivity (DH) is a

common, transient oral pain condition, the pain resulting immediately
on stimulation of exposed dentine
Conflict of interest and source of
funding statement
The authors declare that they have no
conflict of interests.
No funding was received for this systematic review.
S256
and resolving on stimulus removal

(Holland et al. 1997). The pain is
short, sharp and of arresting nature,
affecting quality of life (Boiko et al.
2010), 28% of a study population of
3000 stating that DH affected them
importantly or very importantly
(West et al. 2013b). Prevalence figures range widely depending on how
the data were collected, a recent
study demonstrating 42% of 1835year olds have sensitivity (West et al.
Key words: dentine hypersensitivity;

professionally applied; RCT; self
administered; sensitivity; therapy; toothpaste
Accepted for publication 9 November 2014
2013b). Risk factors include gingival

recession particularly associated with
toothbrushing and periodontal disease. Furthermore, a healthy erosive
diet and lifestyle are linked to tooth
wear and dentine hypersensitivity,
most noticeably in young adults
(West et al. 2013b). As life expectancy of the population is rising and
people are retaining more vital or
minimally restored teeth (Nuttall
et al. 2001) prone to tooth wear,
2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Management of dentine hypersensitivity

dentine hypersensitivity is likely to
become a more frequent occurrence.
The effectiveness of the myriad of
available treatment agents for DH
needs to be assessed and compared
to aid the clinicians management of
this oral pain condition.
Over many years numerous products have been suggested for the
relief of dentine hypersensitivity,
working on treatment mechanisms
to reduce the stimulus-induced fluid
flow in the dentinal tubules and consequent nociceptor activation in the
pulp/dentine border area (N
ahri
et al. 1992, Matthews et al. 2000).
For dentine hypersensitivity to
occur, the dentine surface of a tooth
must be exposed with enamel or
cementum removal, this being
termed lesion localization. Furthermore, a number of dentine
tubules, in close proximity to each
other, must be patent from the pulp
to the oral environment, this being
termed lesion initiation (Addy
2002). These two conditions must be
present in order for the individual to
experience pain (Absi et al. 1987,
Nahri et al. 1992). This explains the
concept of why tubular occlusion
treatment, of whatever nature, is
thought to reduce hypersensitivity
pain, and is the most favoured current mode of treatment action.
Treatment effectiveness depends on
the resistance to occlusion removal
by oral acidic challenges of day-today activity. An alternative mechanism for reducing pain is modification or blocking of pulpal nerve
response. Desensitizing agents such
as potassium ions may reduce intradental nerve excitability by diffusing
along the tubules and raising the
concentration of local extracellular
potassium ions, hence blocking
intra-dental nerve function (N
ahri
et al. 1992). Prior to advocating
treatment regimens it is important
to consider changing aetiological
causative agents to prevent the perpetuation of the condition for either
mode of treatment action to be successful.
The majority of treatment is self
administered utilizing toothpaste
products, with professionally applied
agents usually reserved for more
severe or non-responding cases. It
has been difficult to prove effectiveness of one product over another
due to disparities in trial design,
method of pain evaluation and constituents of the agent as a whole, e.g.

the contribution of silica abrasive
agents to tubule occlusion. An active
agent may be tested against a negative control, the agent minus the
active ingredient, a conventional
fluoride benchmark agent, a comparator agent or a positive control,
making comparisons of active agents
difficult. More recently trial design
has been more comparable but as
yet, one treatment modality has not
been found completely effective, and
superior to all others. The aim of
this systematic review was to evaluate the effectiveness of self administered and/or professionally applied
treatment modalities for the reduction in pain from dentine hypersensitivity.
Materials and Methods
Literature search
The PRISMA checklist was followed

to present this review (Moher et al.
2009) and the protocol was designed
to answer the focused question (Needleman 2002): What is the effectiveness of desensitizing agents, both self
administered
and
professionally
applied, for relieving the pain of DH
compared to placebo and/or benchmark control and/or other active
agents?
Search strategy
An extensive literature search was

conducted using electronic databases
(PubMed, Medline, and The Cochrane Database Trials Register) for
studies published in peer-reviewed
journals. The search was limited to
English language. Searches were
conducted between 14th and 21st
July 2014, and all papers previous to
this were considered for inclusion in
this review.
Search terms
Pubmed
Terms that were searched for
were hypersensitivity OR sensitivity AND dentin AND one
of the following treatments: arginine, NovaMin (GlaxoSmithKline,
Brentford, UK) (CSPS), oxalates,
potassium, PVM copolymer, stannous, strontium, casein, Gluma
S257
(Heraeus Kulzer GmbH, IN 46614

USA), laser, Seal and Protect
(Dentsply, GL103GB), Duraphat
(Colgate Palmolive, Guildford, Surrey GU2 8J2), Bifluorid (Voco
27472 Cuxhaven, Germany), resin,
varnish and glass ionomer. Search
terms and MeSH terms for each
treatment and the number of articles
they yielded are detailed in Tables 1
and 2.
Medline
Terms that were searched for were
treatment.mp and dentine hypersensitivity.mp or *Dentin sensitivity. These search terms were
combined and the number of articles
they yielded were reviewed for inclusion, and detailed in Table 3. This
search was compared with the Pubmed searches and relevant articles
that had not already been identified
by the Pubmed searches were added
to the list for further review.
Cochrane clinical trials database
Terms that were searched for were
(sensitivity Or hypersensitivity) AND
dentin, and the search limited to trials. The number of articles this
search yielded that were reviewed for
inclusion are included in Table 3.
This search was compared with the
Medline and Pubmed searches and
relevant articles that had not already
been identified by the Medline or
Pubmed searches added to the list
for further review.
Criteria for considering publications for
this study
Inclusion criteria
Studies were only considered which
(a)were randomized clinical trials
that recruited human subjects,
(b)were parallel or split-mouth
design
(c)compared the test agent with a
negative control/placebo or comparator agent (negative controls were
true placebos, i.e. the test agent
without the active ingredient or a
conventional benchmark agent with
no ingredients considered to reduce
dentine hypersensitivity, e.g. conventional benchmark fluoride paste.
Positive controls were comparator
products for which efficacy of reducing dentine hypersensitivity had
already been demonstrated).
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West et al.
Table 1. Searches completed in Pubmed 1421st July 2014

Search
Search terms as entered into PubMed (all searches restricted to English language)
Arginine
Casein
hypersensitivity OR sensitivity AND dentin AND arginine

1 hypersensitivity OR sensitivity AND dentin AND Casein
2 hypersensitivity OR sensitivity AND dentin AND CPP NOT Casein
3 hypersensitivity OR sensitivity AND dentin AND ACP NOT Casein
Seal & Protect

Duraphat
Bifluorid
Gluma
PMV copolymer
Varnish
Resin
Strontium
Potassium
Oxalate
NovaMin
hypersensitivity OR sensitivity AND dentin AND Seal & Protect

hypersensitivity OR sensitivity AND dentin AND Duraphat
hypersensitivity OR sensitivity AND dentin AND Bifluorid
hypersensitivity OR sensitivity AND Gluma AND dentin
hypersensitivity OR sensitivity AND dentin AND PVM AND copolymer
hypersensitivity OR sensitivity AND varnish AND dentin*
Sensitivity OR hypersensitivity AND dentin AND resin
Sensitivity OR hypersensitivity AND dentin AND strontium
hypersensitivity OR sensitivity AND dentin AND Potassium
hypersensitivity OR sensitivity AND dentin AND oxalate
1 hypersensitivity OR sensitivity AND dentin AND NovaMin (23 results)
2 hypersensitivity OR sensitivity AND dentin AND calcium sodium
phosphosilicate NOT NovaMin (5 results)
Stannous
Laser
Glass ionomer
hypersensitivity OR sensitivity AND dentin AND stannous

hypersensitivity OR sensitivity AND dentin AND laser NOT caries
hypersensitivity OR sensitivity AND dentin AND glass ionomer NOT resin
Number of
items found
Number of
relevant articles*
63
17
8
6
30
5
17
19
0
78
11
65
527
97
180
98
23
5
4
8
0
22
6
18
28
20
65
15
12
50
172
61
22
41
1
*See Inclusion and Exclusion criteria (102 articles appeared in more than one PubMed search).
(d)tested the efficacy of agents in

the treatment of dentine hypersensitivity.
Exclusion criteria
Studies not meeting the inclusion criteria and:
(a) reviews
(b) case reports
(c) letters
(d) editorials
(e) conference abstracts
(f) articles in publications that are
not available on line
(g) in vitro studies and in situ studies
(studies
involving
intra-oral
appliances holding tooth samples
in the mouth which are investigated for desensitizing properties
such as tubule occlusion)
were excluded.
Selection of studies
Titles derived from these broad

searches were independently screened
by two authors based on the inclusion and exclusion criteria. Disagreements were resolved by discussion.
Following this, abstracts of all titles
agreed upon by both authors were

obtained, and further screened for
meeting the inclusion and exclusion
criteria (Figure 1). The full text of
the selected articles was then
obtained and assessed for study
inclusion and disagreements were
resolved by discussion. The number
of articles assessed at each selection
point and details of how those
selected were grouped for review are
shown in Table 4.
2 weeks or more. These definitions

reflect the fact that studies examining the efficacy of products at
2 weeks were trying to determine
longer term (not immediate effects).
Assessment quality
The methodological quality and risk

of bias of the papers was assessed as
follows:
Description of study design
The study design should include
details of:
Data extraction
Data from the selected articles were

extracted to excel spread sheets for
direct comparison of study methodologies and results.
Data were only extracted for
studies in which the outcome measure was the reduction in dentine
hypersensitivity pain in response to
tactile, evaporative (airblast) or thermal stimulation.
Short-term studies were defined
as those measuring relief of dentine
hypersensitivity immediately after
intervention and at time points up to
1 week, and long-term studies were
defined as those measuring relief
from dentine hypersensitivity at
randomization
blinding
eligibility criteria
Intervention
The study should include
details of administration of the

product
a positive control/comparator
product
a negative control/placebo
Outcome Measures
The study should
PMV copolymer
Gluma
Bifluorid
Duraphat
Seal & Protect
(hypersensitivity[MeSH Terms] OR hypersensitivity[All Fields]) OR (sensitivity and specificity[MeSH Terms] OR (sensitivity[All Fields] AND
specificity[All Fields]) OR sensitivity and specificity[All Fields] OR sensitivity[All Fields]) AND (dentin[MeSH Terms] OR dentin[All Fields]) AND
(seals, earless[MeSH Terms] OR (seals[All Fields] AND earless[All Fields]) OR earless seals[All Fields] OR seal[All Fields]) AND Protect[All Fields]
AND English[lang]
(sodium fluoride topical preparation[Supplementary Concept] OR sodium fluoride topical preparation[All Fields] OR Duraphat[All Fields]) AND
English[lang]
Bifluorid [All Fields] AND English[lang]
specificity[All Fields]) OR sensitivity and specificity[All Fields] OR sensitivity[All Fields]) AND (Gluma[Supplementary Concept] OR Gluma[All
Fields] OR Gluma[All Fields]) AND (dentin[MeSH Terms] OR dentin[All Fields]) AND English[lang]
PVM[All Fields] AND copolymer[All Fields]
1 (hypersensitivity[MeSH Terms] OR hypersensitivity[All Fields]) OR (sensitivity and specificity[MeSH Terms] OR (sensitivity[All

Fields] AND specificity[All Fields]) OR sensitivity and specificity[All Fields] OR sensitivity[All Fields]) AND (dentin[MeSH Terms]
OR dentin[All Fields]) AND (caseins[MeSH Terms] OR caseins[All Fields] OR casein[All Fields]) AND English[lang]
OR dentin[All Fields]) AND (3-(2-carboxypiperazin-4-yl)propyl-1-phosphonic acid[Supplementary Concept] OR 3-(2-carboxypiperazin4-yl)propyl-1-phosphonic acid[All Fields] OR cpp[All Fields]) NOT (caseins[MeSH Terms] OR caseins[All Fields] OR casein[All
Fields]) AND English[lang]
OR dentin[All Fields]) AND (Aust Community Psychol[Journal] OR acp[All Fields] OR Atmos Chem Phys[Journal] OR acp[All
Fields] OR Appl Cogn Psychol[Journal] OR acp[All Fields] OR Appl Cardiopulm Pathophysiol[Journal] OR acp[All Fields] OR
Ann Coloproctol[Journal] OR acp[All Fields]) NOT (caseins[MeSH Terms] OR caseins[All Fields] OR casein[All Fields]) AND
English[lang]
(sensitivity and specificity[MeSH Terms] OR (sensitivity[All Fields] AND specificity[All Fields]) OR sensitivity and specificity[All Fields] OR
sensitivity[All Fields]) OR (hypersensitivity[MeSH Terms] OR hypersensitivity[All Fields]) AND (dentin[MeSH Terms] OR dentin[All Fields]) AND
(arginine[MeSH Terms] OR arginine[All Fields]) AND English[lang]
Arginine
Casein
MeSH terms as entered into PubMed
Search
Table 2. MeSH terms for searches completed in Pubmed 1421st July 2014
22
78
11
19
18
8
6
17
30
Number
of relevant
articles*
63
Number of
items found

S259
specificity[All Fields]) OR sensitivity and specificity[All Fields] OR sensitivity[All Fields]) AND (paint[MeSH Terms] OR paint[All Fields] OR
varnish[All Fields]) AND (dentin[All Fields] OR dentin[All Fields] OR dentinallomanyban[All Fields] OR dentins[All Fields] OR dentina[All Fields] OR
dentinabdichtende[All Fields] OR dentinablagerung[All Fields] OR dentinabrieb[All Fields] OR dentinadhaesiver[All Fields] OR dentinadhasiv[All Fields] OR
dentinadhasivanwendung[All Fields] OR dentinadhasiven[All Fields] OR dentinadhesive[All Fields] OR dentinaira[All Fields] OR dentinaire[All Fields] OR
dentinaires[All Fields] OR dentinal[All Fields] OR dentinale[All Fields] OR dentinales[All Fields] OR dentinalgia[All Fields] OR dentinali[All Fields] OR
dentinallomanyanak[All Fields] OR dentinally[All Fields] OR dentinals[All Fields] OR dentinan[All Fields] OR dentinanasthesie[All Fields] OR dentinanbau[All
Fields] OR dentinar[All Fields] OR dentinara[All Fields] OR dentinare[All Fields] OR dentinaria[All Fields] OR dentinarias[All Fields] OR dentinario[All
Fields] OR dentinarios[All Fields] OR dentinary[All Fields] OR dentinas[All Fields] OR dentinbehandling[All Fields] OR dentinbehandlung[All Fields] OR
dentinbereich[All Fields] OR dentinbestandes[All Fields] OR dentinbildung[All Fields] OR dentinbildungen[All Fields] OR dentinbinder[All Fields] OR
dentinbindere[All Fields] OR dentinbinding[All Fields] OR dentinbloc[All Fields] OR dentinbond[All Fields] OR dentinbonding[All Fields] OR dentinbuild[All
Fields] OR dentincharakterisierung[All Fields] OR dentincomposite[All Fields] OR dentindesinfektion[All Fields] OR dentindurchdringungsfahigkeit[All Fields]
OR dentindysplalsie[All Fields] OR dentindysplasie[All Fields] OR dentine[All Fields] OR dentine[All Fields] OR dentines[All Fields] OR dentinebehandeling
[All Fields] OR dentinedysplasie[All Fields] OR dentinegevoeligheid[All Fields] OR dentinehechtlakken[All Fields] OR dentinei[All Fields] OR dentinelaesies[All
Fields] OR dentinelvaltozasanak[All Fields] OR dentinema[All Fields] OR dentinents[All Fields] OR dentinephtys[All Fields] OR dentines[All Fields] OR
dentinesurfaces[All Fields] OR dentinet[All Fields] OR dentinets[All Fields] OR dentinetubuli[All Fields] OR dentinfehlbildung[All Fields] OR
dentinfehlbildungen[All Fields] OR dentinfeuchtigkeit[All Fields] OR dentinflachen[All Fields] OR dentinfor[All Fields] OR dentinformen[All Fields] OR
dentinfraktur[All Fields] OR denting[All Fields] OR dentinge[All Fields] OR dentingenically[All Fields] OR dentinger[All Fields] OR dentingewebe[All Fields]
OR dentinhaft[All Fields] OR dentinhaftmittel[All Fields] OR dentinhaftmitteln[All Fields] OR dentinhaftung[All Fields] OR dentinhaftvermittler[All Fields]
OR dentinhaftvermittlern[All Fields] OR dentinho[All Fields] OR dentinhyperaesthesi[All Fields] OR dentinhyperaesthesie[All Fields] OR dentinhyperasthesie
[All Fields] OR dentinhyperasthesis[All Fields] OR dentinhypermineralization[All Fields] OR dentinhypersensibilitat[All Fields] OR dentinhypoplasie[All Fields]
OR dentini[All Fields] OR dentinigenesis[All Fields] OR dentinimpragnation[All Fields] OR dentinin[All Fields] OR dentininnervation[All Fields] OR
dentinisolierenden[All Fields] OR dentinites[All Fields] OR dentinitis[All Fields] OR dentinkanaelchen[All Fields] OR dentinkanal[All Fields] OR
dentinkanalchen[All Fields] OR dentinkapillargeruest[All Fields] OR dentinkaries[All Fields] OR dentinkavitaten[All Fields] OR dentinkaviteter[All Fields] OR
dentinkepzo[All Fields] OR dentinklaeber[All Fields] OR dentinkonditionierung[All Fields] OR dentinkontakt[All Fields] OR dentinkronen[All Fields] OR
dentinkronenrelief[All Fields] OR dentinlike[All Fields] OR dentinliquor[All Fields] OR dentinliquors[All Fields] OR dentinnogo[All Fields] OR dentinnoi[All
Fields] OR dentinnye[All Fields] OR dentinnykh[All Fields] OR dentino[All Fields] OR dentinoalveolar[All Fields] OR dentinoameloblastoma[All Fields] OR
dentinoberflache[All Fields] OR dentinoberflachen[All Fields] OR dentinoblast[All Fields] OR dentinoblastos[All Fields] OR dentinoblasts[All Fields] OR
dentinoblasts[All Fields] OR dentinocemental[All Fields] OR dentinocementum[All Fields] OR dentinoclast[All Fields] OR dentinoclastic[All Fields] OR
dentinoclastlike[All Fields] OR dentinoclasts[All Fields] OR dentinoenamel[All Fields] OR dentinofacial[All Fields] OR dentinogenese[All Fields] OR
dentinogeneses[All Fields] OR dentinogenesi[All Fields] OR dentinogenesis[All Fields] OR dentinogenesisimperfecta[All Fields] OR dentinogenetic[All Fields]
OR dentinogenetica[All Fields] OR dentinogeneza[All Fields] OR dentinogenezei[All Fields] OR dentinogenezy[All Fields] OR dentinogenic[All Fields] OR
dentinogenically[All Fields] OR dentinogenom[All Fields] OR dentinogensis[All Fields] OR dentinogingival[All Fields] OR dentinoid[All Fields] OR dentinok
[All Fields] OR dentinoklastische[All Fields] OR dentinol[All Fields] OR dentinom[All Fields] OR dentinoma[All Fields] OR dentinomas[All Fields] OR
dentinome[All Fields] OR dentinoobrazovanii[All Fields] OR dentinopenia[All Fields] OR dentinophilic[All Fields] OR dentinophosphophoryns[All Fields] OR
dentinoplastic[All Fields] OR dentinopulpal[All Fields] OR dentinopulpar[All Fields] OR dentinosarcoma[All Fields] OR dentinosarcomas[All Fields] OR
dentinosklovinna[All Fields] OR dentinous[All Fields] OR dentinova[All Fields] OR dentinove[All Fields] OR dentinovych[All Fields] OR dentinpermeabilitat
[All Fields] OR dentinpost[All Fields] OR dentinposts[All Fields] OR dentinpraparationen[All Fields] OR dentinproducing[All Fields] OR dentinpulp[All Fields]
OR dentinq[All Fields] OR dentinreaktioner[All Fields] OR dentinresten[All Fields] OR dentinretention[All Fields] OR dentins[All Fields] OR
dentinschadigungen[All Fields] OR dentinschliff[All Fields] OR dentinschutz[All Fields] OR dentinsialophosphoprotein[All Fields] OR dentinska[All Fields] OR
dentinske[All Fields] OR dentinskih[All Fields] OR dentinsklerose[All Fields] OR dentinskog[All Fields] OR dentinsku[All Fields] OR dentinsplittern[All Fields]
OR dentinstitute[All Fields] OR dentinstoffwechsel[All Fields] OR dentinstoffwechselstudien[All Fields] OR dentinstoffwechselstudlen[All Fields] OR
dentinstruktur[All Fields] OR dentinstrukturak[All Fields] OR dentinstrukturen[All Fields] OR dentintransparenz[All Fields] OR dentintubules[All Fields] OR
dentinu[All Fields] OR dentinuber[All Fields] OR dentinuberempfindlichkeit[All Fields] OR dentinum[All Fields] OR dentinund[All Fields] OR dentinusur[All
Fields] OR dentinveranderungen[All Fields] OR dentinverbandes[All Fields] OR dentinwachstum[All Fields] OR dentinwandung[All Fields] OR
dentinwiderstandsmessung[All Fields] OR dentinwunde[All Fields] OR dentinwundverband[All Fields] OR dentinwundverbande[All Fields] OR
dentinwundverbanden[All Fields] OR dentinzuwachsrate[All Fields]) AND English[lang]
Search
Varnish
Table 2. (continued)
65
Number of
items found
18
Number
of relevant
articles*
S260
West et al.
(resins, plant[MeSH Terms] OR (resins[All Fields] AND plant[All Fields]) OR plant resins[All Fields] OR resin[All Fields]) AND English[lang]
(strontium[MeSH Terms] OR strontium[All Fields]) AND English[lang]
potassium[Title/Abstract] AND English[lang]
(oxalates[MeSH Terms] OR oxalates[All Fields] OR oxalate[All Fields]) AND English[lang]
(NovaMin[Supplementary Concept] OR NovaMin[All Fields] OR NovaMin[All Fields]) AND English[lang]
((calcium[MeSH Terms] OR calcium[All Fields]) AND (sodium, dietary[MeSH Terms] OR (sodium[All Fields] AND dietary[All Fields]) OR
dietary sodium[All Fields] OR sodium[All Fields] OR sodium[MeSH Terms]) AND phosphosilicate[All Fields]) NOT (NovaMin[Supplementary
Concept] OR NovaMin[All Fields] OR NovaMin[All Fields]) AND English[lang]
stannous[All Fields] AND English[lang]
(lasers[MeSH Terms] OR lasers[All Fields] OR laser[All Fields]) NOT (dental caries[MeSH Terms] OR (dental[All Fields] AND caries[All Fields])
OR dental caries[All Fields] OR caries[All Fields]) AND English[lang] AND English[lang]
(glass ionomer[Supplementary Concept] OR glass ionomer[All Fields]) NOT (resins, plant[MeSH Terms] OR (resins[All Fields] AND plant[All
Fields]) OR plant resins[All Fields] OR resin[All Fields]) AND English[lang]
Resin
See Inclusion and Exclusion criteria (102 articles appeared in more than one pubmed search).
Glass ionomer
Laser
Stannous
NovaMin
Oxalate
Potassium
Strontium
Search
41
172
61
22
12
15
65
20
28
Number
of relevant
articles*
50
23
98
180
97
527
Number of
items found

S261
S262
West et al.
Table 3. Search terms for Medline and Cochrane trials database searches completed 14
21st July 2014
Database
Search
Relevant articles
added
Medline
Database: Medline 1950 to present

Search Strategy:
1 treatment.mp. (3,115,747)
2 dentine hypersensitivity.mp. or *Dentin Sensitivity/(1361)
3 limit 2 to English language (1137)
4 1 and 2 and 3 (559)
Bifluorid (1)
Casein (1)
Laser (1)
Resin (1)
Varnish (2)
sion criteria
Cochrane Central Register of Controlled Trials:

Issue 7 of 12, July 2014
There are 646 results from 800,283 records for
your search on #1 (hypersensitivity
or sensitivity) and dentin in Trials in the
strategy currently being edited
171 relevant original articles (per inclusion/
exclusion criteria)
475 excluded based on inclusion and exclusion criteria
Laser (1)
describe the method by which dentine hypersensitivity is stimulated

describe the method by which
dentine hypersensitivity is scored
score dentine hypersensitivity and
elicited by more than one method
of stimulation
Statistics
The study should include the following:
Justification of the number of

study participants to demonstrate
the study is adequately powered
(The standard of reporting of
power calculations unfortunately
remains rather poor in dentistry
but has improved over the years.
Power calculations are not precise, are usually conducted in
advance of the study, and are
based on outcomes that are perceived to be reasonably plausible
in view of the state of knowledge
at the time. The reviewers therefore accept that if the numbers of
subjects in a study have been
determined by a power calculation, even if they look low compared to comparable studies, this
Results
All papers discussed are tabulated in

Table 5 for each agent.
Arginine and calcium carbonate (A/C)
153 relevant original articles (per inclusion/

exclusion criteria)
406 excluded based on inclusion and excluCochrane
of the body of evidence, the balance

of benefits and risks and public preferences.
aspect of the study will not be

considered weak).
Balanced treatment groups
The number of participants who
completed the study and were
included in the analysis
Studies including all of the above

in each category were considered to
have a low risk of bias, those including at least two criteria in each category were considered to have a
moderate risk of bias, with the
remainder considered have a high
risk of bias.
Due to the heterogeneity of the
study methodology, it was not possible to perform a meta-analysis. The
results, therefore, are descriptive in
nature.
The body of evidence, deemed
high, moderate, low or very low was
determined by taking into consideration the risk of bias of the studies
as assessed above, the directness of
the comparisons made between
products, the consistency of findings
between studies, the precision of the
results and publication bias. Recommendations for effectiveness of an
agent were based on the results of
the studies supported by the quality
This review included consideration of

63 papers of which 30 fulfilled the relevant criteria. The RCT studies all
assessed efficacy of the active ingredient arginine/calcium carbonate in the
reduction in pain of dentine hypersensitivity, the outcome variable. The
majority of studies involved the application of self-administered products;
toothpastes (20) and mouthrinses
which also contained PVM/MA and
fluoride (3). The remainder was professionally applied products, prophylaxis pastes (7).
The effectiveness of arginine in
the reduction of pain from dentine
hypersensitivity, the outcome variable, was most frequently assessed in
a toothpaste formulation, 20 RCTs
being evaluated in this systematic
review. All studies were parallel in
design apart from 1, crossover study
(Schiff et al. 2011). The designs all
used an airblast stimulus and all but
2 (He et al. 2011a,c), had a second
stimulus, a tactile stimulus for evaluation.
Nine studies incorporated a
benchmark or negative control of
fluoride as a toothpaste (Ayad et al.
2009a, Fu et al. 2010, Que et al.
2010, Docimo et al. 2011, Li et al.
2011, Kakar et al. 2012a, Hegde
et al. 2013, Kakar et al. 2013,
Sowinski et al. 2013). Fourteen studies incorporated a positive control
allowing direct comparisons between
agents to be made, these being strontium acetate (6) (Hughes et al. 2010,
Docimo et al. 2011, Li et al. 2011,
Schiff et al. 2011, Orsini et al. 2013,
West et al. 2013a); stannous fluoride
(2) (He et al. 2011a,c); or potassium
(mainly nitrate) (6), (Ayad et al.
2009a,b, Docimo et al. 2009a,b,
Nathoo et al. 2009, Kakar et al.
2012b). All studies had a moderate
risk of bias with the exception of
Sowinski et al. (2013) which had a
high risk of bias.
Results were consistently in
favour of arginine being signifi-
S263
based mouthrinse assessed long term

between 2 and 8 weeks compared to
the control products. There was heterogeneity between these few studies.
Arginine applied professionally as
a prophylaxis paste to reduce dentine hypersensitivity was reviewed in
seven RCTs, six being parallel studies (Hamlin et al. 2009, Schiff et al.
2009, Hamlin et al. 2012, Tsai et al.
2012, Collins et al. 2013, Chu & Lo
2014) and one split mouth (Kapferer
et al. 2013). Cold air was assessed in
seven studies accompanied by tactile
assessment in four of the seven studies (Hamlin et al. 2009, 2012, Schiff
et al. 2009, Kapferer et al. 2013). Six
studies used a benchmark/negative
control only and one, a positive control, potassium nitrate toothpaste
(Chu & Lo 2014). All studies had a
moderate risk of bias as defined in
the assessment methodology. Results
were consistently in favour of the
arginine prophylaxis paste in the
seven studies, six showing immediate
effects and two also long-term efficacy (Schiff et al. 2009, Hamlin
et al. 2012).
(a)
(b)
PVA/MA Polymers
(c)
Fig. 1. Flow chart of searches using (A) Pubmed, (B) Medline and (C) Cochrane database.
cantly more effective than a fluoride control, seven studies showing

long-term effects evaluated after
2 weeks or longer. Similarly, in
studies where arginine was compared to potassium, arginine was
always significantly superior in efficacy, over long-term evaluation.
Comparing strontium acetate to
arginine divulged three studies
being equivocal, one paste not
showing superiority over the other
(Hughes et al. 2010, Orsini et al.
2013, West et al. 2013a), and three
studies (Docimo et al. 2011, Li
et al. 2011, Schiff et al. 2011),
showed arginine significantly more
effective than strontium. These six
studies were fairly equally divided
over immediate and long-term
assessments. Stannous fluoride was
shown in two studies (He et al.
2011a,c) to be significantly superior
to arginine in both the short and

long-term assessment.
Three RCTs investigated arginine in a mouthrinse formulation,
for efficacy in pain reduction. The
analyses were complicated in that
another agents were often included,
e.g. PVM/MA, arginine toothpaste.
The studies were parallel in design
and used the same assessments. Two
studies used a potassium positive
control (Elas Boneta et al. 2013a,b)
and one also incorporated a conventional fluoride negative control mouthrinse (Elas Boneta et al. 2013a),
and a third used only a conventional
fluoride negative control (Hu et al.
2013). One study had a low number
of subjects (Elas Boneta et al.
2013a), but included a power calculation. All studies had a moderate risk
of bias. Results were consistently in
favour of the arginine/PVM/MA-
This review included consideration

of 11 papers, of which six fulfilled
the relevant criteria of including a
polymer as an active ingredient and
measuring its efficacy in reducing the
pain of dentine hypersensitivity. The
PVA/MA product formulations were
combined with arginine (3) (Elas
Boneta et al. 2013a,b, Hu et al.
2013), Triclosan (1) (Chaknis et al.
2011) and potassium (2) (Ayad et al.
1994, Schiff et al. 1994) and were in
the form of self-administered mouthrinses for arginine, and toothpaste
for triclosan and potassium. The
trial designs were all parallel, utilized
airblast and tactile stimuli and had a
moderate risk of bias. Of the three
RCTs investigating PVA/MA with
arginine in a mouthrinse formulation, two studies used a potassium
control and one a negative control
as well, and the third a conventional
fluoride control only (Hu et al.
2013). Results were consistently in
favour of the arginine/PVM/MAbased mouthrinse. With regards to
the PVA/MA combined with potassium nitrate in toothpaste formulation, one study directly tested the
product against a positive control,
S264
West et al.
Table 4. Searches as they are grouped in the results

Results section
Search
Number of items
Total initial
search
Arginine and Calcium

carbonate
PVA/MA -polymers
Potassium
Casein Derivatives
(amorphous calcium
phosphate (ACP) and casein
phosphopeptide (CPP))
Strontium
Stannous Fluoride
Calcium Sodium
Phosphosilicate (CSPS)
Oxalates
Resin-based materials
Varnishes
Lasers
Arginine (PM)
PMV copolymer (PM)
Potassium (PM)
Casein (PM + 1 Medline)
Strontium (PM)
Stannous (PM)
NovaMin (PM)
Oxalates (PM)
Resins (PM + 1 Medline)
Seal & Protect
Glass ionomer
Gluma
Varnish (PM + 2 Medline)
Bifluorid (Medline)
Duraphat
Laser (PB + 1 Medline + 1 Cochrane)
Following review
of title and abstract
Following review
of whole
article and included
in the results*
63
30
30
11
180
32
6
65
6
6
25
3
97
50
28
20
22
12
18
17
12
98
528
17
61
78
67
1
19
174
15
29
4
1
22
20
1
8
43
9
1
2
0
6
5
1
1
8
PM = PubMed.
Articles may appear in more than one section of the results.
potassium, results being equivocal

(Ayad et al. 1994) and the other study
tested the agent against a negative
control demonstrating superiority to
a placebo toothpaste (Schiff et al.
1994). The PVA/MA product with
triclosan was evaluated to reduce the
pain of sensitivity against a negative
control fluoride product and a stannous comparator product, results
demonstrating efficacy against the
negative and to some degree the positive control (Chaknis et al. 2011).
Potassium

of 180 papers, of which 25 fulfilled
the relevant criteria. The RCT studies all assessed the efficacy of the
active ingredient potassium for the
treatment of pain from dentine
hypersensitivity, the outcome measure, but in many different forms
and over many years, nitrate (18)
(Silverman et al. 1996, West et al.
1997, Schiff et al. 1998, Waraaswapati et al. 2005, Ayad et al.
2009a, Docimo et al. 2009a,b, Nathoo et al. 2009, Ni et al. 2010, Pradeep & Sharma 2010, Sharma et al.
2010, Liu & Hu 2012, Kakar et al.
2012b, Pradeep et al. 2012, Elas

Boneta et al. 2013a,b, Sowinski et al.
2013, Veitz-Keenan et al. 2013), citrate (4) (Chesters et al. 1992, Yates
et al. 1998b, Docimo et al. 2007,
Prasad et al. 2010), chloride (2)
(Docimo et al. 2007, Ayad et al.
2009b), binoxalate (1) (Talesara
et al. 2014) and iodide (1) (Craig
et al. 2012). The majority of studies
involved the application of selfadministered potassium products;
toothpastes (21), mouthrinses (2)
(Elas Boneta et al. 2013a,b) and the
remainder (2) evaluated professionally applied products (Craig et al.
2012, Talesara et al. 2014). Studies
were parallel in design apart from 2,
crossover studies (Craig et al. 2012,
Talesara et al. 2014). The designs all
used an airblast stimulus, bar 1
(Craig et al. 2012) which utilized
only thermal stimulus evaluation,
and all products were investigated
over a long-term period. All studies
had a moderate risk of bias except
for that by Talesara et al. (2014) and
Sowinski et al. (2013) which had a
high risk of bias.
The most frequent salt investigated for effectiveness was potassium
nitrate. This was studied in direct
comparison to the positive control

arginine in seven studies, five with
toothpaste (Ayad et al. 2009a,
Docimo et al. 2009a,b, Nathoo et al.
2009, Kakar et al. 2012b), and two
combining mouthrinse and toothpaste in the design (Elas Boneta
et al. 2013a,b). Of the seven studies,
three had a negative control product
included in the design as well. Results
were consistently in favour of arginine in all cases, results for potassium
not that dissimilar to those obtained
for the negative control.
Potassium was found to provide
inferior pain reduction in dentine
hypersensitivity when directly compared to resins, a positive control (1)
(Veitz-Keenan et al. 2013) and inferior to a sealant, the second comparator product; and in other studies
to Calcium Sodium Phosphosilicate
(CSPS) another positive control (2)
(Pradeep & Sharma 2010, Sharma
et al. 2010). The study by Pradeep &
Sharma (2010) also incorporated a
negative control product. Potassium
was also found inferior when compared with stannous fluoride as a
positive control for pain reduction,
(2) (Ni et al. 2010, Sharma et al.
2010), these studies having no nega-
Year
Study design
Multiple-centre,
practitionerbased, parallel
group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
2014
2013
2013
2013
2013
2013
Chu & Lo
(2014)
Collins et al.
(2013)
Elas Boneta
et al.
(2013a)
Elas Boneta
et al.
(2013b)
Hegde et al.
(2013)
Hu et al.
(2013)
Arginine and Calcium Carbonate (A/C)*
References
90
86
118
69
50
303
Sample
size
8% arginine, PVM/
MA copolymer,
pyrophosphates,
0.05% sodium
fluoride, alcohol free
Toothpaste: 8%
arginine and
1450 ppm sodium
MFP, calcium
carbonate
+
Mouthwash: 0.8%
arginine, PVM/MA
copolymer,
pyrophosphates and
0.05% sodium
8% arginine, calcium
carbonate and
1000 ppm sodium
MFP
8% arginine, PVM/
MA copolymer,
pyrophosphates,
0.05% sodium
8% arginine and
calcium carbonate,
fluoride free
toothpaste
8% arginine calcium
carbonate
toothpaste
Test product
Table 5. Studies evaluated for all treatment modalities
0.05% sodium
fluoride, alcohol
free
1000 ppm sodium

MFP
Toothpaste:
containing
1450 ppm fluoride
in dicalcium base
+
Mouthwash:
fluoride/arginine
free
0.05% sodium
fluoride
Fluoride-free
prophylaxis paste
Negative control/
Placebo
Toothpaste: 5%
potassium nitrate
and 1450 ppm
sodium fluoride,
silica base
+
Mouthwash:
0.51% potassium
chloride and
230 ppm sodium
fluoride, alcohol
base
2.4% potassium
nitrate, 0.022%
sodium fluoride
5% potassium
nitrate, 1450 ppm
fluoride
Positive control/
Comparator
Product
Self-administered
mouthrinse
Self-administered
toothpaste
Self-administered
toothpaste/
mouthrinse
Self-administered
mouthrinse
Professional
prophylaxis
Professional
prophylaxis
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 4, 8 weeks
2, 4, 8 weeks
2, 4, 8 weeks
30 min, 2, 4,
6 weeks
Immediate
Immediate
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Airblast
Airblast
Method of
Assessment
86 subjects (35 males and 51 females) complied with the

study protocol and completed the entire study. At each
recall visit, both treatment groups demonstrated
significant reductions in dentin hypersensitivity from their
corresponding baselines (p < 0.05). Subjects assigned the
8% arginine, calcium carbonate and 1000 ppm fluoride
dentifrice demonstrated statistically significant reductions
in responses to tactile stimuli, airblast and VAS responses
in comparison to those using the dentifrice containing
1000 ppm fluoride after 2, 4 and 8 weeks respectively.
Ninety (90) subjects entered and completed the 8 week
study. After 2, 4 and 8 weeks of product use, subjects in
the Arginine Mouthwash group exhibited statistically
significant (p < 0.05) improvements in mean tactile and
airblast hypersensitivity scores as compared to the
Negative Control Mouthwash
A total of 303 patients were recruited by 65 participating

dentists. The mean age of the patients was 40.1, and 59%
were female. The median pre-treatment SS of Groups 1
and 2 were both 7, whereas the post-treatment SS were 3
and 4 respectively (p < 0.001). The median percentage
reductions in sensitivity scores of Groups 1 and 2 were
57.14% and 38.75% respectively (p < 0.001).
All subjects completed the study. At the posthypersensitivity examination, subjects assigned to the Test
Paste group and Control Paste group both exhibited
statistically significant (p = 0000) reductions (compared to
baseline), to airblast hypersensitivity of 44.7% and 25.6%
respectively. At the post-hypersensitivity examination,
subjects in the Test Paste group exhibited a statistically
significant (p = 0.005) reduction of 24.4% in mean
Control Paste group.
Seventy-five subjects were enrolled; 69 subjects completed
the study. There were no differences after 30 min of a
single use, among the three groups with respect to mean
tactile and airblast hypersensitivity scores compared to
potassium nitrate and negative control mouthwashes
(p < 0.05). The arginine group presented a statistically
significant improvement in the mean tactile scores
compared to potassium nitrate and negative control
groups after 2, 4 and 6 weeks (p < 0.001) of product use;
the arginine group showed a statistically significant
enhancement in airblast hypersensitivity mean scores
groups after two (p = 0.001), four (p < 0.001) and 6 weeks
(p < 0.001) of product use.
120 subjects were enrolled, 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. Airblast
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.
Results

S265
Single-centre,
single-blind,
parallel group,
stratified and
randomized study
Single-centre,
double-blind,
parallel group,
stratified and
randomized study
2013
2012
West et al.
(2013a)
Hamlin et al.
(2012)
Single-centre,
double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
randomized study
2013
Orsini et al.
(2013)
Double-blind, splitmouth,
randomized study
2013
2013
Kapferer et al.
(2013)
Single-centre,
double-blind,
parallel group,
randomized study
Study design
Sowinski et al.
(2013)
2013
Year
Kakar et al.
(2013)
References
95
80
100
85
29 (58
teeth)
93
Sample
size
8% arginine and
calcium carbonate
with 1450 ppm
MFP
carbonate with
1450 ppm sodium
MFP
carbonate
carbonate and
1450 ppm sodium
MFP
8% arginine and
calcium carbonate
carbonate and
1000 ppm MFP
Test product
Pumice prophylaxis
paste and
1450 ppm MFP
toothpaste
Fluoride toothpaste
Calcium carbonate
Fluoride toothpaste
Negative control/
Placebo
8% strontium
acetate, silica with
1040 ppm sodium
fluoride
8% strontium
acetate and
1040 ppm sodium
fluoride
30% zinc
substitutedcarbonate
hydroxyapatite
nanocrystals
Positive control/
Comparator
Product
Self-administered
toothpaste and
Professional
prophylaxis
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Professional
prophylaxis
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 8,
24 weeks
Immediate, 3 days
Intervals up to
8 weeks
3 days
Immediate, 4,
12 weeks
2, 4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast,
thermal
Tactile, airblast
Tactile, airblast
Method of
Assessment
At the end of the 8-week period, the results showed a

significant improvement in dentin hypersensitivity in the
Test group as compared to the Negative control group.
The mean tactile hypersensitivity scores at the 8-week
examinations were 39.67 and 38.33 by the Yeaple and Jay
Probes, respectively, for the Test group and 15.72 and
15.00 for the Negative control group. These observations
were consistent with the other hypersensitivity
examinations by airblast and VAS.
A statistically significant difference in airblast (p = 0.001)
and tactile (p = 0.047) hypersensitivity reduction over time
was observed between the two therapy modes. After 12weeks, statistically significant differences were indicated
between the test and control group with respect to
baseline-adjusted mean tactile (41.94%; p = 0.038) and
airblast hypersensitivity scores (46.5%; p = 0.017).
The final sample consisted of 85 individuals: 29 received the
arginine-based dentifrice (group 1), 27 the strontium
acetate-based dentifrice (group 2), and 29 the dentifrice
based on zinc-carbonate hydroxyapatite (group 3). All
dentifrices were mostly effective to reduce DH: the
percentage of score reduction from baseline to 3 days was
>30% for all tests (except for subjective test of group 2).
The comparison among the three dentifrices showed that,
after 3 days, there was an improvement in airblast (mean
percentage of reduction, 39.2% in group 1, 42.0% in
group 2, and 39.2% in group 3), cold water (41.5%,
51.8% and 50%), tactile (50.3%, 40.1% and 33.8%) and
subjective (33.1%, 17.4% and 31.4%) test scores, with
differences being significant for cold water and subjective
tests. For airblast and tactile tests, there were no
significant differences across groups at 3 days. Moreover,
no significant differences at any test were observed in a
subset of patients that were followed up to 8 weeks: all
dentifrices were all highly efficacious.
Consistent with results from previous studies, subjects
assigned dentifrices formulated with potassium nitrate or
8% arginine/calcium carbonate demonstrated
improvements in Yeaple, airblast and VAS responses in
comparison to those assigned the fluoride dentifrice
(p < 0.05). Jay Probe responses correlated significantly
with all other sensitivity measures (p < 0.05). Differences
between these treatments were observed at all posttreatment evaluations using these methods.
All 80 subjects completed the study. Results confirm that
for both treatments, pain was reduced immediately and
relief was sustained after 3 days use. For all 3 measures,
benefit was similar between the two pastes, with no
statistical or clinical difference demonstrated, apart from
response to evaporative stimulus at 3 days, where Schiff
scores were significantly lower in the arginine group,
p = 0.02.
Immediately after professional product application, and
after 8 and 24 weeks, subjects assigned to the Test Group
demonstrated statistically significant improvements in
dentin hypersensitivity compared to subjects assigned to
the Negative Control Group in tactile (49.8%, 57.5% and
32.9% respectively) and airblast (26.0%, 38.4% and
34.3% respectively) sensitivity scores. The instant
reductions in dentin hypersensitivity provided by the
single professional application of a desensitizing paste for
in-office use, containing 8% arginine and calcium
carbonate were maintained by twice daily brushing with
the 8% arginine, calcium carbonate toothpaste with
1450 ppm fluoride as MFP and the Colgate Sensitive ProRelief toothbrush for at least 24 weeks.
Results
S266
West et al.
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
examiner-blind,
parallel group,
randomized study
Single-centre,
examiner-blind,
parallel group,
randomized study
2012
2012
2011
2011
2011
Kakar et al.
(2012a)
Tsai et al.
(2012)
Docimo et al.
(2011)
He et al.
(2011a)
He et al.
(2011c)
Study design
2012
Year
Kakar et al.
(2012b)
References
81
78
150
66
74
88
Sample
size
Stannous-containing
1450 ppm sodium
fluoride
0.454% stannous
fluoride
8% arginine and
calcium carbonate
with 1450 ppm
MFP (Colgate
sensitive Pro-Relief)
8% argininecalcium
carbonate paste
carbonate,
1000 ppm sodium
MFP
8.0% arginine calcium

carbonate and
1000 ppm sodium
MFP
Test product
Fluoride toothpaste
(Crest cavity
protection)
Non-fluoridated
pumice-based
prophylaxis paste
1000 ppm sodium

MFP
Negative control/
Placebo
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
8% strontium
acetate, silica with
1040 ppm sodium
fluoride
(Sensodyne Rapid
Relief)
2% potassium
nitrate
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Selfadministered
toothpaste
Professional
prophylaxis
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 3 days
Immediate, 3 days,
2 weeks
2, 4, 8 weeks
Immediate
2, 4, 8 weeks
2, 4, 8 weeks
Assessment
Timepoints
Airblast
Airblast
Tactile, airblast
Airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
Subjects who brushed with the new dentifrice containing

8.0% arginine, calcium carbonate, and 1000 ppm MFP
exhibited statistically significant reductions (p < 0.05) in
dentin hypersensitivity in response to tactile (36.2%,
33.1% and 29.7%) and airblast (16.4%, 31.1%, 58.8%)
stimuli when compared with the subjects who brushed
with the 2% potassium ion as potassium nitrate dentifrice
after 2, 4 and 8 weeks respectively.
exhibited statistically significant (p < 0.05) greater
reductions in dentin hypersensitivity in response to tactile
(81.9%, 90.5% and 116.7%) and airblast (39.5%, 56.7%,
76.7%) stimuli than subjects assigned the 1000 ppm MFP
dentifrice after 2, 4 and 8 weeks respectively.
Following the post-cleaning airblast hypersensitivity
examination, there was a significant decrease of 83.94% in
the hypersensitivity of subjects using the Test paste. The
group using the Control paste showed a 13.43%
desensitization. There was a statistically significant
difference of 79.65% between the two groups. Subjects in
the age groups 4150, 5160 and 6170 years of age
showed the most reduction in dentin hypersensitivity.
After 2, 4 and 8 weeks of daily use of the products, all
three groups showed a statistically significant reduction
from baseline in tactile and airblast dentin hypersensitivity
(p < 0.05). Colgate Sensitive Pro-Relief toothpaste
produced a significant improvement in mean tactile and
airblast dentin hypersensitivity scores, and was more
effective than Sensodyne Rapid Relief toothpaste and
Crest Cavity Protection toothpastes (p < 0.05).
40 subjects in the SnF2 dentifrice group and 38 subjects in
the control group completed all study procedures. Both
dentifrice groups showed significant sensitivity relief
relative to baseline (p < 0.01). The SnF2 dentifrice
provided a statistically significant (p = 0.005) 7.4%
reduction in sensitivity relative to the positive control
dentifrice immediately after first use and an even more
significant (p = 0.001) 20% reduction at Week 2 based on
the Schiff air sensitivity scale. Based on the VAS, the
SnF2 dentifrice provided statistically significant
(p < 0.0001) reduction in sensitivity relative to the positive
control dentifrice immediately after first use, at Day 3,
and Week 2, with percent reductions of 7.2%, 15.8% and
28.2% respectively. No adverse events were reported with
either dentifrice.
Forty subjects in the experimental group and 41 subjects in
the positive control group completed all study procedures.
On the Schiff Air Sensitivity Scale, the experimental
dentifrice provided statistically significant (p < 0.001)
reductions of 14.8% and 54.1% in sensitivity relative to
the positive control dentifrice immediately after first use
and at Day 3 respectively. On the pain VAS, the
experimental dentifrice provided statistically significant
(p < 0.001) reductions of 22.3% and 74.1% in sensitivity
relative to the positive control dentifrice immediately after
first use and at Day 3 respectively. No adverse events
were reported for any subject.
Results

S267
2010
Double-blind,
parallel group,
randomized study
Double-blind,
crossover,
randomized study
2011
Schiff et al.
(2011)
Fu et al.
(2010)
Double-blind,
parallel group,
randomized study
Study design
2011
Year
Li et al.
(2011)
References
122
121
150
Sample
size
8% arginine, high
cleaning calcium
carbonate,
1450 ppm fluoride,
carbonate,
1450 ppm sodium
MFP
8% strontium acetate,
silica, 1040 ppm
sodium fluoride
Test product
Calcium carbonate,
1450 ppm
fluoride,
1100 ppm fluoride

as NaF in a silica
base
Negative control/
Placebo
8.0% arginine,
calcium
carbonate,
1450 ppm fluoride
8% strontium
acetate, silica,
1040 ppm sodium
fluoride
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 3 days
Product 1 (phase
1): 8 weeks,
product 2 (phase
2): 2, 8 weeks
Immediate, 7 days
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
All 150 subjects complied with the protocol and completed

the study. The positive control toothpaste containing
8.0% arginine and 1450 ppm fluoride as MFP in a
calcium carbonate base provided statistically significant
improvements in mean tactile and airblast dentin
hypersensitivity scores compared to the negative control
toothpaste containing 1100 ppm fluoride as NaF in a
silica base (p < 0.05). The toothpaste containing 8.0%
arginine and 1450 ppm fluoride as MFP in a calcium
carbonate base (positive control) also provided
statistically significant improvements in mean tactile and
airblast dentin hypersensitivity scores compared to the test
toothpaste containing 8% strontium acetate and
1040 ppm fluoride as NaF in a silica base. The test
toothpaste and the negative control toothpaste were not
significantly different from each other.
121 subjects complied with the study protocol and
completed the study. Study Phase I: Subjects who brushed
twice daily for 8 weeks with the arginine/calcium
carbonate dentifrice experienced statistically significant
improvements in mean tactile and airblast hypersensitivity
scores (51.3% and 39.4% respectively) relative to that
experienced by subjects who brushed with the strontium
acetate dentifrice. Study Phase II: Subjects who brushed
with the arginine/calcium carbonate dentifrice for the first
8 weeks of the study and then switched to brush with the
strontium acetate dentifrice for the second 8 weeks of the
study, did not exhibit further improvements in mean
tactile or mean airblast hypersensitivity scores after two
and eight weeks of switch-over product use. However,
subjects who brushed with the strontium acetate dentifrice
for the first 8 weeks of the study and then switched to
brush with the arginine/calcium carbonate dentifrice
exhibited statistically significant improvements in mean
tactile and airblast hypersensitivity scores 2 weeks (35.2%
and 29.9% respectively) and 8 weeks (40.3% and 35.3%
respectively) after product switch-over. Relative to the
subjects who switched from twice daily brushing with the
arginine/calcium carbonate dentifrice to brush with the
strontium acetate dentifrice, those who switched from
brushing with the strontium acetate dentifrice to brush
with the arginine/calcium carbonate dentifrice exhibited
statistically significant improvements in mean tactile
hypersensitivity scores (10.3%) and in mean airblast
hypersensitivity scores (16.3%) 8 weeks after product
switch-over.
All one hundred and twenty-two (122) subjects complied
with the study protocol and completed the study. There
was good balance among the three groups at baseline.
The mean tactile sensitivity scores for the new Pro-Argin
formula dentifrice, the previously validated Pro-Argin
formula dentifrice, and the control dentifrice were at
baseline 14.88, 14.76 and 14.38, and after direct
application were 28.90, 29.02 and 15.88, and after 3 days
of brushing were 34.51, 33.41 and 16.00 respectively. The
mean airblast scores at baseline were 2.11, 2.12 and 2.15,
and after direct application were 1.21, 1.18 and 2.06, and
after 3 days of brushing were 0.80, 0.83 and 1.93
respectively. Immediately after direct application and after
3 days of brushing, for both the tactile and airblast
sensitivity scores, the differences between the two
dentifrices containing 8.0% arginine and the control were
statistically significant. There were no statistically
significant differences between the two 8.0% arginine
dentifrices immediately after direct application and after
3 days of brushing.
Results
S268
West et al.
Examiner-blind,
parallel group,
randomized study
Double-blind,
parallel group,
stratified,
randomized study
Double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
stratified,
randomized study
2010
2009
2009
Que et al.
(2010)
Ayad et al.
(2009a)
Ayad et al.
(2009b)
Study design
2010
Year
Hughes et al.
(2010)
References
77
120
121
77
Sample
size
carbonate,
1450 ppm sodium
MFP
carbonate,
1450 ppm MFP
8% arginine, high
cleaning calcium
carbonate system,
1450 ppm sodium
MFP
1040 ppm sodium
fluoride
Test product
Toothpaste
containing
1450 ppm sodium
MFP
Calcium carbonate,
1450 ppm fluoride
as MFP.
Negative control/
Placebo
2% potassium ion,
dosed as 3.75%
potassium
chloride,
1450 ppm sodium
fluoride
2% potassium ion
dosed as 5%
potassium nitrate,
1450 ppm sodium
fluoride
8% arginine,
calcium
carbonate,
1450 ppm fluoride
as MFP
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 4, 8 weeks
Immediate, 3 days
2, 4, 8 weeks
2, 4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
Seventy-seven subjects completed this clinical study. Both

subject groups exhibited significant cumulative reductions
from baseline to Days 14, 28 and 56 in dentin
hypersensitivity as measured by Schiff, Yeaple and VAS
(for the 8% strontium acetate group, p 0.0001 for all
time points; for the 8% argininecalcium carbonate
group, p = 0.0031 for Yeaple at Day 14, p = 0.0015 for
VAS at Day 14 and p < 0.0001 for all remaining measures
and time points). No significant differences (p > 0.05)
were observed between treatments for any of the time
points and measures except for tactile sensitivity at Day
56, for which the 8% strontium acetate-based dentifrice
was statistically superior (p = 0.0391) to the control 8%
arginine/calcium carbonate dentifrice.
This clinical study demonstrated that the new Pro-Argin
formula toothpaste provided a significant reduction in
dentin hypersensitivity when used over a period of
8 weeks. The study also showed that the new toothpaste
provided significantly greater reductions (p < 0.05) in
71.1% and 61.0%) and airblast (40.7%, 58.8% and
74.4%) stimuli than the negative control toothpaste
containing 1450 ppm fluoride after 2, 4 and 8 weeks of
product use respectively. The results for the new
toothpaste did not differ significantly from those of the
positive control toothpaste at all time points in the study.
120 subjects complied with the protocol and completed the
study. Relative to the desensitizing toothpaste and the
control toothpaste groups, the 8.0% arginine toothpaste
group exhibited statistically significant (p < 0.05)
reductions in dentin hypersensitivity on both tactile and
airblast measures immediately after completion of the first
phase of the study. Reductions in sensitivity for the 8.0%
arginine toothpaste, compared to the benchmark
desensitizing toothpaste and the control toothpaste, were
130.7% and 139.5% (tactile), and 43.8.0% and 49.6%
(airblast) respectively. Relative to the benchmark
desensitizing toothpaste and control toothpaste groups,
the 8.0% arginine group also exhibited statistically
significantly (p < 0.05) reductions in sensitivity after
completion of the second phase of the study, of 104.9%
and 136.1% (tactile), and 44.5% and 53.2% (airblast)
respectively. There was no loss of the instant relief effects
in the 8.0% arginine group after the brushing period.
This clinical study demonstrated that the new toothpaste,
containing 8.0% arginine and 1450 ppm MFP in a
calcium carbonate base, provided a significant reduction
in dentin hypersensitivity when used over a period of 8
weeks. The study also showed that this new arginine
toothpaste provided significantly greater reductions
(p < 0.05) in dentin hypersensitivity in response to tactile
(16.2%, 22.4% and 21.4%) and airblast (16.2%, 29.2%
and 63.4%) stimuli than the benchmark commercial
toothpaste containing 2% potassium ion and 1450 ppm
NaF in a silica base, after 2, 4 and 8 weeks of product
use respectively.
Results

S269
2009
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
2009
Hamlin et al.
(2009)
Nathoo et al.
(2009)
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
2009
Docimo et al.
(2009a)
Single-centre,
parallel-group,
double-blind,
stratified
randomized study
Study design
2009
Year
Docimo et al.
(2009b)
References
125
45
80
80
Sample
size
carbonate,
1450 ppm sodium
MFP
carbonate
carbonate,
1450 ppm sodium
MFP
carbonate,
1450 ppm sodium
MFP
Test product
Pumice prophylaxis
paste
Negative control/
Placebo
2% potassium ion
dosed as 5%
potassium nitrate,
1450 ppm sodium
fluoride
2% potassium ion,
dosed as 5.0%
potassium nitrate,
1450 ppm sodium
fluoride
2% potassium ion,
dosed as 3.75%
potassium
chloride,
1450 ppm sodium
fluoride
Positive control/
Comparator
Product
Self-administered
toothpaste
Professional
prophylaxis
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 3 days
Immediate
1, 2, 4, 8 weeks
2, 4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
This clinical study showed that the new toothpaste,

containing 8.0% arginine and 1450 ppm fluoride as MFP
in a calcium carbonate base provided a significant
reduction in dentin hypersensitivity when used over a
period of 8 weeks. The study also showed that this new
arginine toothpaste provided significantly greater
reductions (p < 0.05) in dentin hypersensitivity in response
to tactile (37.0%, 30.0% and 12.2%) and airblast (23.9%,
32.0% and 29.3%) stimuli than the commercial sensitive
fluoride as NaF in a silica base, after 2, 4 and 8 weeks of
product use respectively.
in a calcium carbonate base, provided a significant
period of 8 weeks. The study also showed that the new
26.4% and 33.8%) stimuli than the benchmark
commercial desensitizing toothpaste containing 2%
potassium ion and 1450 ppm fluoride as NaF in a silica
base, after 2, 4 and 8 weeks of product use respectively.
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 airblast
hypersensitivity scores (48.6%). In addition, subjects
assigned to the control group exhibited a statistically
significant hypersensitivity improvement from baseline
with respect to baseline-adjusted mean airblast
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 airblast hypersensitivity scores (41.9%).
One hundred and twenty-five subjects complied with the
study protocol and completed the study. Relative to the
benchmark desensitizing toothpaste and the control
toothpaste groups, the 8.0% arginine toothpaste group
exhibited statistically significant (p < 0.05) reductions in
dentin hypersensitivity on both tactile and airblast
hypersensitivity scores immediately after direct
application. Reductions in sensitivity for the 8.0%
arginine toothpaste compared to the benchmark
desensitizing toothpaste and control toothpaste were
161.2% and 180.2% (tactile), and 59.8% and 58.0%
the 8.0% arginine group exhibited statistically significant
(p < 0.05) reductions in sensitivity after the subsequent 3
days of twice daily regular toothbrushing of 147.1% and
181.2% (tactile), and 70.1% and 70.9% (airblast)
respectively.
Results
S270
West et al.
ti-
2009
Year
Single-centre,
double-blind,
parallel group,
randomized study
Single-centre,
parallel group,
double-blind,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
2013
2013
2013
Elas Boneta
et al.
(2013a)
Hu et al.
(2013)
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
Study design
Elas Boneta
et al.
(2013b)
PVA/MA Polymers
Schiff et al.
(2009)
References
90
69
118
68
Sample
size
8% arginine, PVM/
MA copolymer,
pyrophosphates,
0.05% sodium
8% arginine, PVM/
MA copolymer,
pyrophosphates,
0.05% sodium
Toothpaste: 8%
arginine and
1450 ppm sodium
MFP, calcium
carbonate +
Mouthwash: 0.8%
arginine, PVM/MA
copolymer,
pyrophosphates and
0.05% sodium
carbonate paste
Test product
0.05% sodium
fluoride, alcohol
free
0.05% sodium
fluoride
Toothpaste:
containing
1450 ppm fluoride
in dicalcium base
+ fluoride/
arginine free
mouthwash.
Pumice prophylaxis
paste
Negative control/
Placebo
2.4% potassium
nitrate and
0.022% sodium
fluoride
Toothpaste: 5%
potassium nitrate
and 1450 ppm
sodium fluoride,
silica base +
mouthwash
0.51% potassium
chloride and
230 ppm sodium
fluoride, alcohol
base
Positive control/
Comparator
Product
Self-administered
mouthrinse
Self-administered
mouthrinse
Self-administered
toothpaste/
mouthrinse
Professional
prophylaxis
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 4, 8 weeks
30 min, 2, 4,
6 weeks
2, 4, 8 weeks
Immediate, 4,
12 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
120 subjects were enrolled, 118 completed the study. The

Tactile hypersensitivity mean scores showed statistically
Arginine regimen provided the greatest reduction in
Tactile and Airblast dentine hypersensitivity compared to
potassium and negative control regimens; and provides
faster dentine hypersensitivity relief than potassium
regimen.
Seventy-five subjects were enrolled; 69 subjects completed
the study. There were no differences after 30 min of a
single use, among the three groups with respect to mean
tactile and airblast hypersensitivity scores compared to
potassium nitrate and negative control mouthwashes
(p < 0.05). The arginine group presented a statistically
significant improvement in the mean tactile scores
groups after 2, 4 and 6 weeks (p < 0.001) of product use;
the arginine group showed a statistically significant
enhancement in airblast hypersensitivity mean scores
groups after two (p = 0.001), four (p < 0.001) and 6 weeks
(p < 0.001) of product use.
Ninety (90) subjects entered and completed the 8 week
study. After 2, 4 and 8 weeks of product use, subjects in
the Arginine Mouthwash group exhibited statistically
significant (p < 0.05) improvements in mean tactile and
Negative Control Mouthwash.
68 subjects completed the 12-week study. No statistically

significant differences from baseline scores were indicated
at the Post-Scaling Examinations for either the Test Paste
or Control Paste groups. Immediately following product
application and 4 weeks after product application,
subjects assigned to the Test Paste group exhibited
statistically significant improvements from baseline with
respect to baseline-adjusted mean airblast (44.1% and
45.9% respectively) and mean tactile hypersensitivity
scores (156.2% and 170.3% respectively). At the same
time points, subjects assigned to the Control Paste group
exhibited statistically significant improvements from
baseline with respect to baseline-adjusted mean airblast
(15.1% and 8.9% respectively) and mean tactile
hypersensitivity scores (43.1% and 8.3% respectively).
Immediately following application of the assigned paste
and 4 weeks later, the Test Paste group demonstrated
statistically significant reductions in dentin
hypersensitivity with respect to baseline-adjusted mean
airblast (34.1% and 40.6% respectively) and mean tactile
hypersensitivity scores (79.0% and 149.6% respectively),
compared to the Control Paste group. No statistically
significant differences were exhibited between paste groups
at the Post-Scaling and 12-week examinations with respect
to mean tactile and baseline-adjusted mean airblast
hypersensitivity scores
Results

S271
Parallel group,
stratified,
randomized study
Parallel group,
stratified,
randomized study
1994
1994
Ayad et al.
(1994)
Schiff et al.
(1994)
Single-centre, splitmouth, study
Multi-centre,
parallel group,
stratified,
randomized study
2014
2013
Talesara et al.
(2014)
Veitz-Keenan
et al. (2013)
Potassium
Single-centre,
double-blind,
parallel group,
randomized study
Study design
2011
Year
Chaknis et al.
(2011)
References
293
20 (80
teeth)
67
97
118
Sample
size
Potassium nitrate
dentifrice
Potassium binoxalate
gel
5% potassium nitrate,
1.3% soluble
pyrophosphate,
1.5% PVM/MA
copolymer, 0.243%
sodium fluoride in a
silica base
1.3% soluble
pyrophosphate,
1.5% PVM/MA
copolymer, 0.243%
sodium fluoride in a
silica base
0.3% triclosan,
2.0% PVM/MA
copolymer
toothpastes, 0.243%
sodium fluoride and
specially designed
silica
Test product
1.3% soluble
pyrophosphate,
1.5% PVM/MA
copolymer,
0.243% sodium
fluoride in a silica
base
0.243% sodium
base
Negative control/
Placebo
Resin restoration
sealant
Nd:YAG laser
5% potassium
nitrate, 0.76%
sodium MFP in a
dicalcium
phosphate
dihydrate base
0.454% stannous
base with sodium
hexameta
phosphate and
zinc lactate
Positive control/
Comparator
Product
Self-administered
toothpaste,
professionally
applied
restoration/
sealant
Professional
application
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
1, 3, 6 months
Immediate, 3, 6,
9 months
6, 12 weeks
6, 12 weeks
4, 8 weeks
Assessment
Timepoints
Airblast
Airblast, thermal
Tactile, thermal,
airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
Both treatment modalities were effective in reducing dentine

hypersensitivity. However, Nd:YAG laser was better when
intra-group comparison was made at 9 months post
treatment. Nd:YAG lasers is better in long-term treatment
(up to 9 months) owing to the melting of dentinal tubules.
However, due to depth of penetration of microcrystals,
gel was better when ease of the procedure is considered.
Nevertheless, both treatment modalities resulted in
recurrence.
Lesion depth and pre-treatment sensitivity (mean, 5.3 on a
0- to 10-point scale) were balanced across treatments, as
was sleep bruxism (present in 42.2% of participants). The
6-month participant recall rate was 99%. Treatments
significantly reduced mean sensitivity (p < 0.01), with the
sealant and restoration groups displaying a significantly
higher reduction (p < 0.01) than did the dentifrice group.
The dentifrice groups mean (standard deviation)
sensitivity at 6 months was 2.1 (2.1); those of the sealant
and restoration groups were 1.0 (1.6) and 0.8 (1.4)
respectively. Patient-reported sensitivity (to cold being
most pronounced) paralleled clinical measurements at
each evaluation.
118 subjects complied with the protocol, and completed the

8-week study. At baseline, the mean tactile sensitivity
scores for toothpastes (1), (2) and (3) were 13.6, 14.1 and
13.1; at 4 weeks 28.75, 20.13 and 20.00; and after 8 weeks
33.1, 24.0 and 20.5 respectively. The mean airblast scores
for toothpastes (1), (2) and (3) at baseline were 2.5, 2.5
and 2.4; at 4 weeks 1.25, 1.50 and 1.85; and after 8 weeks
0.99, 1.36 and 1.5 respectively. At all time points after the
baseline examination, for both tactile and airblast
sensitivity scores, the differences between Test Dentifrice 1
and the Negative Control Dentifrice were statistically
significant (p < 0.05). The differences between Test
Dentifrice 1 and Test Dentifrice 2 were statistically
significant (p < 0.05) at 4 and 8 weeks after baseline
examination for tactile sensitivity scores and at 8 weeks
after baseline examination for airblast sensitivity scores.
After 6 weeks use of the assigned dentifrices, there were no
statistically significant differences between dentifrice
groups in any of the parameters assessed (tactile, cold
airblast and visual analogue scale). After 12 weeks use of
the assigned products, there were no statistically
significant differences between dentifrice groups in any of
the parameters assessed (tactile, cold airblast and visual
analogue scale).
After 6 weeks use of their assigned products, those subjects
in the potassium nitrate/copolymer/pyrophosphate
dentifrice group demonstrated statistically significant
improvements (p < 0.01), as compared to the placebo
dentifrice, in the following parameters: 1) tactile; 2)
thermal (threshold and pain); and 3) airblast. After
12 weeks use of their assigned products, those subjects in
the potassium nitrate/copolymer/pyrophosphate dentifrice
group again demonstrated statistically significant
improvements (p < 0.01), in tactile, thermal (threshold
and pain) and airblast sensitivity, as compared to the
placebo dentifrice.
Results
S272
West et al.
Single-centre,
double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
randomized study
Single-centre,
parallel group,
double-blind,
stratified
randomized study
Single-centre,
parallel group,
double-blind,
randomized study
randomized study
Single-centre, tripleblind, parallel

group,
randomized study
2013
2012
2013
2012
2012
Sowinski et al.
(2013)
Kakar et al.
(2012b)
Elas Boneta
et al.
(2013a)
Craig et al.
(2012)
Pradeep et al.
(2012)
Study design
2013
Year
Elas Boneta
et al.
(2013b)
References
150
19
69
88
100
118
Sample
size
5% potassium nitrate
38% diamine silver

fluoride, saturated
solution of
potassium iodide
8% arginine, PVM/
MA copolymer,
pyrophosphates,
0.05% sodium
8% arginine calcium
carbonate
Toothpaste: 8%
arginine and
1450 ppm sodium
MFP, calcium
carbonate +
Mouthwash: 0.8%
arginine, PVM/MA
copolymer,
pyrophosphates and
0.05% sodium
Potassium nitrate
Test product
Placebo
0.05% sodium
fluoride
mouthwash.
Fluoride toothpaste
Toothpaste:
containing
1450 ppm fluoride
in dicalcium base
+ Mouthwash:
fluoride/arginine
free
Negative control/
Placebo
5% calcium sodium
phosphosilicate
fused silica.
3.85% amine
fluoride
Oxalic acid-based
preparation
containing
potassium
2.4% potassium
nitrate, 0.022%
sodium fluoride
2% potassium
nitrate
Toothpaste: 5%
potassium nitrate
and 1450 ppm
sodium fluoride,
silica base +
Mouthwash:
0.51% potassium
chloride and
230 ppm sodium
fluoride, alcohol
base
Positive control/
Comparator
Product
Self-administered
toothpaste
Professionally
applied
Self-administered
mouthrinse
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste/
mouthrinse
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 6 weeks
1 week
30 min, 2, 4,
6 weeks
2, 4, 8 weeks
Intervals of up to
8 weeks
2, 4, 8 weeks
Assessment
Timepoints
Airblast, thermal
Thermal
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
Consistent with results from previous studies, subjects

assigned dentifrices formulated with potassium nitrate or
8% arginine/calcium carbonate demonstrated
improvements in Yeaple, airblast and VAS responses in
comparison to those assigned the fluoride dentifrice
(p < 0.05). Jay Probe responses correlated significantly
with all other sensitivity measures (p < 0.05). Differences
between these treatments were observed at all posttreatment evaluations using these methods.
exhibited statistically significant reductions (p < 0.05) in
33.1% and 29.7%) and airblast (16.4%, 31.1%, 58.8%)
stimuli when compared to the subjects who brushed with
the 2% potassium ion as potassium nitrate dentifrice after
2, 4 and 8 weeks respectively.
There were no differences after 30 min of a single use,
among the three groups with respect to mean tactile and
airblast hypersensitivity scores compared to potassium
nitrate and negative control mouthwashes (p < 0.05). The
arginine group presented a statistically significant
improvement in the mean tactile scores compared to
potassium nitrate and negative control groups after 2, 4
and 6 weeks (p < 0.001) of product use; the arginine
group showed a statistically significant enhancement in
airblast hypersensitivity mean scores compared to
potassium nitrate and negative control groups after two
(p = 0.001), four (p < 0.001) and 6 weeks (p < 0.001) of
product use.
The mean difference between VAS at baseline and 7 days
for teeth treated with diamine silver fluoride/potassium
iodide was greater than that for teeth treated with the
oxalic acid-based preparation (p = 0.0134). The subjects
subjective assessment of changes in dentine
hypersensitivity indicated that more obtained relief with
the diamine silver fluoride/potassium iodide treatment
(p = 0.0129).
All groups showed a reduction in sensitivity scores at
2 weeks and 6 weeks. The calcium sodium phosphosilicate
group was found to be significantly better compared to
the other groups at the end of 6 weeks.
The Tactile hypersensitivity mean scores showed statistically

Results

S273
Single-centre,
double-blind,
parallel-group,
randomized study
Singlecentre,
doubleblind,
parallel
group,
strati
fied,
rando
mized
study
Single-centre,
double-blind,
parallel group,
stratified,
randomized study

group,
randomized study
Single-centre,
examiner-blind,
parallel group,
randomized study
2010
2010
2010
2010
Ni et al.
(2010)
Sharma et al.
(2010)
Pradeep &
Sharma
(2010)
Prasad et al.
(2010)
Study design
2012
Year
Liu & Hu
(2012)
References
60
110
120
58
79
Sample
size
Potassium citrate,
sodium MFP,
sodium fluoride
toothpaste
Stannouscontaining
sodium
fluoride
dentifrice
2% strontium
chloride, 5%
potassium nitrate,
silica base
Test product
Toothpaste with
fused silica, no
calcium sodium
phosphosilicate
Dentifrice
containing the
same silica base
without any
active ingredient
Negative control/
Placebo
0.3% triclosan, 2%
copolymer,
advanced silica
system
5% calcium sodium
phosphosilicate
with fused silica
7.5% calcium
sodium
phosphosilicate
toothpaste
0.4% stannous
fluoride gel
Potassium
nitrate
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Selfadmini
stered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
6, 12 weeks
2, 6 weeks
2, 4, 12 weeks
4, 8
weeks
Immediate, 3 days
Assessment
Timepoints
Tactile, thermal
Airblast, thermal
Airblast, thermal
Tactile,
airblast
Tactile, airblast
Method of
Assessment
All three products significantly reduced sensitivity versus

baseline at each time point, although the calcium sodium
phosphosilicate (NovaMin) dentifrice reduced sensitivity
significantly more than the others at the 2- and 4-week
time points. At the 2-week time point, for air and water,
respectively, the dentifrice containing NovaMin reduced
sensitivity 45% and 49%, the stannous fluoride gel 30%
and 26%, and the potassium nitrate dentifrice 35% and
34%. At the 12-week time point, the dentifrice containing
NovaMin reduced sensitivity 87% and 91%, stannous
fluoride gel 87% and 85%, and potassium nitrate
dentifrice 84% and 79%.
All three groups showed reduction in sensitivity scores at
2 weeks and 6 weeks for air stimulus and cold water. The
calcium sodium phosphosilicate group, however, was
found to be significantly better in reducing the visual
analogue scale score compared to the potassium nitrate
group and the placebo group at any time point for both
measures of sensitivity.
The two teeth that were selected in each patient were
designated as two different sets. The 12th-week scores as
compared to baseline scores for tactile, heat and cold tests
in the test group showed a reduction in tooth
hypersensitivity by 36.67% (p < 0.01), 20.35% (p < 0.01)
and 53.64% (p < 0.01), respectively, in the first set of
teeth and 43.75% (p < 0.01), 24.48% (p < 0.01) and
59.78% (p < 0.01), respectively, in the second set of teeth.
The 12th-week scores as compared to baseline scores for
tactile, heat and cold tests in the control group showed a
reduction in tooth hypersensitivity by 42.86% (p < 0.01),
13.02% (p < 0.01) and 45.14% (p < 0.01), respectively, in
the first set of teeth and 40% (p < 0.01), 16.59%
(p < 0.01) and 44.16% (p < 0.01), respectively, in the
second set of teeth.
A total of 81 patients were enrolled (40 in the experimental

group; 41 in the control group), of whom 79 (55 women;
24 men) completed the study. After topical use, the
experimental group had a significantly higher mean (SD)
tactile hypersensitivity score (19.47 [14.69] vs 14.27 [5.76];
p = 0.047) and a significantly lower mean airblast
hypersensitivity score (1.93 [0.51] vs 2.22 [0.60]; p = 0.026)
than did the control group. After 3 days, the experimental
group had a significantly higher mean tactile
hypersensitivity score (19.87 [14.95] vs 14.51 [6.00];
p = 0.045) and a significantly lower airblast
hypersensitivity score (1.80 [0.56] and 2.13 [0.60];
p = 0.014) than the control group. After topical use and
after 3 days, the experimental group had increases from
baseline in tactile scores of 54.04% and 56.67%
respectively (both, p = 0.001) and reductions from
baseline in airblast scores of 18.51% and 24.21% (both,
p < 0.001); the control group had increases in tactile
scores of 21.14% and 21.54% (p = 0.022 and p = 0.007)
and reductions in airblast scores of 10.24% and 13.41%
(p = 0.001 and p < 0.001). No adverse events were
reported throughout the study.
Fifty-eight subjects completed all evaluations. Both the
experimental stannous-containing and positive control
dentifrices provided significant (p < 0.05) reductions in
both tactile and thermal dentin hypersensitivity compared
to baseline at both Weeks 4 and 8. There were no
significant differences in Yeaple Probe or Schiff Air Index
results between the dentifrices with either efficacy
measurement at Week 4 and Week 8 (p 0.5375).
Results
S274
West et al.
Single-centre,
double-blind,
parallel group,
stratified,
randomized stud
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
Double-blind,
parallel group,
randomized study
Single-centre,
parallel-group,
double-blind,
stratified
randomized study
2009
2009
2009
Nathoo et al.
(2009)
Ayad et al.
(2009a)
Docimo et al.
(2009a)
Study design
2009
Year
Docimo et al.
(2009b)
References
80
120
125
80
Sample
size
carbonate,
1450 ppm sodium
MFP
carbonate,
1450 ppm MFP
carbonate,
1450 ppm sodium
MFP
carbonate,
1450 ppm sodium
MFP
Test product
Toothpaste
containing
1450 ppm sodium
MFP
Negative control/
Placebo
2% potassium ion,
dosed as 3.75%
potassium
chloride,
1450 ppm sodium
fluoride
2% potassium ion
dosed as 5%
potassium nitrate,
1450 ppm sodium
fluoride
2% potassium ion
dosed as 5%
potassium nitrate,
1450 ppm sodium
fluoride
2% potassium ion,
dosed as 5.0%
potassium nitrate,
1450 ppm sodium
fluoride
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 4, 8 weeks
Immediate, 3 days
Immediate, 3 days
1, 2, 4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment

in a calcium carbonate base, provided a significant
period of 8 weeks. The study also showed that the new
26.4% and 33.8%) stimuli than the benchmark
commercial desensitizing toothpaste containing 2%
potassium ion and 1450 ppm fluoride as NaF in a silica
base, after 2, 4 and 8 weeks of product use respectively.
One hundred and twenty-five subjects complied with the
study protocol and completed the study. Relative to the
benchmark desensitizing toothpaste and the control
hypersensitivity scores immediately after direct
application. Reductions in sensitivity for the 8.0%
arginine toothpaste compared to the benchmark
desensitizing toothpaste and control toothpaste were
161.2% and 180.2% (tactile), and 59.8% and 58.0%
the 8.0% arginine group exhibited statistically significant
(p < 0.05) reductions in sensitivity after the subsequent 3
days of twice daily regular toothbrushing of 147.1% and
181.2% (tactile), and 70.1% and 70.9% (airblast)
respectively.
Relative to the desensitizing toothpaste and the control
measures immediately after completion of the first phase
of the study. Reductions in sensitivity for the 8.0%
arginine toothpaste, compared to the benchmark
desensitizing toothpaste and the control toothpaste, were
130.7% and 139.5% (tactile), and 43.8.0% and 49.6%
the 8.0% arginine group also exhibited statistically
significantly (p < 0.05) reductions in sensitivity after
completion of the second phase of the study, of 104.9%
and 136.1% (tactile), and 44.5% and 53.2% (airblast)
respectively. There was no loss of the instant relief effects
in the 8.0% arginine group after the brushing period.
This clinical study showed that the new toothpaste,
in a calcium carbonate base provided a significant
period of 8 weeks. The study also showed that this new
32.0% and 29.3%) stimuli than the commercial sensitive
fluoride as NaF in a silica base, after 2, 4 and 8 weeks of
product use respectively.
Results

S275
Parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
1998
Yates et al.
(1998b)
Double-blind,
parallel group,
randomized study
2005
Wara-aswapati
et al. (2005)
1998
Double-blind,
parallel group,
stratified,
randomized study
2007
Docimo et al.
(2007)
Schiff et al.
(1998)
Double-blind,
parallel group,
stratified,
randomized study
Study design
2009
Year
Ayad et al.
(2009b)
References
83
48
102
75
77
Sample
size
2% tripotassium
citrate monohydrate,
0.5%
cetylpyridinium
chloride, 0.05%
sodium fluoride
mouthrinse +
standard toothpaste
(1000 ppm fluoride)
5.0% potassium
nitrate, 1500 ppm
sodium MFP in a
precipitated calcium
carbonate base
0.3% triclosan,
0.76% sodium MFP
5.5% potassium
citrate
carbonate,
1450 ppm sodium
MFP
Test product
Placebo mouthrinse
without active
ingredients +
standard
toothpaste
(1000 ppm
fluoride)
Placebo without
potassium nitrate
0.76% sodium
MFP
Negative control/
Placebo
5% potassium
nitrate, 0.76%
SMFP
3.75% potassium
chloride
2% potassium ion,
dosed as 3.75%
potassium
chloride,
1450 ppm sodium
fluoride
Positive control/
Comparator
Product
Self-administered
toothpaste/
mouthrinse
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
28, 56 days
4, 8 weeks
4, 12 weeks
2, 4 weeks
2, 4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile airblast
Tactile, airblast
Method of
Assessment

containing 8.0% arginine and 1450 ppm MFP in a
calcium carbonate base, provided a significant reduction
in dentin hypersensitivity when used over a period of 8
weeks. The study also showed that this new arginine
toothpaste provided significantly greater reductions
(p < 0.05) in dentin hypersensitivity in response to tactile
(16.2%, 22.4% and 21.4%) and airblast (16.2%, 29.2%
and 63.4%) stimuli than the benchmark commercial
NaF in a silica base, after 2, 4 and 8 weeks of product
use respectively.
There was no statistically significant difference in tactile
sensitivity scores and airblast sensitivity scores between
the tested toothpastes at baseline, 2 weeks and 4 weeks.
Both toothpastes provided statistically significant
improvement in tactile sensitivity scores and airblast
sensitivity scores after 2 weeks of use and 4 weeks of use
as compared to baseline scores.
Overall, the GBI scores were significantly reduced
compared with baseline in all groups (p < 0.01). However,
there was no significant difference in GBI score among
the three comparison groups. The PI score decreased in
the test group and benchmark group from baseline to the
end of study, whereas there was no significant change in
the control group. Post hoc comparison indicated that the
PI score was not statistically different between the three
groups. There was a significant difference between the
three treatment groups for sensitivity. For both the tactile
and air stimuli, the reductions in VAS sensitivity scores
for the test group and the control group were significantly
greater compared with the benchmark group. Although
the sensitivity score for air stimulus decreased more
rapidly from baseline to week 4 in the test group, there
was no overall difference between the test group and the
control group.
After 4 weeks use of their assigned products, those subjects
in the potassium nitrate/PCC dentifrice group
demonstrated statistically significant improvements
(p < 0.0001), as compared to the placebo dentifrice
without potassium nitrite, in tactile and thermal
sensitivity. After 8 weeks use of their assigned products,
those subjects in the potassium nitrate/PCC dentifrice
group again demonstrated statistically significant
improvements (p < 0.0001), in tactile and thermal
sensitivity, as compared to the placebo dentifrice without
potassium nitrate.
Both groups showed highly significant improvements in
tooth sensitivity. The pattern was for greater
improvement in the test compared to the control group
(statistically significant for the plaque score), whereas
bleeding scores, already low, showed no change in either
group. By definition, the placebo rinse could not have
exerted any therapeutic action; the study therefore
provides clear direct evidence as to the magnitude (30%
40%) of the little studied, but assumed, placebo response
in dentine hypersensitivity trials.
Results
S276
West et al.
Multi-centre,
double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
randomized study
1996
1992
Silverman
et al. (1996)
Chesters et al.
(1992)
111
220
112
Sample
size
Potassium citrate,
sodium MFP
0.243% sodium
fluoride
Potassium nitrate,
sodium fluoride
Test product
Placebo (0%
potassium nitrate,
0% strontium
chloride, 0%
sodium fluoride)
Sodium MFP
placebo
Sodium MFP
Negative control/
Placebo
Orsini et al.
(2013)
2013
Single-centre,
double-blind,
parallel group,
randomized trial
Single-centre,
double-blind,
split-mouth,
randomized trial
1998
Yates et al.
(1998a)
Strontium
Parallel group,
randomized study
2003
Geiger et al.
(2003)
Single-centre,
double-blind,
split-mouth,
randomized trial
2013
Torwane et al.
(2013)
85
36
30
13 (74
teeth)
1040 ppm sodium
fluoride
Calcium chloride +
potassium
phosphate (ACP)
Amorphous calcium
phosphates (ACP)
30% ethenolic extract

of Indian propolis
Water
Warm distilled
water
Casein Derivatives (Amorphous calcium phosphate (ACP) and casein phosphopeptide CPP)
Single-centre,
double-blind,
parallel group,
randomized study
Study design
1997
Year
West et al.
(1997)
References
8% arginine,
calcium carbonate
and 1450 ppm
sodium MFP
30% zinc
substitutedcarbonate
hydroxyapatite
nanocrystals
RecaldentTM (casein
phosphopeptideamorphous
calcium
phosphate)
1.0 mol/L aqueous
solution of KCl
Potassium nitrate,
sodium MFP
10% strontium
chloride
5% potassium
nitrate
Strontium acetate,
sodium fluoride
Positive control/
Comparator
Product
Self-administered
toothpaste
Professional
prophylaxis
Professional
prophylaxis
Professional
prophylaxis
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
3 days
2, 7, 14, 21, 28, 56,

84 days
7, 28, 180 days
Immediate, 7, 14,
21 days
3, 8 weeks
2, 4, 8 weeks
2, 6 weeks
Assessment
Timepoints
Tactile, airblast,
thermal
Tactile, airblast,
thermal
Tactile, airblast
Tactile, airblast
Tactile, airblast,
electrical
Tactile, airblast
Tactile, airblast
Method of
Assessment
The final sample consisted of 85 individuals: 29 received the

arginine-based dentifrice (group 1), 27 the strontium
acetate-based dentifrice (group 2), and 29 the dentifrice
based on zinc-carbonate hydroxyapatite (group 3). All
dentifrices were mostly effective to reduce DH: the
percentage of score reduction from baseline to 3 days was
>30% for all tests (except for subjective test of group 2).
The comparison among the three dentifrices showed that,
after 3 days, there was an improvement in airblast (mean
percentage of reduction, 39.2% in group 1, 42.0% in
group 2, and 39.2% in group 3), cold water (41.5%,
51.8% and 50%), tactile (50.3%, 40.1% and 33.8%), and
subjective (33.1%, 17.4% and 31.4%) test scores, with
differences being significant for cold water and subjective
tests. For airblast and tactile tests, there were no
significant differences across groups at 3 days. Moreover,
no significant differences at any test were observed in a
subset of patients that were followed up to 8 weeks: all
dentifrices were all highly efficacious.
The results showed that both the experimental and placebo

treatments resulted in a reduction in hypersensitivity at
180 days. However, the ACP treatment group showed a
much more rapid reduction in hypersensitivity over time.
The change in sensitivity was much more apparent using
the air stimulus than the tactile stimulus.
Overall sensitivity decreased considerably and to a similar
degree in test and control teeth with no consistent
significant treatment difference. Plaque scores also
decreased through the study period.
Both the 30% Indian propolis and RecaldentTM showed

significant reduction in DH. RecaldentTM was found to be
significantly better in reducing the DH compared to
propolis and sterile water (p < 0.01)
All 3 dentifrice groups showed statistically significant

reductions in sensitivity over the 8 weeks. However, the
potassium citrate-SMFP dentifrice was significantly more
effective than either the control SMFP dentifrice, or the
potassium nitrate-SMFP dentifrice, at reducing sensitivity
after 3 weeks, and this difference plus further sensitivity
reduction with all 3 dentifrices was observed after
8 weeks.
All 3 toothpaste groups showed reductions in sensitivity

over the 6 weeks; however, no significant differences were
found between the three products at any given time.
Interestingly, there was no significant change in sensitivity
between wash-in baseline and treatment baseline for the
cold air stimulus with the fluoride-only based paste.
However, for the group using the same fluoride
toothpaste, there was significant improvement between
wash-in baseline and week 6, and treatment baseline and
week 6 for this stimulus, suggesting a substantial placebo
effect occurred.
Results demonstrated that after 4 weeks, participants who
used the new dentifrice formulation experienced
significant decreases in dentinal sensitivity compared to
the placebo group for all measured indexes.
Results

S277
2011
2012
Liu & Hu
(2012)
Schiff et al.
(2011)
2013
Year
West et al.
(2013a)
References
Double-blind,
crossover,
randomized study
Single-centre,
double-blind,
parallel-group,
randomized study
Single-centre,
single-blind,
parallel group,
stratified and
randomized study
Study design
121
79
80
Sample
size
silica, 1040 ppm
sodium fluoride
2% strontium
chloride, 5%
potassium nitrate,
silica base
silica with 1040 ppm
sodium fluoride
Test product
Dentifrice
containing the
same silica base
without any
active ingredient
Negative control/
Placebo
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
8% arginine,
calcium carbonate
with 1450 ppm
sodium MFP
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Product 1 (phase
1): 8 weeks,
product 2 (phase
2): 2, 8 weeks
Immediate, 3 days
Immediate, 3 days
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
All 80 subjects completed the study. Results confirm that

for both treatments, pain was reduced immediately and
relief was sustained after 3 days use. For all 3 measures,
benefit was similar between the two pastes, with no
statistical or clinical difference demonstrated, apart from
response to evaporative stimulus at 3 days, where Schiff
scores were significantly lower in the arginine group,
p = 0.02.
A total of 81 patients were enrolled (40 in the experimental
group; 41 in the control group), of whom 79 (55 women;
24 men) completed the study. After topical use, the
experimental group had a significantly higher mean (SD)
tactile hypersensitivity score (19.47 [14.69] vs 14.27 [5.76];
p = 0.047) and a significantly lower mean airblast
hypersensitivity score (1.93 [0.51] vs 2.22 [0.60]; p = 0.026)
than did the control group. After 3 days, the experimental
group had a significantly higher mean tactile
hypersensitivity score (19.87 [14.95] vs 14.51 [6.00];
p = 0.045) and a significantly lower airblast
hypersensitivity score (1.80 [0.56] and 2.13 [0.60];
p = 0.014) than the control group. After topical use and
after 3 days, the experimental group had increases from
baseline in tactile scores of 54.04% and 56.67%
respectively (both, p = 0.001) and reductions from
baseline in airblast scores of 18.51% and 24.21% (both,
p < 0.001); the control group had increases in tactile
scores of 21.14% and 21.54% (p = 0.022 and p = 0.007)
and reductions in airblast scores of 10.24% and 13.41%
(p = 0.001 and p < 0.001). No adverse events were
reported throughout the study.
One hundred and twenty-one subjects complied with the
study protocol and completed the study. Study Phase I:
Subjects who brushed twice daily for 8 weeks with the
arginine/calcium carbonate dentifrice experienced
airblast hypersensitivity scores (51.3% and 39.4%
respectively) relative to that experienced by subjects who
brushed with the strontium acetate dentifrice. Study Phase
II: Subjects who brushed with the arginine/calcium
carbonate dentifrice for the first 8 weeks of the study and
then switched to brush with the strontium acetate
dentifrice for the second 8 weeks of the study, did not
exhibit further improvements in mean tactile or mean
airblast hypersensitivity scores after 2 and 8 weeks of
switch-over product use. However, subjects who brushed
with the strontium acetate dentifrice for the first 8 weeks
of the study and then switched to brush with the arginine/
calcium carbonate dentifrice exhibited statistically
significant improvements in mean tactile and airblast
hypersensitivity scores 2 weeks (35.2% and 29.9%
respectively) and 8 weeks (40.3% and 35.3% respectively)
after product switch-over. Relative to the subjects who
switched from twice daily brushing with the arginine/
calcium carbonate dentifrice to brush with the strontium
acetate dentifrice, those who switched from brushing with
the strontium acetate dentifrice to brush with the
arginine/calcium carbonate dentifrice exhibited statistically
significant improvements in mean tactile hypersensitivity
scores (10.3%) and in mean airblast hypersensitivity
scores (16.3%) 8 weeks after product switch-over.
Results
S278
West et al.
Single-centre,
double-blind,
parallel group,
randomized study
Double-blind,
randomized study
Examiner-blind,
parallel group,
randomized study
Examiner-blind,
parallel group,
stratified,
randomized study
Multi-centre,
double-blind,
randomized study
2011
2010
2010
2008
Li et al.
(2011)
Hughes et al.
(2010)
Mason et al.
(2010)
Kobler et al.
(2008)
Study design
2011
Year
Docimo et al.
(2011)
References
132
79
77
150
150
Sample
size
Strontium chloridecontaining varnish

desensitizer,
1040 ppm sodium
base
1040 ppm sodium
fluoride
silica, 1040 ppm
sodium fluoride
silica with 1040 ppm
sodium fluoride
(Sensodyne Rapid
Relief)
Test product
Placebo
1450 ppm sodium

base,
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
8% arginine and
calcium carbonate
with 1450 ppm
MFP (Colgate
sensitive ProRelief)
Fluoride toothpaste
(Crest cavity
protection)
1100 ppm fluoride

as NaF in a silica
base
Positive control/
Comparator
Product
Negative control/
Placebo
Professional
application
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 8, 12, 24 weeks
Immediate, 3 days
2, 4, 8 weeks
Immediate, 7 days
2, 4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
After 2, 4 and 8 weeks of daily use of the products, all

three groups showed a statistically significant reduction
from baseline in tactile and airblast dentin hypersensitivity
(p < 0.05). Colgate Sensitive Pro-Relief toothpaste
produced a significant improvement in mean tactile and
airblast dentin hypersensitivity scores, and was more
effective than Sensodyne Rapid Relief toothpaste and
Crest Cavity Protection toothpastes (p < 0.05).
All 150 subjects complied with the protocol and completed
the study. The positive control toothpaste containing
8.0% arginine and 1450 ppm fluoride as MFP in a
calcium carbonate base provided statistically significant
improvements in mean tactile and airblast dentin
hypersensitivity scores compared to the negative control
toothpaste containing 1100 ppm fluoride as NaF in a
silica base (p < 0.05). The toothpaste containing 8.0%
arginine and 1450 ppm fluoride as MFP in a calcium
carbonate base (positive control) also provided
airblast dentin hypersensitivity scores compared to the test
toothpaste containing 8% strontium acetate and
1040 ppm fluoride as NaF in a silica base. The test
toothpaste and the negative control toothpaste were not
significantly different from each other.
Seventy-seven subjects completed this clinical study. Both
subject groups exhibited significant cumulative reductions
from baseline to Days 14, 28 and 56 in dentin
hypersensitivity as measured by Schiff, Yeaple and VAS
(for the 8% strontium acetate group, p 0.0001 for all
time points; for the 8% arginine/calcium carbonate group,
p = 0.0031 for Yeaple at Day 14, p = 0.0015 for VAS at
Day 14 and p < 0.0001 for all remaining measures and
time points). No significant differences (p > 0.05) were
observed between treatments for any of the time points
and measures except for tactile sensitivity at Day 56, for
which the 8% strontium acetate-based dentifrice was
statistically superior (p = 0.0391) to the control 8%
arginine/calcium carbonate dentifrice.
Seventy-nine subjects completed this clinical study. Both
subject groups exhibited reductions in dentin
hypersensitivity directly after a single dab-on application.
These reductions were significant across all measures for
the test dentifrice. Between-treatment analyses showed the
test dentifrice to be significantly better at relieving
subjects sensitivity across all measures (Schiff p = 0.0003,
tactile p = 0.0003 and VAS p = 0.0077) compared to the
control. After the additional 3 days of twice daily
brushing, between-treatment analyses showed the test
dentifrice to be significantly better at relieving subjects
sensitivity across all measures (Schiff p = 0.0102, tactile
p = 0.0493 and VAS p = 0.0067) than the control
dentifrice.
A reduction in discomfort and pain was observed in 95
patients (72%) after treatment with SR. Statistical
analysis showed a significant positive effect of SR
compared to the placebo group (p < 0.05, McNemar test).
Results

S279
Double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Two-centre, doubleblind, parallel

group study
Multi-centre,
double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
study
Double-blind
parallel group,
randomized study
1997
1996
1996
1994
1992
West et al.
(1997)
Gillam et al.
(1996)
Silverman
et al. (1996)
Pearce et al.
(1994)
Gillam et al.
(1992b)
Study design
2008
Year
Du Min et al.
(2008)
References
40
119
220
56
112
71
Sample
size
Strontium chloride
hexahydrate with
silica abrasive
10% strontium
chloride
0.243% sodium
fluoride
0.23% sodium
fluoride
Strontium acetate,
sodium fluoride
Toothpaste with
calcium sodium
phosphosilicate
Test product
Placebo (0%
potassium nitrate,
0% strontium
chloride, 0%
sodium fluoride)
0.76% sodium
monofluoro
phosphate, 0.1%
sodium fluoride
0.75% sodium
MFP, 0.13%
calcium glycero
phosphate,
0.016% sodium
fluoride
Sodium MFP
Placebo toothpaste
Negative control/
Placebo
Strontium chloride
hexahydrate with
diatomaceous
earth abrasive
system
8% strontium
acetate, 0.23%
sodium fluoride
1% strontium
chloride
5% potassium
nitrate
3.75% potassium
chloride, 0.8%
sodium MFP
Potassium nitrate,
sodium fluoride
Toothpaste
containing
strontium
chloride
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
4, 8 weeks
1, 4, 8, 12 weeks
2, 4, 8 weeks
2, 6 weeks
2, 6 weeks
2, 6 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, thermal,
airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Airblast, thermal
Method of
Assessment
There was an overall and progressive reduction in all

sensitivity parameters in the three groups with no
significant differences between the treatments. Plaque and
gingivitis scores were already relatively low in this patient
group at baseline but improved further as the study
continued. The improvements, however, were comparable
in the three groups. Under the conditions of this clinical
trial the 2 desensitizing toothpastes showed similar
reductions, but no greater than that observed in the
conventional fluoride toothpaste.
There was no difference between the dentifrices as regards
reduction in cervical dentinal hypersensitivity at each time
point. The response to both dentifrices was evident within
4 weeks of use and the degree of improvement increased
throughout the 8-week study period. The results support
the conclusion that changing the abrasive component of
SCH dentifrices did not significantly increase or decrease
the (desensitizing) activity of the original product.
The placebo and the NovaMin groups showed a

statistically significant decrease in sensitivity by both
measures after 6 weeks (p < 0.05). The SrCl2 group
showed a statistically significant decrease from baseline at
the 2-week time point, but not at the 6-week time point
for the evaporative stimulus. The percent reduction in
sensitivity at 6 weeks for the NovaMin test group was
35% for air and 39% for cold water stimulus, versus 11%
for air and 22% for cold water for the SrCl2 paste. The
reductions for the placebo paste were 21% for the air
stimulus and 18% for water. A cross-tabulation measure
of the reduction in sensitivity at each time point for all
three treatments showed that the NovaMin product was
more effective than either of the other products. For the
air stimulus in the NovaMin group, 58% of subjects
improved at each time point compared with 26% for the
SrCl2 group and 20% for the placebo group.
Of the original 120 subjects, 112 completed the trial. All 3
toothpaste groups showed reductions in sensitivity over
the 6 weeks; however, no significant differences were
found between the three products at any given time.
Interestingly, there was no significant change in sensitivity
between wash-in baseline and treatment baseline for the
cold air stimulus with the fluoride-only based paste.
However, for the group using the same fluoride
toothpaste, there was significant improvement between
wash-in baseline and week 6, and treatment baseline and
week 6 for this stimulus, suggesting a substantial placebo
effect occurred.
Results for Yeaple probe scores (Wilcoxon tests) between
2 weeks and baseline were highly significant for KCl/
MFP, significant for NaMFP and non-significant for
SrAc2F; scores between 6 weeks and baseline were,
however, highly significant for all groups. Subjective
Yeaple probe VAS scores (paired t-tests) between 6 weeks
and baseline were significant for all groups; significance
was demonstrated in the KCl/MFP group between
2 weeks and baseline. Subjective air visual analogue
scores (paired t-tests) between 2 weeks and baseline were
highly significant for all groups. There were no significant
differences between groups at any time point.
Results demonstrated that after 4 weeks, participants who
used the new dentifrice formulation experienced
significant decreases in dentinal sensitivity compared to
the placebo group for all measured indexes.
Results
S280
West et al.
Single-centre,
double-blind,
parallel group,
randomized study
1984
Collins &
Perkins
(1984)
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
Single-centre,
examiner-blind,
parallel group,
stratified,
randomized study
Single-centre,
examiner-blind,
parallel group,
randomized study
2014
2013
2011
He et al.
(2014)
Parkinson
et al. (2013)
He et al.
(2011a)
Stannous fluoride
Double-blind,
parallel group,
randomized study
1987
Minkoff &
Axelrod
(1987)
Double-blind
parallel group,
randomized study
Study design
1992
Year
Gillam et al.
(1992a)
References
78
117
116
89
57
40
Sample
size
0.454% stannous
fluoride
0.454% stannous
fluoride, 1000 ppm
sodium MFP
anhydrous dentifrice
0.454% stannous
fluoride
10% strontium
chloride
10% strontium
chloride hexahydrate
Strontium chloride
hexahydrate with
silica abrasive
Test product
Standard fluoride
toothpaste
(Colgate Cavity
Protection)
Sodium fluoride
dentifrice
Sodium citrate in
pluronic gel
Placebo
Negative control/
Placebo
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
Sodium citrate in
pluronic gel with
0.2% sodium
fluoride
Strontium chloride
hexahydrate with
diatomaceous
earth abrasive
system
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste and
gel
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 3 days,
2 weeks
4, 8 weeks
Immediate, 3 days,
2 weeks
2, 4, 8 weeks
2, 4, 8, 12 weeks
12 weeks post
treatment regime
Assessment
Timepoints
Airblast
Tactile, airblast
airbalst, tactile
Tactile, airblast
Tactile, airblast
(thermal
threshold)
Tactile, airblast
Method of
Assessment
All 116 enrolled subjects completed all evaluations. The

stannous fluoride dentifrice provided significantly
(p < 0.0001) superior dentin hypersensitivity reduction
compared to the negative control dentifrice at each time
point and by both evaluation measures: superior mean
relative Yeaple Probe (tactile) benefits were 124.5% after
one use, 203.8% after 3 days, and 222.5% after 2 weeks;
and superior mean relative Schiff Air Index (thermal)
benefits were 27.6% after a single use, 44.6% at Day 3,
and 74.2% at Week 2. Both dentifrices were well
tolerated.
117 subjects completed the clinical study. At the 4- and 8week time points, between-treatment analyses
demonstrated the test dentifrice to be significantly better
at relieving subjects sensitivity, for both validated clinical
measures, compared to the negative control (at 4 weeks
Schiff p < 0.0001 tactile threshold p < 0.0001; at 8 weeks
Schiff p < 0.0001; tactile threshold p < 0.0001).
40 subjects in the SnF2 dentifrice group and 38 subjects in
the control group completed all study procedures. Both
dentifrice groups showed significant sensitivity relief
relative to baseline (p < 0.01). The SnF2 dentifrice
provided a statistically significant (p = 0.005) 7.4%
reduction in sensitivity relative to the positive control
dentifrice immediately after first use and an even more
significant (p = 0.001) 20% reduction at Week 2 based on
the Schiff air sensitivity scale. Based on the VAS, the
SnF2 dentifrice provided statistically significant
(p < 0.0001) reduction in sensitivity relative to the positive
control dentifrice immediately after first use, at Day 3,
and Week 2, with percent reductions of 7.2%, 15.8% and
28.2% respectively. No adverse events were reported with
either dentifrice.
The results from these methods of assessment demonstrated

that 12 weeks following the cessation of 8 weeks
controlled use of standard and low abrasive SCH
dentifrices, sensitivity levels reversed on slightly in both
groups and, overall, sensitivity remained significantly
lower than at baseline. The abrasivity of the dentifrice did
not affect the desensitivity activity.
The results from all three methods of assessment indicated
that the strontium chloride dentifrice, in comparison with
a placebo, reduced dentinal hypersensitivity to a
significantly greater degree. This therapeutic response to
the active agent was apparent within 2 weeks and
increased continuously thereafter for the length of the
study. One can conclude that the regular at-home use of a
dentifrice containing 10% strontium chloride hexahydrate
is an effective means for reducing the discomfort and pain
engendered by thermal and tactile stimuli in patients with
dentinal hypersensitivity.
The three dentifrices relieved both tactile and thermal
sensitivity, but there was no statistical difference at
8 weeks between the three agents. There was a difference
in the time it took the dentifrices to achieve a statistically
significant reduction in dentin sensitivity.
Results

S281
Single-centre,
examiner-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
2011
2010
2010
Ni et al.
(2010)
Sharma et al.
(2010)
Examiner-blind,
parallel group,
randomized study
2011
He et al.
(2011b)
He et al.
(2011c)
Single-centre,
double-blind,
parallel group,
randomized study
Study design
2011
Year
Chaknis et al.
(2011)
References
120
58
81
111
118
Sample
size
0.4% stannous
fluoride gel
Stannous-containing
sodium fluoride
dentifrice
Stannous-containing
1450 ppm sodium
fluoride
0.454% stannous
fluoride
0.454% stannous
base with sodium
hexameta
phosphate and zinc
lactate (toothpaste
1)
Test product
0.76% sodium
MFP
0.243% sodium
base (toothpaste
3)
Negative control/
Placebo
5% potassium
nitrate toothpaste
7.5% calcium
sodium
phosphosilicate
toothpaste
Potassium nitrate
8% arginine,
calcium
carbonate,
1450 ppm sodium
MFP
0.3% triclosan,
2.0% PVM/MA
copolymer
toothpastes,
0.243% sodium
fluoride and
specially designed
silica (toothpaste
2)
Positive control/
Comparator
Product
Self-administered
toothpaste/gel
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 4, 12 weeks
4, 8 weeks
Immediate, 3 days
Immediate, 3 days,
2 weeks
4, 8 weeks
Assessment
Timepoints
Airblast, thermal
Tactile, airblast
Airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment

8-week study. At baseline, the mean tactile sensitivity
scores for toothpastes (1), (2) and (3) were 13.6, 14.1 and
13.1; at 4 weeks 28.75, 20.13 and 20.00; and after 8 weeks
33.1, 24.0 and 20.5 respectively. The mean airblast scores
for toothpastes (1), (2) and (3) at baseline were 2.5, 2.5
and 2.4; at 4 weeks 1.25, 1.50 and 1.85; and after 8 weeks
0.99, 1.36 and 1.5 respectively. At all time points after the
baseline examination, for both tactile and airblast
sensitivity scores, the differences between Test Dentifrice 1
and the Negative Control Dentifrice were statistically
significant (p < 0.05). The differences between Test
Dentifrice 1 and Test Dentifrice 2 were statistically
significant (p < 0.05) at 4 and 8 weeks after baseline
examination for tactile sensitivity scores and at 8 weeks
after baseline examination for airblast sensitivity scores.
111 subjects were enrolled and randomized to one of the
two treatment groups. Immediately after the first use, the
SnF, dentifrice provided statistically significant
(p < 0.0001) reductions in sensitivity relative to the
negative control dentifrice of 13.8% for the thermal Schiff
Air Sensitivity Scale and 14.6% for the air VAS. The
SnF, dentifrice also provided statistically significant
(p < 0.0001) reductions in sensitivity relative to the
negative control at Day 3 and at Week 2 based on the
thermal Schiff Air Sensitivity Scale (31.8% and 61.3%
respectively) and the thermal air VAS (34.8% and 66.6%
respectively). For the tactile Yeaple probe, the SnF2
dentifrice demonstrated significantly (p < 0.0001) better
sensitivity scores relative to the negative control at Day 3
and Week 2, with improvements of 186% and 239%
respectively. Both dentifrices were well tolerated.
Forty subjects in the experimental group and 41 subjects in
the positive control group completed all study procedures.
On the Schiff Air Sensitivity Scale, the experimental
dentifrice provided statistically significant (p < 0.001)
reductions of 14.8% and 54.1% in sensitivity relative to
the positive control dentifrice immediately after first use
and at Day 3 respectively. On the pain VAS, the
experimental dentifrice provided statistically significant
(p < 0.001) reductions of 22.3% and 74.1% in sensitivity
relative to the positive control dentifrice immediately after
first use and at Day 3 respectively. No adverse events
were reported for any subject.
Fifty-eight subjects completed all evaluations. Both the
experimental stannous-containing and positive control
dentifrices provided significant (p < 0.05) reductions in
both tactile and thermal dentin hypersensitivity compared
to baseline at both Weeks 4 and 8. There were no
significant differences in Yeaple Probe or Schiff Air Index
results between the dentifrices with either efficacy
measurement at Week 4 and Week 8 (p 0.5375).
fluoride gel 87% and 85%, and potassium nitrate
Results
S282
West et al.
Double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
stratified,
randomized study
Double-blind,
parallel-group,
stratified,
randomized study
Parallel group,
stratified,
randomized study
Single-centre,
parallel group,
stratified,
randomized study
Double-blind,
parallel group,
stratified,
randomized study
Examiner-blind,
parallel group,
stratified
randomized study
2005
2006
2000
2000
2000
2000
Schiff et al.
(2005)
Schiff et al.
(2006)
Schiff et al.
(2000b)
Conforti et al.
(2000)
Sowinski et al.
(2000a)
Sowinski et al.
(2000b)
Study design
2010
Year
Day et al.
(2010)
References
97
109
66
120
90
77
31
Sample
size
0.454% stannous
base
0.454% stannous
base
0.454% stannous
base
0.454% stannous
base
Stabilized 0.454%
stannous fluoride,
sodium hexameta
phosphate
Stabilized 0.454%
stannous fluoride,
sodium hexameta
phosphate
Stannous-containing
sodium fluoride
dentifrice
Test product
0.243% sodium
base
0.243% sodium
base
0.243% sodium
base
Sodium fluoride
Sodium fluoride
Sodium fluoride
Negative control/
Placebo
5% potassium
nitrate, 0.243%
sodium fluoride in
a silica base
5% potassium
nitrate, 0.76%
sodium MFP in a
dicalcium
phosphate base
5% potassium
nitrate, 0.243%
sodium fluoride in
a silica base
Positive control/
Comparator
Product
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
4, 8 weeks
4, 8 weeks
3, 7, 10, 14 days
4, 8 weeks
4, 8 weeks
4, 8 weeks
2, 4 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, thermal
Tactile, airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Airblast
Method of
Assessment
After 4 weeks, subjects assigned to the Colgate Sensitive

Maximum Strength dentifrice group exhibited a
statistically significant improvement over the Sensodyne
dentifrice group with respect to tactile sensitivity scores,
and a statistically significant improvement over the
Sensodyne dentifrice group with respect to airblast
sensitivity scores. Correspondingly significant
improvements were presented after 8 weeks.
Thirty-one subjects were included in the analyses. For the

two most sensitive teeth, the experimental dentifrice
showed statistically significantly less sensitivity (p < 0.05)
versus the control at weeks two and four and for weeks
two and four combined. The sensitivity reduction ranged
from 24.9% to 28.4% over the control. For all 12 teeth,
the experimental group had statistically significantly
(p < 0.03) lower sensitivity scores versus the control group
at week two and weeks two and four combined.
The mean sensitivity score based on the Schiff Air Index for
the experimental group was statistically significantly lower
than that of the sodium fluoride control group, at both
weeks 4 and 8 (p < 0.0001). The mean sensitivity score
based on the Yeaple Probe Index for the stannous
fluoride/sodium hexametaphosphate group was
statistically significantly higher, indicating a reduction in
sensitivity, than that of the sodium fluoride control group,
at both weeks 4 and 8 (p < 0.0001).
The mean sensitivity score based on the Schiff Air Index for
the stannous fluoride + SHMP group was statistically
significantly lower than that of the control group, at both
weeks four and eight (p < 0.0001). At week eight, the
stannous fluoride + SHMP dentifrice group had an
adjusted mean 44% lower than that of the control group.
The mean tactile sensitivity score for the stannous fluoride
+ SHMP group was statistically significantly higher,
indicating a reduction in sensitivity, than that of the
control group, at both weeks four and eight (p < 0.0001).
At week eight, the stannous fluoride + SHMP dentifrice
group had a mean desensitizing improvement of 71%
greater than the control.
After 4- and 8-weeks use of their assigned products,
participants in the new dentifrice group demonstrated
statistically significant improvements (p < 0.05) in tactile
and airblast sensitivity, as compared to those using the
positive and negative control dentifrices.
Participants who used the new formulation dentifrice
containing potassium nitrate/stannous fluoride/silica
demonstrated a statistically significant improvement in
both tactile sensitivity and airblast sensitivity after 10 and
14 days use of the dentifrice (p < 0.05), as compared to a
commercially available control dentifrice. It was
concluded that a new dentifrice formulation containing
5.0% potassium nitrate and 0.454% stannous fluoride in a
silica base provided a statistically significant reduction in
dentinal hypersensitivity after only 10 days, as compared
to a commercially available non-desensitizing control
dentifrice.
The new dentifrice group demonstrated statistically
significant improvements in tactile and thermal sensitivity
over the two control groups.
Results

S283
29 studies, both:
double-blind,
parallel group,
stratified,
randomized
studies
2001
Sowinski et al.
(2001)
Single-site, doubleblind, parallel

group, stratified,
randomized study
Single-centre,
double-blind,
parallel group,
randomized,
study
Single-centre,
parallel group,
stratified,
randomized study
2013
2013
2012
Acharya et al.
(2013)
Milleman
et al. (2012)
Neuhaus et al.
(2013)
Calcium Sodium Phosphosilicate (CSPS)
Examiner-blind,
parallel group,
stratified,
randomized study
Study design
2000
Year
Schiff et al.
(2000a)
References
139
20
149
Study 1:
81
Study
2: 105
101
Sample
size
NovaMin, no
NaF paste
NovaMin, NaF
paste
15% NovaMin
paste
Study 1: None
Study 2: 3.75%
potassium
chloride, 0.3%
triclosan, 0.32%
sodium fluoride
5% potassium
nitrate, 0.76%
sodium MFP in a
dicalcium
phosphate base
Positive control/
Comparator
Product
5% potassium
nitrate
Prophy paste, no
NaF
Paste without
NovaMin, or
fluoride
Study 1: 0.32%
sodium fluoride
Study 2: None
Negative control/
Placebo
5% calcium sodium
phosphosilicate
15% NovaMin,
2.7% sodium
fluoride paste
Both studies: 0.59%

stannous fluoride,
0.32% sodium
fluoride, 10%
potassium nitrate,
silica
0.454% stannous
base
Test product
Professionally
applied
prophylaxis
Self-administered
toothpaste
Professionally
applied
prophylaxis
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 28 days
2, 4, 8 weeks
Immediate, 28 days
4, 8 weeks
4, 8 weeks
Assessment
Timepoints
Tactile, airblast
Airblast
Tactile, airblast
Tactile, airblast
Tactile, airblast
Method of
Assessment
Subjects having received the test prophylaxis pastes showed

statistically lower (anova, p < 0.05) dentine
hypersensitivity compared with the control group
immediately after the prophylaxis procedure (Yeaple
Probe: Test-A = 20.9 12.6, Test-B = 22.7 12.9,
Control=11.2 3.1; Schiff score: Test-A = 1.1 0.6,
Test-B = 1.1 0.6, Control = 2.0 0.7) and after
28 days (Yeaple probe: Test-A = 21.5 11.9, TestB = 20.6 11.3, Control = 11.8 6.0; Schiff score: TestA = 1.0 0.6, Test-B = 1.0 0.6, Control = 2.0 0.7).
The study demonstrated reduction in symptoms for all
treatment groups from baseline to 2, 4 and 8 weeks. The
calcium sodium phosphosilicate group showed a higher
degree of effectiveness at reducing hypersensitivity to air
evaporative stimulus at 2 weeks, than commercially
available potassium nitrate. However, there was no
significant difference in scores of subjects using the
calcium sodium phosphosilicate toothpaste as compared
to potassium nitrate at 4 weeks and 8 weeks.
A total of 139 patients completed the study. Subjects
having received the NovaMin containing prophylaxis
pastes (Groups A and B) showed statistically lower
(ANOVA, p < 0.05) dentin hypersensitivity compared to
the control group immediately after the prophylaxis
procedure. Group A tactile improvements were 86%
immediate, and 88% after 28 days; airblast improvements
were 49% immediate, and 50% after 28 days. Group B
tactile improvements were 67% immediate, and 65% after
28 days; airblast improvements were 43% immediate, and
34% after 28 days. Group C experienced little
improvement in tactile and airblast scores, 9% and 4%,
respectively, immediately following treatment, and 10%
and 1%, respectively, after 28 days. At both time points,
the reduction in sensitivity was meaningful and
significantly better than in the group receiving a standard
prophylaxis paste as the comparator (p < 0.05). Both
NovaMin pastes were effective and there was no
statistical difference between the pastes with and without
fluoride. There were no adverse events reported during the
course of this study.

entire study. After 4 weeks, subjects assigned to the
Colgate Sensitive Maximum Strength group exhibited a
statistically significant improvement over the Fresh Mint
Sensodyne dentifrice group with respect to tactile
sensitivity scores, and a statistically significant
improvement over the Sensodyne dentifrice group with
respect to airblast sensitivity scores. Correspondingly
significant improvements were presented after 8 weeks.
In study 1, the group using the new dentifrice tolerated
greater pressure after 4 (34.9 g) and 8 weeks (38.4 g) than
the group using the fluoride dentifrice (22.9 g and 19.0 g
respectively). These differences were statistically significant
(p < 0.001). At 4 and 8 weeks, the mean airblast scores
for the group using the new dentifrice (1.39 and 0.83)
were lower than for the group using fluoride dentifrice
(1.78 and 1.76) and were significantly different at 8 weeks
(p < 0.001). In study 2 the group using the new dentifrice
tolerated greater pressure after 4 (40.5 g) and 8 weeks
(43.7 g) than the group using Sensodyne F (27.8 g and
33.2 g respectively). These differences were statistically
significant (p < 0.001). At 4 and 8 weeks, the mean
airblast scores for the group using the new dentifrice (1.10
and 0.67) were significantly lower than the group using
Sensodyne F (1.90 and 1.57) (p < 0.001).
Results
S284
West et al.
Parallel group,
randomized study

group,
randomized study
Single-centre,
single-blind,
parallel group,
randomized study
Single-centre,
double-blind,
parallel group,
stratified,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
Double-blind,
parallel group,
randomized,
study
Single-centre,
double-blind,
parallel group,
randomized study

group,
randomized study
2012
2012
2010
2010
2010
2010
2010
Pradeep et al.
(2012)
Rajesh et al.
(2012)
Sharma et al.
(2010)
Salian et al.
(2010)
Litkowski &
Greenspan
(2010)
Narongdej
et al. (2010)
Pradeep &
Sharma
(2010)
Study design
2012
Year
Surve et al.
(2012)
References
110
60
66
30
120
30
150
20
Sample
size
5% calcium sodium
phosphosilicate with
fused silica
Paste of NovaMin in
water + 7.5%
NovaMin
toothpaste (group1)
placebo paste +
7.5% NovaMin
toothpaste (group 2)
7.5% NovaMin
2.5% NovaMin
5% NovaMin
7.5% calcium sodium

phosphosilicate
toothpaste
5% calcium sodium
phosphosilicate
5% calcium sodium
phosphosilicate,
fused silica
Paste with calcium

sodium
phosphosilicate
Test product
Toothpaste with
fused silica, no
calcium sodium
phosphosilicate
Placebo paste
1000 ppm sodium

MFP
Paste without
desensitizing
agent
Placebo paste
Negative control/
Placebo
5% potassium
nitrate
Placebo paste + 5%
potassium nitrate
toothpaste
(group3)
5% potassium
nitrate
5% potassium
nitrate toothpaste
0.4% stannous
fluoride gel
5% potassium
nitrate
85% amine
fluoride
Paste with
potassium nitrate
Positive control/
Comparator
Product
Self-administered
toothpaste
Professionally
applied
prophylaxis +
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste/gel
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
2, 6 weeks
Immediate, 1, 2,
4 weeks
2, 4, 8 weeks
2, 4 weeks
2, 4, 12 weeks
6, 8 weeks
2, 6 weeks
2, 4, 8 weeks
Assessment
Timepoints
Airblast, thermal
Tactile, thermal
Tactile, airblast
Tactile, airblast,
thermal
Airblast, thermal
Airblast, thermal
Airblast, thermal
Tactile
Method of
Assessment

fluoride gel 87% and 85% and potassium nitrate
Compared to baseline, there was a significant decrease in
dentin hypersensitivity in Groups A and B following
4 weeks use of the dentifrice containing 5% potassium
nitrate and the dentifrice containing 5% calcium sodium
phosphosilicate (NovaMin) respectively. There was a
statistically greater reduction in hypersensitivity at both 2
and 4 weeks following use of the dentifrice containing
NovaMin compared with the use of a non-desensitizing
dentifrice, as well as the dentifrice containing potassium
nitrate. Air and cold water scores were significantly lower
following 4 weeks use of the potassium nitrate dentifrice
compared to the non-desensitizing dentifrice. Tubule
occlusion was observed in the companion in vitro study
following treatment with 5% NovaMin, but not after
treatment with the 5% potassium nitrate or nondesensitizing dentifrices.
Comparison of the mean change from baseline among the
three treatment groups indicated a meaningful reduction
in sensitivity scores in the 7.5% group that was significant
compared to reductions observed in the placebo control
group at all time points.
Groups 1 and 2 showed significant hypersensitivity
reduction over baseline at all time points. Group 3
showed significant hypersensitivity reduction at 1 week
onward. Group 1 showed significant improvement
compared with groups 2 and 3, except for response to
tactile stimulus at 4 weeks with group 2. Between groups
2 and 3, there were significant differences at 2 and 4
weeks.
All three groups showed reduction in sensitivity scores at
2 weeks and 6 weeks for air stimulus and cold water. The
calcium sodium phosphosilicate group, however, was
found to be significantly better in reducing the visual
analogue scale score compared to the potassium nitrate
group and the placebo group at any time point for both
measures of sensitivity.
Dentifrices were prescribed for all patients and sensitivity

scores were re-evaluated at 2, 4 and 8 weeks. Though
both groups showed significant reductions in sensitivity
scores, only at 8 weeks was there a marginally significant
difference (p = 0.0551) in sensitivity scores between the
test group and the positive control group.
All groups showed a reduction in sensitivity scores at
2 weeks and 6 weeks. The calcium sodium phosphosilicate
group was found to be significantly better compared to
the other groups at the end of 6 weeks.
5% NovaMin containing dentifrice significantly reduced
DH within 6 th and 8 th week of usage when compared
to a placebo dentifrice.
Results

S285
randomized study
Single-centre,
participant-blind,
split-mouth,
randomized study
2012
2012
2010
Craig et al.
(2012)
Camilotti
et al. (2012)
Erdemir et al.
(2010)
Single-centre,
double-blind,
split-mouth,
randomized study
Split-mouth,
randomized study
Single-centre,
examiner-blind,
parallel-group,
randomized study
Double-blind,
parallel group,
randomized study
Study design
2012
2013
2008
Year
Vora et al.
(2012)
Sharma et al.
(2013)
Oxalates**
Du Min et al.
(2008)
References
11 (131
teeth)
42 (252
teeth)
19
50 (150
teeth)
56
71
Sample
size
BisBlock (oxalic acid)
3% potassium oxalate
(Oxa-gel = group
G7)
38% diamine silver

fluoride, saturated
solution of
potassium iodide
Oxalate rinse
1.4% potassium
oxalate rinse +
fluoride toothpaste
(Colgate Cavity
Protection)
Toothpaste with
calcium sodium
phosphosilicate
Test product
Water + thickener
Water
Fluoride toothpaste
(Colgate Cavity
Protection)
Fluoride
toothpaste (Crest
Cavity protection)
Placebo toothpaste
Negative control/
Placebo
Duraphat
Fluorniz
Duofluorid XII
Flutop
Fluorphat
All contain NaF
at varying
concentrations
Pain-Free (2%
oxalic acid
solution and
emulsion)
Seal & Protect
(resin based
material)
Oxalic acid-based
preparation
containing
potassium
Glutaraldehyde/
HEMA rinse
Toothpaste
containing
strontium
chloride
Positive control/
Comparator
Product
Professionally
applied
Professionally
applied
Professionally
applied
Professionally
applied
Self-administered
toothpaste and
mouthrinse
Self-administered
toothpaste
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 1, 2, 3,
4 weeks
Immediate (week
1), 2, 3 weeks (at
time of
application)
30 days
1 week
Immediate, day1,
1 week, 1, 3,
6 months
Immediate, and
daily for 5 days
2, 6 weeks
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Thermal
Tactile, airblast
Tactile, airblast
Airblast, thermal
Method of
Assessment
The results of the statistical analysis showed that all VAS

scores at the post-treatment evaluation periods were
reduced significantly compared with those at baseline
(p < 0.05). More teeth were sensitive to air stimuli than to
tactile stimuli. The mean VAS scores for DH in the
mandibular teeth were significantly higher than for those
in maxillary teeth immediate after treatment (for tactile
stimuli) and 2 weeks after the first application (for air
stimuli) (p < 0.05)
All sensitivity assessments were similar at baseline in the 56

randomized subjects. By the third day, the Yeaple probe
sensitivity scores for subjects treated with Colgate
toothpaste plus LADS improved significantly compared to
Crest toothpaste alone (p < 0.05). By the fifth day, the
mean scores for subjects treated with Colgate toothpaste
plus LADS were significantly improved compared with
subjects treated with either toothpaste alone (p < 0.05).
The other sensitivity assessments showed that Colgate
toothpaste plus LADS achieved statistically significant
improvements compared with Colgate and/or Crest
toothpaste alone from the third day.
All subjects completed the trial. Both the two desensitizing
agents and placebo showed significant reduction in
sensitivity at baseline and throughout the 6-month
evaluation. The effects of the three treatments were
significantly different. Pain reduction with GLU was
consistently highest, followed by PLA that was
significantly greater than BIS. VAS scores for the
evaporative stimulus were moderately, but significantly
lower than for tactile stimulation.
The mean difference between VAS at baseline and 7 days
for teeth treated with diamine silver fluoride/potassium
iodide was greater than that for teeth treated with the
oxalic acid-based preparation (p = 0.0134). The subjects
subjective assessment of changes in dentine
hypersensitivity indicated that more obtained relief with
the diamine silver fluoride/potassium iodide treatment
(p = 0.0129).
After the second week, statistically significant differences
were observed for all materials compared with the
baseline. After 30 days, Group G7 had presented a
significant gradual reduction along all the evaluated time
intervals.
The placebo and the NovaMin groups showed a

statistically significant decrease in sensitivity by both
measures after 6 weeks (p < 0.05). The SrCl2 group
showed a statistically significant decrease from baseline at
the 2-week time point, but not at the 6-week time point
for the evaporative stimulus. The percent reduction in
sensitivity at 6 weeks for the NovaMin test group was
35% for air and 39% for cold water stimulus, versus 11%
for air and 22% for cold water for the SrCl2 paste. The
reductions for the placebo paste were 21% for the air
stimulus and 18% for water. A cross-tabulation measure
of the reduction in sensitivity at each time point for all
three treatments showed that the NovaMin product was
more effective than either of the other products. For the
air stimulus in the NovaMin group, 58% of subjects
improved at each time point compared with 26% for the
SrCl2 group and 20% for the placebo group.
Results
S286
West et al.
Single-blind,
parallel group,
randomized study
randomized study
2006
2004
Merika et al.
(2006)
Gillam et al.
(2004)
randomized study
Single-centre,
single-blind, splitmouth,
randomized study
2014
2014
Ding et al.
(2014)
Mehta et al.
(2014)
Resin-Based Materials
Double-blind,
parallel group,
randomized study
2007
Pamir et al.
(2007)
Double-blind,
parallel group,
randomized
study.
Study design
2009
Year
Vieira et al.
(2009)
References
49
31 (119
teeth)
13
48
60
24 (131
teeth)
Sample
size
MS Coat One F
(MSC)
Nanoseal (NAN)
Teethmate
Desensitizer (TMD)
Gluma Dentin
Desensitizer
(Gluma)
Ferric oxalate
Oxalate preparation
(SuperSeal)
BisBlock (oxalic acid)
3% potassium oxalate
gel
Test product
Warm water
Placebo
Water
Placebo gel
Negative control/
Placebo
Gluma Desensitizer
PowerGel (GLU)
Clinpro XT
Varnish (VXT)
paste-liquid
Fluoride varnish
(Duraphat)
Seal&Protect (resin
based)
Vivasens
(precipitates
calcium ions and
proteins in dentin
fluid)
GaAlAs laser
Positive control/
Comparator
Product
Professional
prophylaxis
Professional
prophylaxis
Professionally
applied
Professionally
applied
Professionally
applied
Professionally
applied
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 1 week,
1, 3, 6 months
Immediate, 1,
4 weeks
Immediate, 4 weeks
4 weeks
4 weeks
4 weeks, 3 months
Assessment
Timepoints
Tactile, airblast
Tactile, airblast
Tactile, airblast,
thermal
Tactile, airblast,
thermal
Airblast, thermal
Tactile, airblast
Method of
Assessment
For both stimuli, mean TSS was significantly decreased in

the VXT and Gluma groups at all time points (all,
p < 0.001) compared with baseline. Regarding
comparisons of TSS between treatment groups, the VXT
group had significantly lower mean TSS compared with
the Gluma group (p < 0.05) and placebo control group
(p < 0.05) at all time points after treatment regardless of
stimuli. Group Effect, Time Effect and Group x Time
Effect were all significantly different (all, p < 0.001).
Forty-nine subjects completed the trial. Pre-operative dentin
hypersensitivity (DH) for the groups was not significantly
different. All desensitizers reduced DH significantly
throughout the 6-months observation. ANOVA revealed
significant differences among VAS scores, obtained with
the desensitizing agents (p < 0.001). Ranking by post hoc
testing was as follows: MSC > NAN > TMD > GLU
(p < 0.05). Upon PS NAN and TMD showed slight but
significant regain of sensitivity after 6 months. For GLU
PS scores immediately after application and after
6 months were not significantly different, whereas recalls
after 1 week, 1 month and 3 months revealed significantly
lower scores.
In both the active and control groups, there were

statistically significant reductions in dentinal
hypersensitivity immediate after and 3 months after the
treatments, when compared with the hypersensitivity at
baseline. No significant differences among the three
groups could be detected in their efficacy at either the
immediate or 3 month evaluations irrespective of the
stimulus.
The VAS scores of the treatment and placebo groups were
not different from each other at baseline (p > 0.05), and
thermal stimuli caused higher patient discomfort than
evaporative stimuli (p < 0.05). Alleviation effects of the
desensitizing agents were not significantly different from
each other; however, the placebo was an exception
(p < 0.05). The differences between the VAS scores at
baseline and after 4 weeks were significant for all three
desensitizing agents (p < 0.05). However, in the placebo
group, the evaporative stimuli led to insignificant pain
variations (p > 0.05).
Both treatments resulted in statistically significant
reductions in VAS scores for all stimuli (p < 0.05).
However, analysis of covariance failed to identify
statistically significant differences in the magnitude of
reductions in sensitivity achieved by each of the products
(p > 0.05). The treatments had similar efficacy and both
can be considered effective therapies for treating dentine
sensitivity.
No statistically significant differences were noted between
ferric oxalate and placebo preparations at +5 min and
4 weeks for any of the test stimuli. There was, however, a
clear trend towards immediate reduction (+5 min) in DH
reverting back to baseline values at 4 weeks with the
exception of the Biomat Thermal Probe mean values,
which maintained the reductions in DH compared with
placebo. The results of this study demonstrated that a 1min application of ferric oxalate is both rapid and
effective in reducing DH although its long-term
effectiveness still needs to be determined.
Results

S287
2007
2007
Pamir et al.
(2007)
Polderman &
Frencken
(2007)
2011
Sethna et al.
(2011)
2010
2012
Ehlers et al.
(2012)
Erdemir et al.
(2010)
2013
Year
Veitz-Keenan
et al. (2013)
References
Single-centre,
split-mouth,
randomized study
Double-blind,
parallel group,
randomized study
Single-centre,
double-blind,
split-mouth,
randomized study
Subject-blind, splitmouth,
randomized study
Split-mouth,
randomized study
Multi-centre,
parallel group,
stratified,
randomized study
Study design
14 (28
teeth,
3
month)
12
(24
teeth,
19.2
month)
9 (18
teeth,
25.2
month)
60
11 (131
teeth)
250
22 (150
teeth)
293
Sample
size
Gluma Desensitizer
Seal&Protect (resin
based)
Seal & Protect (resin

based)
Gluma varnish
containing
glutaraldehyde
Glutaraldehyde-based
desensitizing system
(Gluma)
Resin restoration
Test product
Water
Negative control/
Placebo
Low-viscosity
glass ionomer
(Fuji VII)
BisBlock (oxalic
acid)
Vivasens
(precipitates
calcium ions and
proteins in dentin
fluid)
Pain-Free (2%
oxalic acid
solution and
emulsion)
BisBlock (oxalic
acid)
Cervitec varnish
containing
chlorhexidine
Er:YAG laser
Potassium nitrate
dentifrice
Sealant
Positive control/
Comparator
Product
Professionally
applied
Professionally
applied
Professionally
applied
Professional
prophylaxis
Professional
prophylaxis
Self-administered
toothpaste,
professionally
applied
restoration/
sealant
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate,
1, 3, 19.2,
25.2 months
4 weeks
Immediate, 1,2, 3,
4 weeks
Immediate, 4,
12 weeks
Immediate, 1 week,
1, 3, 6 months
1, 3, 6 months
Assessment
Timepoints
Airblast
Airblast, thermal
Tactile, airblast
Tactile, airblast,
thermal
Airblast
Airblast
Method of
Assessment
Lesion depth and pre-treatment sensitivity (mean, 5.3 on a

0- to 10-point scale) were balanced across treatments, as
was sleep bruxism (present in 42.2% of participants). The
6-month participant recall rate was 99%. Treatments
significantly reduced mean sensitivity (p < 0.01), with the
sealant and restoration groups displaying a significantly
higher reduction (p < 0.01) than did the dentifrice group.
The dentifrice groups mean (standard deviation)
sensitivity at 6 months was 2.1 (2.1); those of the sealant
and restoration groups were 1.0 (1.6) and 0.8 (1.4)
respectively. Patient-reported sensitivity (to cold being
most pronounced) paralleled clinical measurements at
each evaluation.
Both techniques showed an effective reduction in cervical
dentin hypersensitivity. The subjects experienced equal
improvements compared to their status before and
6 months after treatment with both methods (p < 0.001).
Statistical analysis indicated that both the desensitizing
varnishes were effective in alleviating dentine
hypersensitivity at all time intervals compared to baseline.
There was a highly statistically significantly greater
reduction in dentine hypersensitivity to evaporative
stimulus, cold stimulus and tactile stimulus after
application of Cervitec than after Gluma Desensitizer
(p < 0.001). Both the varnishes have a therapeutic
potential to alleviate dentine hypersensitivity at all time
intervals compared to baseline. However, Cervitec varnish
is more efficacious in reducing dentine hypersensitivity
than Gluma varnish at both 4 weeks and 12 weeks post
treatment.
The results of the statistical analysis showed that all VAS
scores at the post-treatment evaluation periods were
reduced significantly compared with those at baseline
(p < 0.05). More teeth were sensitive to air stimuli than to
tactile stimuli. The mean VAS scores for DH in the
mandibular teeth were significantly higher than for those
in maxillary teeth immediate after treatment (for tactile
stimuli) and 2 weeks after the first application (for air
stimuli) (p < 0.05)
The VAS scores of the treatment and placebo groups were
not different from each other at baseline (p > 0.05), and
thermal stimuli caused higher patient discomfort than
evaporative stimuli (p < 0.05). Alleviation effects of the
desensitizing agents were not significantly different from
each other; however, the placebo was an exception
(p < 0.05). The differences between the VAS scores at
baseline and after 4 weeks were significant for all three
desensitizing agents (p < 0.05). However, in the placebo
group, the evaporative stimuli led to insignificant pain
variations (p > 0.05).
Evaluations in the Gluma group were discontinued after
3 months. The mean DIS score for hypersensitive teeth in
the glass ionomer group was statistically significantly
lower than that in the Gluma group, immediately after
application (p = 0.0005), after 1 month (p = 0.02) and
after 3 months (p = 0.003). After 3 months, 11/14 of the
hypersensitive teeth in the glass ionomer group and 2/14
in the Gluma group were free of sensitivity. The mean
DIS score for hypersensitive teeth in the glass ionomer
group remained low after 19.2 months (0.25: SE = 0.13)
and 25.2 months (0.22: SE = 0.15). The null-hypothesis
was rejected. The low-viscosity glass ionomer (Fuji VII) is
more effective in treating hypersensitive teeth than Gluma
Desensitizer after 3 months. The positive treatment effect
of the glass ionomer continued until 25.2 months.
Results
S288
West et al.
Multi-centre,
parallel group,
stratified,
randomized study
2011
2011
Castillo et al.
(2011)
Sethna et al.
(2011)
Subject-blind, splitmouth,
randomized study
Single-centre,
double-blind,
parallel group,
randomized study
2012
Drebenstedt
et al. 2012,
randomized study
Single-blind, splitmouth,
randomized study
Study design
2014
2004
Year
Ding et al.
(2014)
Varnishes
Duran &
Sengun
(2004)
References
250
126
112
31 (119
teeth)
52 (277
teeth)
Sample
size
Gluma varnish
containing
glutaraldehyde
Diammine silver
fluoride varnish
Cervitec Plus (C+),

CHX varnish
containing thymol
CHX diacetate
hydrate and
ethanol/water as
solvent)
Clinpro XT Varnish
(VXT) paste-liquid
Single Bond
Health-Dent
Desensitizer
Gluma Desensitizer
SE Bond & Protect
LinerF.
Fluoline
Test product
Sterile water
Placebo containing
water and ethanol
only
Warm water
Negative control/
Placebo
Cervitec varnish
containing
chlorhexidine
Cervitec (C);
original CHX
varnish
containing thymol
CHX diacetate
hydrate, and ethyl
acetate as solvent)
Gluma Dentin
Desensitizer
(Gluma)
Positive control/
Comparator
Product
Professional
prophylaxis
Professional
prophylaxis
Professional
prophylaxis
Professional
prophylaxis
Professional
prophylaxis
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 4,
12 weeks
24 hours, 7 days
Day 1, 7, 30, 90
Immediate, 1,
4 weeks
Immediate,
10 days,
3 months
Assessment
Timepoints
Tactile, airblast,
thermal
Airblast
Airblast
Tactile, airblast
Airblast
Method of
Assessment
For both stimuli, mean TSS was significantly decreased in

the VXT and Gluma groups at all time points (all,
p < 0.001) compared with baseline. Regarding
comparisons of TSS between treatment groups, the VXT
group had significantly lower mean TSS compared with
the Gluma group (p < 0.05) and placebo control group
(p < 0.05) at all time points after treatment regardless of
stimuli. Group Effect, Time Effect and Group x Time
Effect were all significantly different (all, p < 0.001).
Thirty days after application of C and C+, all
hypersensitivity decreased significantly in relation to
baseline measurements (p < 0.001), with no changes
taking place in the placebo group. Significant differences
were observed between C and C+ vs placebo (p < 0.001),
whereas no significant difference between C and C+ was
seen after 30 days (p = 0.840). After 90 days, the
reduction in hypersensitivity with C+ was still significant
compared with baseline measurements (p = 0.001).
However, C was not significantly different compared with
baseline measurements (p = 0.05). Analysis of all
hypersensitive posterior teeth examined showed no
significant difference between C and C+ after 90 days
(p = 0.362). For anterior teeth, the difference between C
and C+ was significant (p = 0.012). Both C and C+ reduce
cervical tooth hypersensitivity, whereas C+ reduces
hypersensitivity for a longer period of time.
The diammine silver fluoride reduced pain at 7 days at both
sites. At the Lima site, the average change in pain scores
between baseline and day 7 for the silver fluoride group
was 35.8 (SD = 27.7) mm vs. 0.4 (SD = 16.2) mm for
the control group (p < 0.001). In Cusco, the average
change in pain scores for the silver fluoride group was 23.4 (SD = 21.0) mm and -5.5 (18.1) mm for the control
group (p = 0.002). No tissue ulceration, white changes, or
argyria was observed. A small number of participants in
the silver fluoride group experienced a mild but transient
increase in erythema in the gingiva near the tooth. No
changes were observed in the Gingival Index.
Statistical analysis indicated that both the desensitizing
varnishes were effective in alleviating dentine
hypersensitivity at all time intervals compared to baseline.
There was a highly statistically significantly greater
reduction in dentine hypersensitivity to evaporative
stimulus, cold stimulus, and tactile stimulus after
application of Cervitec than after Gluma Desensitizer
(p < 0.001). Both the varnishes have a therapeutic
potential to alleviate dentine hypersensitivity at all time
intervals compared to baseline. However, Cervitec varnish
is more efficacious in reducing dentine hypersensitivity
than Gluma varnish at both 4 weeks and 12 weeks post
treatment.
Statistical analysis showed that all of the VAS scores at

post-treatment evaluation points were significantly
decreased compared with baseline data (p < 0.05). There
was a significant reduction in mean sensitivity scores in
the Protect Liner F and the Health-Dent Desensitizer
groups when compared with Fluoline varnish at the 10day time point (p < 0.05). At 3 months, the Protect Liner
F group continued to show a significantly reduced
sensitivity level when compared with Health-Dent
Desensitizer, Single Bond, Fluoline and Gluma
Desensitizer (p < 0.05).
Results

S289
2003
1997
Corona et al.
(2003)
Kielbassa
et al. (1997)
Single-centre, splitmouth,
randomized study
2013
2014
2012
Femiano et al.
(2013)
Talesara et al.
(2014)
Ehlers et al.
(2012)
Split-mouth,
randomized study
Split-mouth,
randomized study
2014
Multi-centre,
double-blind,
parallel group,
randomized study
randomized
study.
Split-mouth study
Parallel group,
randomized study
Study design
Ko et al.
(2014)
Lasers
2011
Year
Yilmaz et al.
(2011)
References
22 (150
teeth)
20 (80
teeth)
24 (262
teeth)
86
25 (50
teeth,
at 3
weeks)
21 (42
teeth,
at 12
mon
ths)
12 (60
teeth)
48 (244
teeth)
Sample
size
Er:YAG laser
Nd:YAG laser
Glutaraldehydebased
desensitizing
system
Potassium
binoxalate gel
2% sodium fluoride
solution
HEMA-G
solution
Diode laser + 2%
sodium fluoride
solution
Diode laser only
Sodium fluoride
lacquer (6%)
GaAlAs laser
GaAlAs laser
Positive control/
Comparator
Product
LED toothbrush
(wavelength
635 nm, output
12.9 lW) +
fluoride
toothpaste
(Baseline
assessment)
Placebo NaF
varnish (saline)
Placebo laser
Negative control/
Placebo
Laser-emitting
toothbrush
(wavelength 635 nm,
output 6 mW) +
fluoride toothpaste
Bifluorid 12
containing 6%
calcium fluoride, 6%
sodium fluoride
Sodium fluoride
varnish (Duraphat)
NaF varnish
Test product
Professional
application
Professional
application
Professional
application
Self-administered
toothbrushing
with paste
Professional
prophylaxis
Professional
prophylaxis
Professional
prophylaxis
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Immediate, 1 week,
1, 3, 6 months
Immediate, 3, 6,
9 months
Immediate, 1,
6 months
2, 4 weeks
1, 2, 3, 4 weeks,
6, 12 months
Immediate, 15,
30 days
Immediate, 1 week,
1, 3, 6 months
Assessment
Timepoints
Airblast
Airblast, thermal
Airblast
Airblast
Airblast
Airblast
Airblast
Method of
Assessment
Results demonstrated that the use of both control and test

toothbrushes resulted in decreased discomfort after
4 weeks. In the test group, pain intensity scores decreased
from 5.8 1.2 to 2.3 1.6, and in the control group, the
scores decreased from 6.4 1.3 to 5.5 2.0 (p < 0.05).
This decrease was significantly greater in the test group.
There were no significant adverse events or side effects.
The outcomes showed a significant reduction in discomfort
compared to baseline values for teeth of SG-3
immediately post treatment (82.6%) (p < 0.001), after
1 month (69.5%) (p < 0.001) and after 6 months (60.8%)
(p < 0.001), respectively, compared with the reduction
scores of 51.6% (p < 0.001), 29.7% (p < 0.05) and 4.7%
(p > 0.05), recorded for SG-1; 72.2% (p < 0.001), 62.5%
(p < 0.001) and 47.2% (p < 0.05), recorded for SG-2;
77.4% (p < 0.001), 56.1% (p < 0.001) and 27.3%
(p < 0.05), recorded for SG-4.
Both treatment modalities were effective in reducing dentine
hypersensitivity. However, Nd:YAG laser was better when
intra-group comparison was made at 9 months post
treatment. Nd:YAG lasers is better in long-term treatment
(up to 9 months) owing to the melting of dentinal tubules.
However, due to depth of penetration of microcrystals,
gel was better when ease of the procedure is considered.
Nevertheless, both treatment modalities resulted in
recurrence.
Both techniques showed an effective reduction in cervical
dentin hypersensitivity. The subjects experienced equal
improvements compared to their status before and
6 months after treatment with both methods (p < 0.001).
GaAlAs laser and NaF varnish treatments resulted in a

significant reduction in the VAS scores immediately after
treatments that were maintained throughout the study
when compared to the baseline and placebo treatments. In
the NaF group, there was a significant increase in the
VAS scores at 3 and 6 months compared to at 1 week
and 1 month. The placebo treatments showed no
significant changes in VAS scores throughout the study
period. Within the limits of the study, GaAlAs laser
irradiation was effective in the treatment of DH, and it is
a more comfortable and faster procedure than traditional
DH treatment.
Considering the treatments separately, there was no
significant difference for the fluoride varnish at the three
examination periods, and for laser therapy, significant
difference (p < 0.05) was found solely between the values
obtained before the treatment and 30 days after the first
application. It may be concluded that both treatments
may be effective in decreasing cervical dentinal
hypersensitivity. Moreover, the low-level GaAlAs laser
showed improved results for treating teeth with higher
degree of sensitivity.
Results demonstrated a distinct reduction in hypersensitivity
after 1, 2 and 3 weeks in the Bifluorid 12 group. Initially,
no obvious effects could be observed in the control group.
However, a clear alleviation could be observed after 2 and
3 weeks with the control. After 4 weeks, the overall
sensitivity scores were comparably low, without any
significant differences between the two fluoride lacquers.
In both groups, the effects of treatment were seen over
the 12-month observation period. Bifluorid 12 was
considered at least comparable to the control.
Results
S290
West et al.
randomized study
randomized study
Double-blind,
parallel group,
randomized study
2008
2002
1994
Tengrungsun
& Sangkla
(2008)
Schwarz et al.
(2002)
Gerschman
et al. (1994)
71
30 (104
pairs of
teeth)
70
62 (434
teeth)
Sample
size
GaAlAs laser
Er:YAG laser
GaAlAs laser
GaAIAs infrared
diode laser
Test product
Unpowered placebo
laser
Untreated teeth
Negative control/
Placebo
Dentin Protector
system
Dentin bonding
agent
Cyanoacrylate glue
Positive control/
Comparator
Product
Arginine Calcium carbonate is either the test or positive comparator control product.
Sponsored by industry or donation from industry.
Potassium is either the test or positive comparator control product.
Strontium is either the test or positive comparator control product.

Stannous is either the test or positive comparator control product.
**
Oxalate is either the test or positive comparator control product.
Varnish is either the test or positive comparator control product.
Single-centre,
double-blind,
split-mouth,
randomized study
Study design
2013
Year
Flecha et al.
(2013)
References
Professional
application
Professional
application
Professional
application
Professional
application
Self-administered
(toothpaste,
mouthrinse, gel) or
Professionally
Applied
Airblast
Tactile, Airblast
(described as
thermal)
1, 2, 8 weeks
following reapplication of
laser.
Airblast
Airblast, thermal
Method of
Assessment
Immediate, 1 week,
2, 6 months
Immediate, 15,
30 days
24 hours, 30, 90,

180 days
Assessment
Timepoints
Both groups had significant reductions in DH. However,

there was no significant difference between the two groups
6 months. Intra-group analysis showed that the effect of
cyanoacrylate obtained at 24 hours remained for 90 days
in response to air-jet test and 30 days for cold-spray test.
There was a statistically significant difference between all
other intra-group comparisons at the time intervals
(p < 0.001).
The reduction in dentin hypersensitivity was observed in
both treatments using the GaAlAs laser and dentin
bonding agent. However, a greater reduction was
observed over time up to day 15 and no significant
change was observed between days 15 and 30. Statistically
significant differences in the level of dentin
hypersensitivity between bonding agent and the GaAlAs
laser were found at each observation period (p < 0.05).
Both treatment forms resulted in significant improvements
of discomfort immediately after and 1 week post
treatment. After 2 months, the discomfort in the Dentin
Protector (R) group increased up to 65% of the baseline
score and even up to 90% after 6 months, whereas the
effect of the laser remained at the same level that was
achieved immediately after treatment. The differences
immediately after, 1 week, 2 and 6 months post treatment
between both groups were statistically high significant
(p 0.001 respectively). Compared to the untreated
control group, both treatment forms resulted in a
significant reduction in discomfort at each follow-up
examination.
In both the tactile and thermal sensitivity groups differences
between the active and placebo groups were significant
from the first week and increased further in the second
and eighth weeks. The mean value of thermal sensitivity
decreased 67% (p < 0.001) compared with placebo (17%)
and tactile sensitivity decreased 65% (p = 0.002)
compared with placebo (21%) at 8 weeks. Results
demonstrate that the GaAlAs laser is an effective method
for the treatment of both thermal and tactile dentinal
hypersensitivity. There were no reported adverse reactions
or instances of oral irritation.
Results

S291
S292
West et al.
ve control. Potassium was found

equivocal to strontium acetate for
dentine hypersensitivity reduction
(West et al. 1997) and strontium
chloride (Silverman et al. 1996), both
studies having negative controls.
With regards to the comparison
of potassium to the negative control,
in some studies potassium reduced
pain to a similar degree to the negative control (Wara-aswapati et al.
2005, West et al. 1997, Ayad et al.
2009a, Pradeep & Sharma 2010,
Pradeep et al. 2012) while the other
studies showed potassium was superior (Chesters et al. 1992, Silverman
et al. 1996, Sowinski et al. 2013).
In the four studies assessing
potassium citrate (Chesters et al.
1992, Yates et al. 1998b, Docimo
et al. 2007, Prasad et al. 2010), this
salt was shown to be equal in efficacy to potassium chloride (Docimo
et al. 2007), superior to potassium
nitrate (Chesters et al. 1992) and a
negative control (Chesters et al.
1992), and equivocal to a negative
control (Yates et al. 1998b). There
were equivocal data for comparison
to triclosan (Prasad et al. 2010). The
studies by Docimo et al. (2007) and
Prasad et al. (2010) having no negative controls and the other two studies having positive and negative
controls. There was only one study
for binoxalate (Talesara et al. 2014)
and one for iodide (Craig et al.
2012), which showed laser treatment
was superior to potassium professional treatment and professionally
applied potassium iodide was superior to a professionally applied oxalate preparation, respectively, but no
negative controls were used.
Casein derivatives (amorphous calcium
phosphate (ACP) and casein
phosphopeptide CPP)

of 32 papers, of which only three
fulfilled the relevant criteria. Of these
three studies one tested ACP-CPP
(Torwane et al. 2013) and the other
two ACP (Yates et al. 1998a, Geiger
et al. 2003). All products were professionally applied. Two studies were
split mouth and the other parallel
(Geiger et al. 2003). The ACP-CPP
(Recaldent) was applied per the
manufacturers instructions, and the
ACP products as solutions. All three
studies evaluated pain with airblast
and tactile stimuli and were of low

(Yates et al. 1998a), moderate
(Torwane et al. 2013) or high (Geiger et al. 2003) risk of bias. One
study used potassium as a direct
comparator (Geiger et al. 2003), a
second study used ethanolic extract
of Indian propolis as a direct comparator (Torwane et al. 2013) and
water as a negative control and a
third study simply used a negative
control of water (Yates et al. 1998a).
All products were examined for their
effect on the reduction in dentine
hypersensitivity pain, the outcome
measure, immediately and long term.
In the study by Torwane et al.
(2013) ACP-CPP was found to result
in similar pain reduction as the positive control and was more efficacious
than the negative control, water.
Yates et al. (1998a) showed that
treatment with ACP was no better
than treatment with water in reducing pain, and Geiger et al. 2003
showed that it resulted in similar
pain scores as the potassium control.
Strontium

the relevant criteria. The majority of
strontium chloride papers (8) were
pre and up to 2008 (Collins & Perkins 1984, Minkoff & Axelrod 1987,
Gillam et al. 1992a,b, Pearce et al.
1994, Silverman et al. 1996, Du Min
et al. 2008, Kobler et al. 2008), bar
one (Liu & Hu 2012); and the
majority of strontium acetate studies
(7) 2008 onwards (Hughes et al.
2010, Mason et al. 2010, Docimo
et al. 2011, Li et al. 2011, Schiff
et al. 2011, Orsini et al. 2013, West
et al. 2013a), bar 3 (Pearce et al.
1994, Gillam et al. 1996, West et al.
1997). All papers focused on the
medium of toothpaste with no professionally applied products evaluated. All articles had a moderate risk
of bias as determined by the assessment criteria.
The consideration of the effectiveness of strontium in the reduction in
pain of dentine hypersensitivity, the
outcome variable, has been divided
into studies investigating strontium
chloride and those investigating
strontium acetate. Of the eight studies on strontium chloride dated 2008
and earlier, although all studies
demonstrated an improvement in
patients perceptions of the pain of

their dentine hypersensitivity, there
was not a consistent significant
improvement in pain reduction
compared to the negative controls or
comparator agents. The more recent
study, Liu & Hu (2012), did observe
a significant reduction in dentine
hypersensitivity compared to a fluoride control, but the test product
had two actives, potassium as well
as strontium, making comparisons
difficult.
Of the seven strontium acetate
RCTs (20102013), all were parallel
in design and used airblast and tactile stimuli. Of these studies, six
compared strontium acetate directly
to arginine (Hughes et al. 2010, Docimo et al. 2011, Li et al. 2011, Schiff
et al. 2011, Orsini et al. 2013, West
et al. 2013a), two with an additional
fluoride negative control (Docimo
et al. 2011, Li et al. 2011). Further
studies investigated strontium acetate
versus a negative control only
(Mason et al. 2010), strontium acetate versus a negative control and a
positive control, potassium (West
et al. 1997) and strontium acetate
versus a negative control and a comparator, strontium chloride (Pearce
et al. 1994).
Strontium acetate was shown to
be more effective at reducing pain
than a negative control in two recent
studies (Mason et al. 2010, Docimo
et al. 2011) and comparable in
another study (Li et al. 2011). Comparing strontium acetate to arginine,
in three studies the pain reduction
achieved by the two agents was similar (Hughes et al. 2010, Orsini et al.
2013, West et al. 2013a), and three
showed that arginine was significantly more effective at pain reduction (Docimo et al. 2011, Li et al.
2011, Schiff et al. 2011). These six
studies were fairly equally divided
over immediate and long-term
assessment. Strontium was shown to
reduce pain to a similar degree as
potassium in one study (West et al.
1997).
Stannous fluoride

the relevant criteria. The RCTs used
stannous in the form of stannous
fluoride toothpaste, three of the
studies with hexametaphosphate

(Schiff et al. 2005, 2006, Chaknis
et al. 2011), and six studies 2000
2001 investigated a combination of
stannous fluoride and potassium salts
(Conforti et al. 2000, Schiff et al.
2000a,b, Sowinski et al. 2000a,b,
2001). One study, Sharma et al. 2010
used a self-administered stannous gel.
No studies included professionally
applied stannous salts. All studies
included parallel groups and assessed
pain evaluation to cold air, with only
three not using tactile as a second
stimulus (Day et al. 2010, He et al.
2011a,c). All studies were assessed as
having a moderate risk of bias.
Eleven studies incorporated a
direct benchmark or negative control
fluoride toothpaste (Conforti et al.
2000, Sowinski et al. 2000a, 2001,
Schiff et al. 2000b, 2005, 2006, Day
et al. 2010, Chaknis et al. 2011, He
et al. 2011b, Parkinson et al. 2013,
He et al. 2014). Potassium was often
used as a positive control comparator
product to stannous fluoride (seven
studies) (Schiff et al. 2000a,b, Sowinski et al. 2000a,b, 2001, Ni et al.
2010, Sharma et al. 2010), however,
as discussed elsewhere in this review,
potassium has poor effectiveness.
One study compared stannous gel
(Sharma et al. 2010) to a positive
control, potassium/calcium sodium
phophosilicate (CPSP). Three studies
included a potassium control and a
negative control to evaluate a stannous/potassium formulation (Sowinski et al. 2000a, Schiff et al. 2000b,
Sowinski et al. 2001). One study
compared to a comparator, triclosn
PVM/MA and a negative fluoride
control
(Chaknis et al. 2011).
Another two studies incorporated a
positive control, arginine (He et al.
2011a,c). Fifteen studies evaluated
efficacy after 2 weeks or more, categorized as long-term effects.
The effectiveness for stannous in
the reduction in pain of dentine
hypersensitivity, the outcome variable, was assessed. Comparing stannous agents to negative controls,
seven studies showed superiority for
stannous fluoride over the negative
control and four studies showed
superiority for the stannous/potassium agent over the negative control.
Comparing stannous fluoride to
arginine yielded two studies (He
et al. 2011a,c), which showed stannous to be significantly superior to
arginine in both the short- and long-
term results. One study for NovaMin which used a stannous gel as the
comparator (Sharma et al. 2010)
generated results which were generally positive towards NovaMin,
and one study which compared
PVM/MA with stannous showed the
former to be superior (Chaknis et al.
2011). In the combined stannous/
potassium paste studies (6), results
always in favour of the stannous
product, being more efficacious than
potassium or negative control,
except (Ni et al. 2010) and this
showed equivocal results.
Generally, the efficacy of the
stannous products in reducing the
pain for dentine hypersensitivity
appears to be measured in the long
term, three studies, which were all
favourable measuring both immediately and long term, and two studies
short term only.
Calcium sodium phosphosilicate (CSPS)

the relevant criteria. The majority of
CSPS papers were regarding toothpaste (10) (Du Min et al. 2008, Litkowski
&
Greenspan
2010,
Narongdej et al. 2010, Pradeep &
Sharma 2010, Salian et al. 2010,
Sharma et al. 2010, Pradeep et al.
2012, Surve et al. 2012, Rajesh et al.
2012, Acharya et al. 2013), and the
other two prophylaxis pastes (Milleman et al. 2012, Neuhaus et al.
2013). All studies were parallel in
design, with 10 studies having the
recommended 2 stimuli (Du Min
et al. 2008, Litkowski & Greenspan
2010, Narongdej et al. 2010, Pradeep
& Sharma 2010, Sharma et al. 2010,
Salian et al. 2010, Milleman et al.
2012, Pradeep et al. 2012, Rajesh
et al. 2012, Neuhaus et al. 2013). Of
the studies evaluating toothpaste, five
studies had a high risk of bias as
determined by the assessment criteria
(Salian et al. 2010, Narongdej et al.
2010, Surve et al. 2012, Rajesh et al.
2012, Acharya et al. 2013), the
remainder having a moderate risk of
bias. When assessing the quality of
the body of evidence for professionally applied CSPS agents one study
had a moderate risk of bias (Neuhaus
et al. 2013) and the other a high risk
of bias (Narongdej et al. 2010).
With regards to the studies evaluating toothpastes, three studies
S293
incorporated a positive and negative

control, (Pradeep & Sharma 2010,
Salian et al. 2010, Pradeep et al.
2012). In total six studies evaluated
CSPS agents against a negative control (Du Min et al. 2008, Litkowski
& Greenspan 2010, Pradeep & Sharma 2010, Salian et al. 2010, Pradeep
et al. 2012, Rajesh et al. 2012). Of
the comparisons to positive controls
CSPS was evaluated against potassium nitrate (7) (Narongdej et al.
2010, Pradeep & Sharma 2010, Salian et al. 2010, Sharma et al. 2010,
Pradeep et al. 2012, Surve et al.
2012, Acharya et al. 2013), strontium chloride (1) (Du Min et al.
2008) and stannous fluoride gel (1)
(Sharma et al. 2010).
Results were consistently in
favour of CSPS being significantly
more effective than a negative control, conventional fluoride control
and the potassium salt. The one
study directly comparing CSPS to
stannous showed the former was
more effective. All study products
were assessed long term.
The two studies which evaluated
CSPS agents as prophylaxis pastes
evaluated the agents versus a comparator and negative control (Milleman
et al. 2012, Neuhaus et al. 2013).
Both studies were shown to be
more efficacious than the negative
control.
Oxalates

of 98 papers, of which nine fulfilled
the relevant criteria. The majority
of oxalate RCTs (8) (Gillam
et al. 2004, Merika et al. 2006,
Pamir et al. 2007, Vieira et al. 2009,
Erdemir et al. 2010, Camilotti et al.
2012, Craig et al. 2012, Vora et al.
2012) involved professionally applied
products. The other study involved a self-administered mouthrinse
(Sharma et al. 2013). Clinical study
designs varied between parallel design
(4) (Merika et al. 2006, Pamir et al.
2007, Vieira et al. 2009, Sharma et al.
2013) and split mouth (5) (Gillam
et al. 2004, Erdemir et al. 2010, Camilotti et al. 2012, Craig et al. 2012,
Vora et al. 2012). The majority of
studies assessed long-term results (7)
(Gillam et al. 2004, Merika et al.
2006, Pamir et al. 2007, Vieira et al.
2009, Erdemir et al. 2010, Camilotti
et al. 2012, Vora et al. 2012) rather
S294
West et al.
than short term (2) (Craig et al. 2012,

Sharma et al. 2013), changes in pain.
Studies all evaluated pain with airblast, and all bar one study with tactile stimulus as well. The study by
Camilotti et al. (2012) had a high risk
of bias, the remainder had a moderate
risk of bias as determined by the
assessment criteria.
In all studies the efficacy for oxalates in the reduction in pain in dentine hypersensitivity, the outcome
variable, was assessed. The agents
used were commercially available
products such as 3% monohydrogenmonopotassium, 30% dipotassium, combination of monohydrogen
monopotassium, 1.4% potassium
oxalate, ferric and oxalate containing
resin. The oxalate salts were directly
compared to resins, e.g. Gluma,
Seal and Protect; diamine silver
fluoride, lasers and placebo agents.
One study, Sharma et al. (2013)
evaluated oxalate mouthrinse with
fluoride toothpaste versus fluoride
toothpaste alone, showing superiority for the test agent. Six studies
evaluated oxalates professionally
applied against a negative control,
water being most frequently used
(Pamir et al. 2007, Camilotti et al.
2012, Vora et al. 2012), results being
equivocal. When comparing oxalates
with resins and sealants, results were
inconsistent,
showing
oxalates
reduced pain less (Camilotti et al.
2012, Vora et al. 2012) in some cases
and to a similar degree in other cases
(Gillam et al. 2004, Merika et al.
2006, Pamir et al. 2007, Erdemir
et al. 2010).
Polderman & Frencken 2007, Sethna

et al. 2011, Ehlers et al. 2012, Ding
et al. 2014, Mehta et al. 2014) fulfilled the relevant criteria. In these
studies all products were professionally applied and all evaluated the
agents over long-term assessments
using an airblast stimuli. Studies had
a moderate risk of bias except for
Ding et al. (2014) where the risk of
bias was high.
The majority of studies compared
resins directly with comparator
products and were shown to consistently reduce dentine hypersensitivity, however, the studies showed
great heterogeneity in study design.
The effectiveness of resins in the
reduction in pain from dentine
hypersensitivity, the outcome variable, demonstrated efficacy in pain
reduction compared to potassium
paste (Veitz-Keenan et al. 2013).
Seal and Protect gave similar
results to other commercially available sealants investigated (Erdemir
et al. 2010). Only two studies evaluated the efficacy of resins against
negative controls (Pamir et al. 2007,
Ding et al. 2014), both showing the
agents tested to be superior in
achieving a reduction in dentine
hypersensitivity pain. The results for
Gluma were equivocal when
compared with lasers (Ehlers et al.
2012), both treatments resulting
in decreased hypersensitivity, but
Gluma was inferior in efficacy as
compared to other bonding agents
(Sethna et al. 2011, Ding et al. 2014,
Mehta et al. 2014) and glass ionomers (Duran & Sengun 2004).
Resin-based materials
Varnishes
Glass ionomer, resin-reinforced glass

ionomer/compomers, adhesive resin
primers and adhesive resin bonding
systems have been used for the
treatment of dentine hypersensitivity
over many years. This group of
materials have been assessed under
the search headings of resins, glass
ionomers, Seal and Protect and
Gluma.
This review included consideration of 684 papers, of which one
from the resins (Veitz-Keenan et al.
2013), zero from the glass ionomers,
two from the Seal and Protect
(Pamir et al. 2007, Erdemir et al.
2010) and six from the Gluma
searches (Duran & Sengun 2004,
Varnishes and topically applied solutions have also been used for the
over many years. This group of dental materials makes up a disparate,
anomalous group and have been
placed together due to lack of numbers of studies on each. The search
has been undertaken on the following headings of varnishes, Bifluorid
and Duraphat.
This review included consideration of 87 papers of which seven
papers, five from the varnishes
(Castillo et al. 2011, Sethna et al.
2011, Yilmaz et al. 2011, Drebenstedt et al. 2012, Ding et al. 2014),
one paper from the Bifluorid
search (Kielbassa et al. 1997) and

one paper from the Duraphat
search (Corona et al. 2003) fulfilled
the review inclusion and exclusion
criteria. The articles were all of moderate risk of bias except for Corona
et al. (2003) and Ding et al. (2014)
which have a high risk of bias as
assessed by the assessment criteria.
The group of varnish agents
included Clinpro XT (1) (Ding
et al. 2014), Cervitec (2) (Sethna
et al. 2011, Drebenstedt et al. 2012),
sodium fluoride (1) (Yilmaz et al.
2011) and diamine silver (1) (Castillo
et al. 2011). Three studies were split
mouth (Castillo et al. 2011, Sethna
et al. 2011, Ding et al. 2014). Four
studies included a negative control,
often water (Castillo et al. 2011,
Drebenstedt et al. 2012, Ding et al.
2014). When compared with either
negative control or baseline sensitivity scores studies showed that varnishes
consistently
caused
a
reduction in the reported pain of
dentine hypersensitivity with the
exception of fluoride varnishes which
were shown to have limited (Yilmaz
et al. 2011) or no efficacy (Corona
et al. 2003). Positive controls where
the efficacy of products could be
compared directly, included a multitude of resins and varnishes and
lasers. Cervitec appeared to be
more effective than Gluma and
placebo (Sethna et al. 2011, Drebenstedt et al. 2012) and similarly Clinpro XT was more effective than
Gluma in one study (Ding et al.
2014), whereas the Bifluoridwas
superior to the fluoride control, in
another study (Kielbassa et al.
1997).
Lasers

of 174 papers, of which eight fulfilled the relevant criteria (Gerschman et al. 1994, Tengrungsun &
Sangkla 2008, Schwarz et al. 2002,
Ehlers et al. 2012, Femiano et al.
2013, Flecha et al. 2013, Ko et al.
2014, Talesara et al. 2014). Two
studies included parallel design studies and six were split-mouth design.
All assessed pain evaluation to cold
air. Two studies were at a high risk
of bias (Tengrungsun & Sangkla
2008, Talesara et al. 2014) with the
remainder at a moderate risk of
bias.

The trials included Nd:Yag laser,
a laser-emitting toothbrush and
GaAIAs laser. All studies utilized
professionally applied products, and
were evaluated over long-term
assessments. Of the eight studies,
seven compared efficacy with comparator products with only Gerschman et al. (1994) using only a
negative control. Laser treatment
consistently decreased the pain of
dentine hypersensitivity, however,
studies demonstrated minimal superiority over comparator agents,
which were of many types.
Discussion
This systematic review has investigated the effectiveness of both selfapplied and professionally administered agents for the alleviation of
pain from dentine hypersensitivity.
Dentine hypersensitivity being a
painful oral condition affecting the
quality of life (Boiko et al. 2010) for
many people (West et al. 2013b).
Evaluation of treatment for the relief
of pain has always been fraught with
difficultly due to the subjective opinion of the patient, pan perception
being dependent on many factors.
Over the years, an abundance of
agents have been advocated for the
alleviation of dentine hypersensitivity, both self-applied and professionally administered, but as yet the gold
standard agent for treatment of this
condition has not been ascertained.
Ideally a treatment for dentine
hypersensitivity should follow Grossmans principles (Grossman 1935), of
being easy to administer, effective,
safe, fast acting and having long-lasting treatment effects. The time period
for evaluation of dentine hypersensitivity varied considerably on reviewing the studies. Traditional studies
examined the long-term effects of
active agents, usually testing efficacy
after 2, 4 and 8 weeks, and some
after periods of up to 6 months to a
year. However, the majority of recent
studies have focused on achieving
immediate reduction in pain, some
trials being of only a couple of days
in duration. The products tested in
these short-term studies being
designed to be used regularly, e.g.
twice daily toothpaste application,
and hence able to maintain pain
reduction over long-term periods. In
this review, studies were classified
into those that assessed efficacy

immediately after product application and up to 1 week; and those that
assessed long-term effects of 2 weeks
and over. This is in accordance with
the researchers aiming to prove
immediate efficacy or efficacy starting
after a couple of weeks, which is the
time needed, e.g. for potassium to
have an effect.
Potassium salts have been used
over many years, being investigated
as active agents and more recently
being used as positive controls, as
can be seen in this review. It also
appears that potassium is often
added to the treatment product in
addition to the active ingredient, an
extra active. The effectiveness of
potassium in the reduction in DH
pain is, however, questionable, and
it can be argued that this agent is far
from ideal as a positive control in
RCTs. If used, study conclusions
need to reflect potassiums lack of
proven effectiveness as a treatment
for dentine hypersensitivity.
A major challenge encountered
when reviewing dentine hypersensitivity studies to evaluate the pain
relief from potential desensitizing
agents, was the large heterogeneity
amongst the trial designs. For product comparison, studies need to be
well structured according to current
guidance and ideally of similar
design, using clinically relevant stimuli, with pain evaluated over similar
time periods. Few guidelines on trial
design exist. Holland et al. set out
guidance in 1997, suggesting e.g. it
was preferable to have two clinically
relevant stimuli to evoke pain such
as an airblast, tactile or thermal
stimulus. This was a factor included
in our assessment criteria for the
quality of the articles reviewed. The
majority of studies used a short, cold
airblast stimulus followed by assessment of pain, and many used a tactile
stimulus as well. Thermal stimulation
was also used and considered a satisfactory second stimulus.
Assessing the studies in this
review, it was difficult to make conclusive statements about relative
treatment effectiveness for a number
of reasons. Many different active
ingredients were evaluated, and further a number of different salts of
the active ingredients were tested.
For example potassium was used in
the form of nitrate, chloride, citrate
S295
and in combination with polymers,

stannous and arginine. These agents
were in a variety of formulations
and delivery mechanisms such as
toothpaste, gel, mouthrinse or professionally applied agents. They also
may contain a number of additional
ingredients which alone or combined, can have an effect on the
management of dentine hypersensitivity. To directly compare the
effects of each active, a number of
studies with the same formulation
are necessary. More weight was
therefore given where effectiveness
was supported by a greater number
of studies which tested the active in
the same formulation and delivered
by the same mechanism.
All the trials assessed were randomized controlled clinical studies.
No in situ studies were included
although they have value in supporting the efficacy of the clinical study,
particularly with respect to the
assessment of tubule occlusion, and
ability of an agent to withstand dissolution and removal from the dentine tubule due to acidic dietary
challenges. The studies included were
all parallel or split-mouth design,
most being of parallel design to
negate the possibility of carry-over
from the effect of the study product.
It is possible to perform split-mouth
studies if the agent can be controlled
in the oral environment, such as a
varnish or laser therapy. Studies
evaluating toothpaste would be difficult to undertake in split-mouth
design, and would have to be
assessed very carefully for bias.
The ideal dentine hypersensitivity
study should have a negative control/placebo/benchmark agent group
and comparator/positive control
agent group, as suggested in the
guidance of Holland et al. (1997).
Interestingly, many of the studies
investigating the efficacy of dentine
hypersensitivity only had one control. In conducting this review, studies therefore were assessed as having
a lower risk of bias if they included
both a negative and positive control.
When reviewing the studies
included in this review, it was apparent that the majority were either
sponsored by industry or received a
donation from industry. Only 24
studies did not fall into these categories out of 105. This could be
perceived as a factor influencing
S296
West et al.
bias, however, in reviewing studies

sponsored by industry, the majority
of recent trials were conducted to
International Conference on Harmonisation Good Clinical Practice
guidelines
(http://www.ich.org/)
many agents being either medicines
or medical devices and the majority
of studies were found to be at moderate risk of bias, satisfying all but
one of our assessment criteria fully.
All studies should be published, irrespective of whether results demonstrate efficacy of the agent tested,
but it was impossible to ascertain if
this was the case. EU ethical regulations now state all studies should be
registered at the time of ethical
approval application, which will give
greater transparency. Industry has
embraced this guidance.
For the reasons explained, a
meta-analysis on the results of this
review was not possible and evidence
has therefore been provided in the
form of descriptive analyses. Recommendations have been suggested for
each agent.
Arginine
The quality of the body of evidence

supporting the conclusion that arginine is more effective at reducing the
pain from dentine hypersensitivity as
compared to a negative control or a
conventional fluoride paste for
immediate and long-term treatment,
was high. Similarly, the quality of
evidence for arginine being more
effective than potassium, was high.
Comparing arginine to strontium,
reviewers concluded that no superiority between these agents could be
confirmed, the evidence being moderate, with further studies required.
Evidence from two studies was high
that arginine was not as effective as
stannous fluoride paste at reducing
the pain of dentine hypersensitivity.
Comparing this systematic review
with two previous systematic reviews
on toothpaste containing arginine
(Sharif et al. 2013, Yan et al. 2013),
one identified 14 studies and the
other only two to fit the inclusion
criteria. The analyses showed the
evidence was moderate that argininecontaining toothpaste was efficacious
when compared with placebo and
potassium salt-containing toothpaste,
and low in comparison to strontiumcontaining toothpaste.
In
this
systematic
review,
although studies supported the effectiveness of arginine as a mouthrinse
to reduce the pain of dentine hypersensitivity, the quality of the evidence was low as its efficacy has not
been investigated directly against a
substantive positive control, and
there are few studies with some
imprecision. Studies also consistently
showed that arginine applied professionally provided relief from the pain
of dentine hypersensitivity, but with
only one study directly comparing
efficacy against a positive control,
the quality of evidence demonstrating that this treatment was better
than other treatments for dentine
hypersensitivity, was low.
Recommendations
The review suggests that when arginine is self administered as a toothpaste, it is an effective treatment
agent for the pain relief of dentine
hypersensitivity. This is supported
by high-quality evidence, and the
authors recommend its use for the
The findings of the review suggest
arginine applied professionally is
effective in the treatment of dentine
hypersensitivity, however, there was
insufficient evidence for the authors
to recommend this agent compared
to other professionally applied
agents.
PVA/MA Polymers
There was limited evidence of effectiveness of PVA/MA mouthrinse formulations per se assessing the studies
included in this review. Many active
agents were combined with other
agents making interpretation difficult.
Overall the quality of evidence that
PVA/MA alone or in combination
with other active ingredients was low
regarding its effectiveness in alleviating of dentine hypersensitivity.
Recommendations
This review is unable to recommend
the use of PVA/MA polymers in the
at the present time, the evidence
being inconclusive.
Potassium
Considering the studies included in

this review, the quality of the evi-
dence that potassium is inferior to

comparator products was high for
arginine, CSPS and stannous for the
long-term treatment of dentine
hypersensitivity. The quality of evidence for potassium being as effective
as other positive control agents, or
more effective than negative controls
was low with further studies required.
From these results effectiveness of
the agent is difficult to confirm.
As discussed above, there is much
debate on the effectiveness of potassium toothpaste, a Cochrane review
(Poulsen et al. 2001, 2006) for potassium nitrate showed that the quality
of evidence supporting the efficacy
of potassium salts was low. This
unproven status for potassium raises
issues as to why potassium has been
used as the positive control in recent
clinical studies, and this lack of good
evidence of effectiveness has also
been highlighted in another recent
systematic review by Pol et al. 2010.
Studies evaluating potassium as the
active agent and studies using potassium as the comparator/positive control need to be of sufficient length of
time, otherwise the agent will be
ineffective, which one could argue
was occurring in some of the recent
studies.
Previous
systematic
reviews
include the potassium ion, e.g. the
review on oxalates (Cunha-Cruz
et al. 2011), showing no evidence for
potassium efficacy. The systematic
review on potassium toothpaste
(Karim & Gillam 2013), identified six
papers fitting the inclusion criteria,
and again found minimal evidence
for the effectiveness of potassium in
reducing the pain of dentine hypersensitivity.
Recommendations
Our review demonstrated there is
limited evidence for the effectiveness
of potassium salts for the pain
relief of dentine hypersensitivity
and cannot recommend its use for
Casein derivatives
Limited conclusions can be drawn from

the studies reviewed here as the quality
of evidence for the effectiveness of
casein derivatives in the reduction in
pain of dentine hypersensitivity was
very low. There are two systematic

reviews (Azarpazhooh & Limeback
2008, Talioti et al. 2014) that have
also examined the clinical efficacy of
casein derivatives. These reviews
came to similar conclusions.
Recommendations
Our review demonstrated there is
insufficient evidence for effectiveness
of casein derivatives to relieve the
pain of dentine hypersensitivity and
cannot recommend its use for the
Strontium
In summary, the quality of evidence

supporting strontium chloride salts
as being more effective than negative
controls or comparator actives in
pain reduction in dentine hypersensitivity is low with more studies
needed to indicate whether this salt
is effective.
Strontium acetate showed equivocal effects of pain reduction as compared to arginine, trends showing
arginine was slightly more effective,
the quality of evidence was moderate
with more studies required to confirm which agent is the most effective. Similarly, the quality of
evidence demonstrating that strontium acetate was more effective than
a fluoride control was moderate in
recent studies. Comparing this systematic review with one previous
systematic review on strontium
toothpastes (Karim & Gillam 2013),
one paper was identified fitting the
inclusion criteria, giving minimal evidence to interpret.
Recommendations
This review showed that when strontium acetate is self administered as a
toothpaste, it is an effective treatment agent for the pain relief of
dentine hypersensitivity. This is supported by moderate quality evidence,
and the authors recommend its
use for the treatment of dentine
hypersensitivity.
Stannous
The quality of evidence supporting

the effectiveness of stannous salts
alone, or in combination with potassium in reducing the pain of dentine
hypersensitivity as compared to
conventional fluoride pastes was
moderate.
Even though there are only two

studies where stannous fluoride has
been directly compared with arginine
for the relief of dentine hypersensitivity, the quality of the body of evidence supporting stannous being a
more effective agent, was high.
There are no systematic reviews published on stannous fluoride toothpaste.
Recommendations
Considering the results together as a
whole, the review suggests when
stannous fluoride is self administered
as a toothpaste, it is an effective
treatment agent for the pain relief of
dentine hypersensitivity. This is supported by high-quality evidence, and
the authors recommend its use for
Calcium sodium phosphosilicate (CSPS)
The RCTs comparing the efficacy of

CSPS toothpaste with a variety of
positive and negative controls over
long-term assessments showed CSPS
to be consistently more effective in
the treatment of dentine hypersensitivity. Although results were consistently in favour of CSPS, the quality
of the evidence for this finding was
low as some of the studies were at a
high risk of bias. Similarly, CSPS
applied professionally was shown in
two studies to be more effective than
a negative control, for the reduction
in dentine hypersensitivity pain, but
the quality of evidence was also low.
Heterogeneity was found between the
designs of the studies and there was
often a lack of detail, few participants
and a lack of power calculation. A
previous systematic review published
on CSPS toothpaste (Talioti et al.
2014) evaluated three studies with limited data to support of effectiveness.
Recommendations
This review suggested that when
CSPS is self administered as a toothpaste, it is an effective treatment
agent for the pain relief of dentine
hypersensitivity. This was supported
by a low-quality body of evidence,
which was consistently in favour of
effectiveness. The authors recommend its use for the treatment of
dentine hypersensitivity, being mindful of the fact that evidence is not
strong.
S297
The findings of the review suggested CSPS applied professionally is

hypersensitivity, however, there is
to recommend this agent compared to
other professionally applied agents.
Oxalates

for effectiveness of oxalates in reducing the pain of dentine hypersensitivity was low. It was difficult to
compare the results of studies due to
the huge variation in oxalate products evaluated and multitude of negative and positive controls employed.
Most studies examined professionally applied agents, however, in the
one study which evaluated a selfadministered agent, a mouthrinse,
Sharma et al. (2013), it was demonstrated this agent was more efficacious than a negative control.
A systematic review by CunhaCruz et al. (2011) failed to show
substantial significance for oxalate
treatment, with the possible exception of 3% monohydrogen oxalate.
Since this review further studies have
been published, which are included
in our review.
Recommendations
there is limited evidence for the recommendation of self-applied or professionally administered oxalates in
the treatment of dentine hypersensitivity at present.
Resins

for the effectiveness of resins was
low and little interpretation can be
placed on the findings with regards
to resins due to the vast heterogeneity of the studies, as compared to
comparator products. Similarly, a
recent systematic review by Lin et al.
(2013) revealed little difference
between a number of professionally
applied products. The authors found
the studies difficult to compare due
to the multitude of different controls, and lack of negative controls,
weakening the interpretation of the
findings and support the systematic
review by Lin et al. (2013). A further
systematic review published in 2013
analysed clinical trials on dentine
S298
West et al.
desensitizing agents identifying five

with satisfactory longer term (up to
6 months) results (da Rosa et al.
2013), however, again, the trial
designs and products were vastly different, giving little meaning to the
interpretation.
Recommendations
The findings of the review suggested
resins applied professionally are
hypersensitivity, however, there was
to recommend these agents compared to other professionally applied
agents.
Varnishes
For all of these varnish products,

their effectiveness was limited to the
duration for which they remained on
the tooth surface. There was limited
evidence of effectiveness as compared to specific comparator treatments due to the low quality of the
body of evidence resulting from the
heterogeneity of the studies and lack
of sufficient controls. Previous systematic reviews confirm these findings (Lin et al. 2013, da Rosa et al.
2013).
Recommendations
that with the exception of fluoride
varnishes, these agents applied professionally show some effectiveness
in the treatment of dentine hypersensitivity, however, there is insufficient
evidence for the authors to recommend these agents compared to
other professionally applied agents.
Lasers

for the effectiveness of lasers in
reducing the pain of dentine hypersensitivity was low. Lasers appear to
have equivocal or weak effectiveness
as compared to dentine bonding
agents, potassium gel and a variety
of controls. Other systematic reviews
(He et al. 2011d, Sgolastra et al.
2011, 2013) on lasers concluded that
there was weak evidence for laser
treatment with a strong placebo
effect. There do not appear to be
enough studies on a particular type
of laser for thorough systematic
analysis at present.
Recommendations
The findings of the review suggested
lasers applied professionally may be
hypersensitivity, however, there is
to recommend this agent compared
to other professionally applied
agents.
Conclusions
This systematic review assessed 11

treatment modalities for dentine
hypersensitivity including self administered agents and professionally
applied agents. Based on this review
the authors concluded that arginine,
stannous fluoride, calcium sodium
phosphosilicate and strontium, as
self administered toothpaste, are
effective in pain reduction in dentine
hypersensitivity. These data suggest
that with twice daily use, all four
products would be expected to bring
about rapid and considerable relief
of symptoms during product use.
These toothpastes are easy to use
and readily available over the counter.
Professionally applied products
appear effective in the treatment of
dentine hypersensitivity, however,
there is insufficient evidence for the
authors to recommend one agent
compared to another.
References
Absi, E. G., Addy, M. & Adams, D. (1987) Dentine hypersensitivity: a study of the patency of
dentinal tubules in sensitive and nonsensitive
cervical dentine. Journal of Clinical Periodontology 14, 280284.
Acharya, A. B., Surve, S. M. & Thakur, S. L.
(2013) A clinical study of the effect of calcium
sodium phosphosilicate on dentin hypersensitivity. Journal of Clinical and Experimental Dentistry 5, e18e22.
Addy, M. (2002) Dentine hypersensitivity: new
perspectives on an old problem. International
Dental Journal 52 (Suppl), 367375.
Ayad, F., Ayad, N., Delgado, E., Zhang, Y. P.,
DeVizio, W., Cummins, D. & Mateo, L. R.
(2009a) Comparing the efficacy in providing
instant relief of dentin hypersensitivity of a
new toothpaste containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride to a
benchmark desensitizing toothpaste containing
2% potassium ion and 1450 ppm fluoride, and
to a control toothpaste with 1450 ppm fluoride:
a three-day clinical study in Mississauga,
Canada. Journal of Clinical Dentistry 20, 115
122.
Ayad, F., Ayad, N., Zhang, Y. P., DeVizio, W.,
Cummins, D. & Mateo, L. R. (2009b) Comparing the efficacy in reducing dentin hypersensi-
tivity of a new toothpaste containing 8.0%

arginine, calcium carbonate, and 1450 ppm
fluoride to a commercial sensitive toothpaste
containing 2% potassium ion: an eight-week
clinical study on Canadian adults. Journal of
Clinical Dentistry 20, 1016.
Ayad, F., Berta, R., De Vizio, W., McCool, J.,
Petrone, M. E. & Volpe, A. R. (1994) Comparative efficacy of two dentifrices containing 5%
potassium nitrate on dentinal sensitivity: a
twelve-week clinical study. Journal of Clinical
Dentistry, 5 Spec No., 97101.
Azarpazhooh, A. & Limeback, H. (2008) Clinical
efficacy of casein derivatives: a systematic
review of the literature. Journal of the American
Dental Association 139, 915924.
Boiko, O. V., Baker, S. R., Gibson, B. J., Locker,
D., Sufi, F., Barlow, A. P. S. & Robinson, P.
G. (2010) Construction and validation of the
quality of life measure for dentine hypersensitivity (DHEQ). Journal of Clinical Periodontology 37, 973980.
Camilotti, V., Zilly, J., Busato Pdo, M., Nassar,
C. A. & Nassar, P. O. (2012) Desensitizing
treatments for dentin hypersensitivity: a randomized, split-mouth clinical trial. Brazilian
Oral Research 26, 263268.
Castillo, J. L., Rivera, S., Aparicio, T., Lazo, R.,
Aw, T.-C., Mancl, L. L. & Milgtom, P. (2011)
The short term effects of diammine sliver fluoride on tooth sensitivity: a randomized controlled trial. Journal of Dental Research 90,
203208.
Chaknis, P., Panagakos, F. S., DeVizio, W.,
Sowinski, J., Petrone, D. & Proskin, H. (2011)
Assessment of hypersensitivity reduction of a
dentifrice containing 0.3% triclosan, 2.0%
PVM/MA copolymer, 0.243% NaF and specially-designed silica as compared to a dentifrice containing 0.454% stannous fluoride,
sodium hexametaphosphate and zinc lactate
and to a dentifrice containing 0.243% NaF on
dentin hypersensitivity reduction: an 8-week
study. American Journal of Dentistry 24 Spec
No. A, 14A20A.
Chesters, R., Kaufman, H. W., Wolff, M. S.,
Huntington, E. & Kleinberg, I. (1992) Use of
multiple sensitivity measurements and logit statistical analysis to assess the effectiveness of a
potassium-citrate-containing dentifrice in reducing dentinal hypersensitivity. Journal of Clinical
Periodontology 19, 256261.
Chu, C. H. & Lo, E. C. (2014) Immediate postapplication effect of professional prophylaxis
with 8% arginine-calcium carbonate desensitizing paste on hypersensitive teeth. A practitioner-based clinical trial. American Journal of
Dentistry 27, 711.
Collins, J. F. & Perkins, L. (1984) Clinical evaluation of the effectiveness of three dentifrices in
relieving dentin sensitivity. Journal of Periodontology 55, 720725.
Collins, J. R., Richardson, D., Sotero, K., Mateo,
L. R. & Mauriz, I. (2013) Beneficial effects of
an arginine-calcium carbonate desensitizing
paste for treatment of dentin hypersensitivity.
American Journal of Dentistry 26, 6367.
Conforti, N., Battista, G. W., Petrone, D. M., Petrone, M. E., Chaknis, P., Zhang, Y. P., DeVizio, W., Volpe, A. R. & Proskin, H. M. (2000)
Comparative investigation of the desensitizing
efficacy of a new dentifrice: a 14-day clinical
study. Compendium of Continuing Education in
Dentistry. Supplement 27, 1722; quiz 28.
Corona, S. A., Nascimento, T. N., Catirse, A. B.,
Lizarelli, R. F., Dinelli, W. & Palma-Dibb, R.
G. (2003) Clinical evaluation of low-level laser

therapy and fluoride varnish for treating cervical dentinal hypersensitivity. Journal of Oral
Rehabilitation 30, 11831189.
Craig, G. G., Knight, G. M. & McIntyre, J. M.
(2012) Clinical evaluation of diamine silver
fluoride/potassium iodide as a dentine desensitizing agent. A pilot study. Australian Dental
Journal 57, 308311.
Cunha-Cruz, J., Stout, J. R., Heaton, L. J. & Wataha, J. C. (2011) Northwest PRECEDENT.
Dentin hypersensitivity and oxalates: a systematic review. Journal of Dental Research 90,
304310.
Day, T., Einwag, J., Hermann, J. S., He, T.,
Anastasia, M. K., Barker, M. & Zhang, Y.
(2010) A clinical assessment of the efficacy of a
stannous-containing sodium fluoride dentifrice
on dentinal hypersensitivity. Journal of Contemporary Dental Practice 11, E001E008.
Ding, Y. J., Yao, H., Wang, G. H. & Song, H.
(2014) A randomized double-blind placebocontrolled study of the efficacy of Clinpro XT
varnish and Gluma dentin desensitizer on dentin hypersensitivity. American Journal of Dentistry 27, 7983.
Docimo, R., Montesani, L., Maturo, P., Costacurta, M., Bartolino, M., DeVizio, W., Zhang,
Y. P., Cummins, D., Dibart, S. & Mateo, L.
R. (2009a) Comparing the efficacy in reducing
dentin hypersensitivity of a new toothpaste
containing 8.0% arginine, calcium carbonate,
and 1450 ppm fluoride to a commercial sensitive toothpaste containing 2% potassium ion:
an eight-week clinical study in Rome, Italy.
Journal of Clinical Dentistry 20, 1722.
Docimo, R., Montesani, L., Maturo, P., Costacurta, M., Bartolino, M., DeVizio, W., Zhang,
Y. P. & Dibart, S. (2007) Desensitizing efficacy
of a new toothpaste containing 5.5% potassium
citrate: a 4-week clinical study. American Journal of Dentistry 20, 209211.
Docimo, R., Montesani, L., Maturo, P., Costacurta, M., Bartolino, M., Zhang, Y. P., DeVizio, W., Delgado, E., Cummins, D., Dibart, S.
& Mateo, L. R. (2009b) Comparing the efficacy
in reducing dentin hypersensitivity of a new
toothpaste containing 8.0% arginine, calcium
carbonate, and 1450 ppm fluoride to a benchmark commercial desensitizing toothpaste containing 2% potassium ion: an eight-week
clinical study in Rome, Italy. Journal of Clinical Dentistry 20, 137143.
Docimo, R., Perugia, C., Bartolino, M., Maturo,
P., Montesani, L., Zhang, Y. P., DeVizio, W.,
Mateo, L. R. & Dibart, S. (2011) Comparative
evaluation of the efficacy of three commercially
available toothpastes on dentin hypersensitivity
reduction: an eight-week clinical study. Journal
of Clinical Dentistry 22, 121127.
Drebenstedt, S., Zapf, A., Rodig, T., Mausberg,
R. F. & Ziebolz, D. (2012) Efficacy of two different CHX containing desensitizers: a double
blind study. Operative Dentistry 37, 161171.
Du Min, Q., Bian, Z., Jiang, H., Greenspan, D.
C., Burwell, A. K., Zhong, J. & Tai, B. J.
(2008) Clinical evaluation of a dentifrice containing calcium sodium phosphosilicate (NovaMin)
for
the
treatment
of
dentin
hypersensitivity. American Journal of Dentistry
21, 210214.
Duran, I. & Sengun, A. (2004) The long-term
effectiveness of five current desensitizing products on cervical dentine sensitivity. Journal of
Oral Rehabilitation 31, 351356.
Ehlers, V., Ernst, C. P., Reich, M., K
ammerer, P.
& Willershausen, B. (2012) Clinical comparison
of Gluma and Er:YAG laser treatment of
cervically exposed hypersensitive dentin. American Journal of Dentistry 25, 131135.

Elas Boneta, A. R., Gal
an Sal
as, R. M., Mateo,
L. R., Stewart, B., Mello, S., Arvanitidou, L.
S., Panagakos, F. & DeVizio, W. (2013a) Efficacy of a mouthwash containing 0.8% arginine,
PVM/MA copolymer, pyrophosphates, and
0.05% sodium fluoride compared to a commercial mouthwash containing 2.4% potassium
nitrate and 0.022% sodium fluoride and a control mouthwash containing 0.05% sodium fluoride on dentine hypersensitivity: a six-week
randomized clinical study. Journal of Dentistry
41(Suppl 1), S34S41.
Elas Boneta, A. R., Ramirez, K., Naboa, J.,
Mateo, L. R., Stewart, B., Panagokos, F. & De
Vizio, W. (2013b) 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. Journal of Dentistry 41(Suppl
1), S42S49.
Erdemir, U., Yildiz, E., Kilic, I., Yucel, T. &
Ozel, S. (2010) The efficacy of three desensitizing agents used to treat dentin hypersensitivity.
Journal of the American Dental Association 141,
285296.
Femiano, F., Femiano, R., Lanza, A., Festa, M.
V., Rullo, R. & Perillo, L. (2013) Efficacy of
diode laser in association to sodium fluoride vs
Gluma desensitizer on treatment of cervical
dentin hypersensitivity. A double blind controlled trial. American Journal of Dentistry 26,
214218.
Flecha, O. D., Azevedo, C. G., Matos, F. R.,
Vieira-Barbosa, N. M., Ramos-Jorge, M. L.,
Goncalves, P. F. & Koga Silva, E. M. (2013)
Cyanoacrylate versus laser in the treatment of
dentin hypersensitivity: a controlled, randomized, double-masked and non-inferiority clinical
trial. Journal of Periodontology 84, 287294.
Fu, Y., Li, X., Que, K., Wang, M., Hu, D.,
Mateo, L. R., DeVizio, W. & Zhang, Y. P.
(2010) Instant dentin hypersensitivity relief of a
new desensitizing dentifrice containing 8.0%
arginine, a high cleaning calcium carbonate system and 1450 ppm fluoride: a 3-day clinical
study in Chengdu, China. American Journal of
Dentistry 23 Spec No. A, 20A27A.
Geiger, S., Matalon, S., Blasbalg, J., Tung, M. &
Eichmiller, F. C. (2003) The clinical effect of
amorphous calcium phosphate (ACP) on root
surface hypersensitivity. Operative Dentistry 28,
496500.
Gerschman, J. A., Ruben, J. & Gebart-Eaglemont, J. (1994) Low level laser therapy for dentinal tooth hypersensitivity. Australian Dental
Journal 39, 353357.
Gillam, D. G., Bulman, J. S., Jackson, R. J. &
Newman, H. N. (1996) Comparison of 2 desensitizing dentifrices with a commercially available fluoride dentifrice in alleviating cervical
dentine sensitivity. Journal of Periodontology
67, 737742.
Gillam, D. G., Newman, H. N., Bulman, J. S. &
Davies, E. H. (1992a) Dentifrice abrasivity and
cervical dentinal hypersensitivity. Results
12 weeks following cessation of 8 weeks supervised use. Journal of Periodontology 63, 712.
Gillam, D. G., Newman, H. N., Davies, E. H. &
Bulman, J. S. (1992b) Clinical efficacy of a low
abrasive dentifrice for the relief of cervical dentinal hypersensitivity. Journal of Clinical Periodontology 19, 197201.
S299
Gillam, D. G., Newman, H. N., Davies, E. H.,

Bulman, J. S., Troullos, E. S. & Curro, F.
A. (2004) Clinical evaluation of ferric oxalate
in relieving dentine hypersensitivity. Journal
of Oral Rehabilitation 31, 245250. Erratum
in: Journal of Oral Rehabilitation 2004; 31,
827.
Grossman, L. E. (1935) A systematic method for
the treatment of hypersensitive dentine. Journal
of the American Dental Association 22, 592
602.
Hamlin, D., Mateo, L. R., Dibart, S., Delgado,
E., Zhang, Y. P. & DeVizio, W. (2012) Comparative efficacy of two treatment regimens
combining in-office and at-home programs for
dentin hypersensitivity relief: a 24-week clinical
study. American Journal of Dentistry 25, 146
152.
Hamlin, D., Williams, K. P., Delgado, E., Zhang,
Y. P., DeVizio, W. & Mateo, L. R. (2009)
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. American Journal of Dentistry 22 Spec
No. A, 16A20A.
He, S., Wang, Y., Li, X. & Hu, D. (2011d) Effectiveness of laser therapy and topical desensitising agents in treating dentine hypersensitivity:
a systematic review. Journal of Oral Rehabilitation 38, 348358.
He, T., Barker, M. L., Biesbrock, A. & Sharma,
N. (2014) A randomized controlled clinical trial
to assess the desensitizing effect of a stannous
fluoride dentifrice. American Journal of Dentistry 27, 106110.
He, T., Chang, J., Cheng, R., Li, X., Sun, L. &
Biesbrock, A. R. (2011a) Clinical evaluation of
the fast onset and sustained sensitivity relief of
a 0.454% stannous fluoride dentifrice compared to an 8.0% arginine-calcium carbonatesodium monofluorophosphate dentifrice. American Journal of Dentistry 24, 336340.
He, T., Barker, M. L., Qaqish, J. & Sharma, N.
(2011b) Fast onset sensitivity relief of a 0.454%
stannous fluoride dentifrice. Journal of Clinical
Dentistry 22, 4650.
He, T., Cheng, R., Biesbrock, A. R., Chang, A.
& Sun, L. (2011c) Rapid desensitizing efficacy
of a stannous-containing sodium fluoride
dentifrice. Journal of Clinical Dentistry 22,
4045.
Hegde, S., Rao, B. H., Kakar, R. C. & Kakar, A.
(2013) A comparison of dentifrices for clinical
relief from dentin hypersensitivity using the Jay
Sensitivity Sensor Probe. American Journal of
Dentistry 26 Spec No. B, 29B36B.
Holland, G. R., N
arhi, M. N., Addy, M., Gangarosa, L. & Orchardson, R. (1997) Guidelines
for the design and conduct of clinical trials on
dentine hypersensitivity. Journal of Clinical
Hu, D., Stewart, B., Mello, S., Arvanitidou, L.,
Panagakos, F., De Vizio, W., Zhang, Y. P.,
Mateo, L. R. & Yin, W. (2013) Efficacy of a
mouthwash containing 0.8% arginine, PVM/
MA copolymer, pyrophosphates, and 0.05%
sodium fluoride compared to a negative control
mouthwash on dentin hypersensitivity reduction. A randomized clinical trial. Journal of
Dentistry 41(Suppl 1), S26S33.
Hughes, N., Mason, S., Jeffery, P., Welton, H.,
Tobin, M., OShea, C. & Browne, M. (2010) A
comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride
versus a marketed control dentifrice containing
S300
West et al.
8% arginine, calcium carbonate, and 1450 ppm

sodium monofluorophosphate in reducing
dentinal hypersensitivity. Journal of Clinical
Dentistry 21, 4955.
Kakar, A., Dibart, S. & Kakar, K. (2013) Clinical
assessment of a new dentifrice with 8% arginine and calcium carbonate on dentin hypersensitivity in an Indian population using a new
measuring device: the Jay Sensitivity Sensor
Probe. American Journal of Dentistry 26 Spec
No. B, 13B20B.
Kakar, A., Kakar, K., Sreenivasan, P. K.,
DeVizio, W. & Kohli, R. (2012a) Comparison
of the clinical efficacy of a new dentifrice
and 1000 ppm fluoride to a commercially
available sensitive toothpaste containing 2%
potassium ion on dentin hypersensitivity: a randomized clinical trial. Journal of Clinical Dentistry 23, 4047.
Kakar, A., Kakar, K., Sreenivasan, P. K., DeVizio, W. & Kohli, R. (2012b) Comparison of the
clinical efficacy in reducing dentin hypersensitivity of a new dentifrice containing 8.0% arginine, calcium carbonate, and 1000 ppm sodium
monofluorophosphate to a commercially available toothpaste containing 1000 ppm sodium
monofluorophosphate: an eight-week clinical
trial on adults in New Delhi, India. Journal of
Kapferer, I., Pflug, C., Kisielewsky, I., Giesinger,
J., Beier, U. S. & Dumfahrt, H. (2013) Instant
dentin hypersensitivity relief of a single topical
application of an in-office desensitizing paste
containing 8% arginine and calcium carbonate:
a split-mouth, randomized-controlled study.
Acta Odontologica Scandinavica 71, 994999.
Karim, B. F. & Gillam, D. G. (2013) The efficacy
of strontium and potassium toothpastes in
treating dentine hypersensitivity: a systematic
review. International Journal of Dentistry 2013,
573258.
Kielbassa, A. M., Attin, T., Hellwig, E. & SchdeBrittinger, C. (1997) In vivo study on the effectiveness of a lacquer containing CaF2/NaF in
treating dentine hypersensitivity. Clinical Oral
Investigations 1, 9599.
Ko, Y., Park, J., Kim, C., Park, J., Baek, S. H. &
Kook, Y. A. (2014) Treatment of dentin hypersensitivity with a low-level laser emitting toothbrush: double-blind randomised clinical trial of
efficacy. Journal of Oral Rehabilitation 41, 523
531.
Kobler, A., Kub, O., Schaller, H. G. & Gernhardt, C. R. (2008) Clinical effectiveness of a
strontium chloridecontaining desensitizing
agent over 6 months: a randomized, doubleblind, placebo-controlled study. Quintessence
International 39, 321325.
Li, Y., Lee, S., Zhang, Y. P., Delgado, E., DeVizio, W. & Mateo, L. R. (2011) Comparison of
clinical efficacy of three toothpastes in reducing
dentin hypersensitivity. Journal of Clinical Dentistry 22, 113120.
Lin, P. Y., Cheng, Y. W., Chu, C. Y., Chien, K.
L., Lin, C. P. & Tu, Y. K. (2013) In-office
treatment for dentin hypersensitivity: a systematic review and network meta-analysis. Journal
of Clinical Periodontology 40, 5364.
Litkowski, L. & Greenspan, D. C. (2010) A clinical study of the effect of calcium sodium phosphosilicate on dentin hypersensitivity-proof of
principle. Journal of Clinical Dentistry 21, 77
81.
Liu, H. & Hu, D. (2012) Efficacy of a commercial
dentifrice containing 2% strontium chloride
and 5% potassium nitrate for dentin hypersen-
sitivity: a 3-day clinical study in adults in

China. Clinical Therapeutics 34, 614622.
Mason, S., Hughes, N., Sufi, F., Bannon, L.,
Maggio, B., North, M. & Holt, J. (2010) A
comparative clinical study investigating the efficacy of a dentifrice containing 8% strontium
acetate and 1040 ppm fluoride in a silica base
and a control dentifrice containing 1450 ppm
fluoride in a silica base to provide immediate
relief of dentin hypersensitivity. Journal of Clinical Dentistry 21, 4248.
Matthews, B., Andrew, D. & Wanachantararak,
S. (2000) Biology of the dental pulp with special reference to its vasculature and innervation. In: Addy, M., Embery, G., Edgar, W. M.
& Orchardson, R. (eds). Tooth Wear and Sensitivity, pp. 3951. London: Martin Dunitz.
Mehta, D., Gowda, V. S., Santosh, A., Finger,
W. J. & Sasaki, K. (2014) Randomized controlled clinical trial on the efficacy of dentin
desensitizing agents. Acta Odontologica Scandinavica 9, 16.
Merika, K., HeftitArthur, F. & Preshaw, P. M.
(2006) Comparison of two topical treatments
for dentine sensitivity. European Journal of
Prosthodontics and Restorative Dentistry 14,
3841.
Milleman, J. L., Milleman, K. R., Clark, C. E.,
Mongiello, K. A., Simonton, T. C. & Proskin,
H. M. (2012) NUPRO sensodyne prophylaxis
paste with NovaMin for the treatment of dentin hypersensitivity: a 4-week clinical study.
Minkoff, S. & Axelrod, S. (1987) Efficacy of
strontium chloride in dental hypersensitivity.
Journal of Periodontology 58, 470474.
Moher, H., Liberati, A., Tetzlaff, J. & Altman,
D. G. (2009) The PRISMA Group. Preferred
reporting items for systematic reviews and
meta-analysis: the PRISMA Statement. PLoS
Medicine 6, e1000097.
N
ahri, M., Jyv
asj
arvi, E. & Virtannen, A. (1992)
Role of intradental A- and C- type fibres in
dental pain mechanisms. Proceedings of the
Finnish Dental Society 88 (Suppl 1), 507516.
Narongdej, T., Sakoolnamarka, R. & Boonroung,
T. (2010) The effectiveness of a calcium sodium
phosphosilicate desensitizer in reducing cervical
dentin hypersensitivity: a pilot study. Journal of
the American Dental Association 141, 995999.
Nathoo, S., Delgado, E., Zhang, Y. P., DeVizio,
W., Cummins, D. & Mateo, L. R. (2009) Comparing the efficacy in providing instant relief of
dentin hypersensitivity of a new toothpaste
and 1450 ppm fluoride relative to a benchmark
desensitizing toothpaste containing 2% potassium ion and 1450 ppm fluoride, and to a control toothpaste with 1450 ppm fluoride: a
three-day clinical study in New Jersey, USA.
Needleman, I. G. (2002) A guide to systematic
reviews. Journal of Clinical Periodontology 29
(Suppl 3), 69.
Neuhaus, K. W., Milleman, J. L., Milleman, K.
R., Mongiello, K. A., Simonton, T. C., Clark,
C. E., Proskin, H. M. & Seemann, R. (2013)
Effectiveness of a calcium sodium phosphosilicate-containing prophylaxis paste in reducing
dentine hypersensitivity immediately and
4 weeks after a single application: a doubleblind randomized controlled trial. Journal of
Clinical Periodontology 40, 349357.
Ni, L. X., He, T., Chang, A. & Sun, L. (2010)
The desensitizing efficacy of a novel stannouscontaining sodium fluoride dentifrice: an 8week randomized and controlled clinical trial.
American Journal of Dentistry 23 Spec No. B,

17B21B.
Nuttall, N., Steele, J. G., Nunn, J., Pine, C.,
Treasure, E., Bradnock, G., Morris, J., Kelly,
M., Pitts, N. B. & White, D. (2001) A guide to
the UK Adult Dental Health Survey 1998, pp.
16. London: British Dental Association.
Orsini, G., Procaccini, M., Manzoli, L., Sparabombe, S., Tiriduzzi, P., Bambini, F. & Putignano, A. (2013) A 3-day randomized clinical
trial to investigate the desensitizing properties
of three dentifrices. Journal of Periodontology
84, 6573.
Pamir, T., Dalgar, H. & Onal, B. (2007) Clinical
evaluation of three desensitizing agents in
relieving dentin hypersensitivity. Operative Dentistry 32, 544548.
Parkinson, C., Hughes, N., Jeffery, P., Jain, R.,
Kennedy, L., Qaqish, J., Gallob, J. T. &
Mason, S. (2013) The efficacy of an experimental dentifrice containing 0.454% w/w stannous
fluoride in providing relief from the pain of
dentin hypersensitivity: an 8-week clinical
study. American Journal of Dentistry 26 Spec
No. A, 25A31A.
Pearce, N. X., Addy, M. & Newcombe, R. G.
(1994) Dentine hypersensitivity: a clinical
trial to compare 2 strontium densensitizing
toothpastes with a conventional fluoride
toothpaste. Journal of Periodontology 65, 113
119.
Pol, D. G., Jonnala, J., Chute, M., Gunjikar, T.
& Pol, S. (2010) Potassium nitrate in the treatment of dentine hypersensitivity a mini analysis of studies. Journal of the Indian Dental
Association 4, 339403.
Polderman, R. N. & Frencken, J. E. (2007) Comparison between effectiveness of a low-viscosity
glass ionomer and a resin-based glutaraldehyde
containing primer in treating dentine hypersensitivity-a 25.2-month evaluation. Journal of
Dentistry 35, 144149.
Poulsen, S., Errboe, M., Hovgaard, O. &
Worthington, H. W. (2001) Potassium nitrate
toothpaste for dentine hypersensitivity. Cochrane Database Systematic Review 2, CD001476.
Poulsen, S., Errboe, M., Lescay Mevil, Y. &
Glenny, A. M. (2006) Potassium containing
toothpastes for dentine hypersensitivity. Cochrane
Database
Systematic
Review
19,
CD001476.
Pradeep, A. R., Agarwal, E., Naik, S. B., Bajaj,
P. & Kalra, N. (2012) Comparison of efficacy
of three commercially available dentifrices [corrected] on dentinal hypersensitivity: a randomized clinical trial. Australian Dental Journal 57,
429434. Erratum in: Australian Dental Journal
2013; 58, 272.
Pradeep, A. R. & Sharma, A. (2010) Comparison
of clinical efficacy of a dentifrice containing
calcium sodium phosphosilicate to a dentifrice
containing potassium nitrate and to a placebo
on dentinal hypersensitivity: a randomized
clinical trial. Journal of Periodontology 81,
11671173.
Prasad, K. V., Sohoni, R., Tikare, S., Yalamalli,
M., Rajesh, G. & Javali, S. B. (2010) Efficacy
of two commercially available dentifrices in
reducing dentinal hypersensitivity. Indian Journal of Dental Research 21, 224230.
Que, K., Fu, Y., Lin, L., Hu, D., Zhang, Y. P.,
Panagakos, F. S., DeVizio, W. & Mateo, L. R.
(2010) Dentin hypersensitivity reduction of a
new toothpaste containing 8.0% arginine and
1450 ppm fluoride: an 8-week clinical study on
Chinese adults. American Journal of Dentistry
23 Spec No. A, 28A35A.

Rajesh, K. S., Hedge, S., Arun Kumar, M. S. &
Shetty, D. G. (2012) Evaluation of the efficacy
of a 5% calcium sodium phosphosilicate
(NovaMin) containing dentifrice for the relief
of dentinal hypersensitivity: a clinical study.
Indian Journal of Dental Research 23,
363367.
da Rosa, W. L., Lund, R. G., Piva, E. & da Silva,
A. F. (2013) The effectiveness of current dentin
desensitizing agents used to treat dental hypersensitivity: a systematic review. Quintessence
International 44, 535546.
Salian, S., Thakur, S., Kulkarni, S. & LaTorre,
G. (2010) A randomized controlled clinical
study evaluating the efficacy of two desensitizing dentifrices. Journal of Clinical Dentistry 21,
8287.
Schiff, T., Bonta, Y., Proskin, H. M., DeVizio,
W., Petrone, M. & Volpe, A. R. (2000a)
Desensitizing efficacy of a new dentifrice containing 5.0% potassium nitrate and 0.454%
stannous fluoride. American Journal of Dentistry 13, 111115.
Schiff, T., Delgado, E., Zhang, Y. P., Cummins,
D., DeVizio, W. & Mateo, L. R. (2009) Clinical evaluation of the efficacy of an in-office
desensitizing paste containing 8% arginine and
calcium carbonate in providing instant and
lasting relief of dentin hypersensitivity. American Journal of Dentistry 22 Spec No. A, 8A
15A.
Schiff, T., Dos Santos, M., Laffi, S., Yoshioka,
M., Baines, E., Brasil, K. D., McCool, J. J. &
De Vizio, W. (1998) Efficacy of a dentifrice
containing 5% potassium nitrate and 1500
PPM sodium monofluorophosphate in a precipitated calcium carbonate base on dentinal
hypersensitivity. Journal of Clinical Dentistry 9,
2225.
Schiff, T., Dotson, M., Cohen, S., De Vizio, W.,
McCool, J. & Volpe, A. (1994) Efficacy of a
dentifrice containing potassium nitrate, soluble
pyrophosphate, PVM/MA copolymer, and
sodium fluoride on dentinal hypersensitivity: a
twelve-week clinical study. Journal of Clinical
Dentistry 5 Spec No, 8792.
Schiff, T., He, T., Sagel, L. & Baker, R. (2006)
Efficacy and safety of a novel stabilized
stannous fluoride and sodium hexametaphosphate dentifrice for dentinal hypersensitivity.
Journal of Contemporary Dental Practice 7,
18.
Schiff, T., Mateo, L. R., Delgado, E., Cummins,
D., Zhang, Y. P. & DeVizio, W. (2011) Clinical
efficacy in reducing dentin hypersensitivity of a
dentifrice containing 8.0% arginine, calcium
carbonate, and 1450 ppm fluoride compared to
a dentifrice containing 8% strontium acetate
and 1040 ppm fluoride under consumer usage
conditions before and after switch-over. Journal
of Clinical Dentistry 22, 128138.
Schiff, T., Saletta, L., Baker, R. A., Winston, J.
L. & He, T. (2005) Desensitizing effect of a stabilized stannous fluoride/Sodium hexametaphosphate
dentifrice.
Compendium
of
Continuing Education in Dentistry 26 (Suppl 1),
3540.
Schiff, T., Zhang, Y. P., DeVizio, W., Stewart,
B., Chaknis, P., Petrone, M. E., Volpe, A. R.
& Proskin, H. M. (2000b) A randomised clinical trial of the desensitizing efficacy of three
dentifrices. Compendium of Continuing Education in Dentistry 27, 410.
Schwarz, F., Arweiler, N., Georg, T. & Reich, E.
(2002) Desensitizing effects of an Er:YAG laser
on hypersensitive dentine. Journal of Clinical
Sethna, G. D., Prabhuji, M. L. & Karthikeyan, B.

V. (2011) Comparison of two different forms
of varnishes in the treatment of dentine hypersensitivity: a subject-blind randomised clinical
study. Oral Health and Preventive Dentistry 9,
143150.
Sgolastra, F., Petrucci, A., Gatto, R. & Monaco,
A. (2011) Effectiveness of laser in dentinal
hypersensitivity treatment: a systematic review.
Journal of Endodontics 37, 297303.
Sgolastra, F., Petrucci, A., Severino, M., Gatto,
R. & Monaco, A. (2013) Lasers for the
treatment of dentin hypersensitivity: a metaanalysis. Journal of Dental Research 92, 492
499.
Sharif, M. O., Iram, S. & Brunton, P. A. (2013)
Effectiveness of arginine-containing toothpastes
in treating dentine hypersensitivity: a systematic
review. Journal of Dentistry 41, 483492.
Sharma, D., McGuire, J. A. & Amini, P. (2013)
Randomized trial of the clinical efficacy of a
potassium oxalate-containing mouthrinse in
rapid relief of dentin sensitivity. Journal of
Sharma, N., Roy, S., Kakar, A., Greenspan, D.
C. & Scott, R. (2010) A clinical study comparing oral formulations containing 7.5% calcium
sodium phosphosilicate (NovaMin), 5% potassium nitrate, and 0.4% stannous fluoride for
the management of dentin hypersensitivity.
Silverman, G., Berman, E., Hanna, C. B., Salvato, A., Fratarcangelo, P., Bartizek, R. D., Bollmer, B. W., Campbell, S. L., Lanzalaco, A. C.,
Mackay, B. J., McClanahan, S. F., Perlich, M.
A. & Shaffer, J. B. (1996) Assessing the efficacy
of three dentifrices in the treatment of dentinal
hypersensitivity. Journal of the American Dental
Association 127, 191201.
Sowinski, J. A., Battista, G. W., Petrone, M. E.,
Chaknis, P., Zhang, Y. P., DeVizio, W., Volpe,
A. R. & Proskin, H. M. (2000a) A new desensitizing dentifrice-an 8-week clinical investigation. Compendium of Continuing Education in
Dentistry 27, 1116.
Sowinski, J. A., Bonta, Y., Battista, G. W., Petrone, D., DeVizio, W., Petrone, M. & Proskin,
H. M. (2000b) Desensitizing efficacy of Colgate
Sensitive Maximum Strength and Fresh Mint
Sensodyne dentifrices. American Journal of
Sowinski, J. A., Kakar, A. & Kakar, K. (2013)
Clinical evaluation of the Jay Sensitivity Sensor
Probe: a new microprocessor-controlled instrument to evaluate dentin hypersensitivity. American Journal of Dentistry 26 Spec No. B, 5B
12B.
Sowinski, J., Ayad, F., Petrone, M., DeVizio, W.,
Volpe, A., Ellwood, R. & Davies, R. (2001)
Comparative investigations of the desensitising
efficacy of a new dentifrice. Journal of Clinical
Surve, S. M., Acharya, A. B., Shetty, A. & Thakur, S. L. (2012) Efficacy of calcium sodium
phosphosilicate in managing dentinal hypersensitivity. General Dentistry 60, 308311.
Talesara, K., Kulloli, A., Shetty, S. & Kathariya,
R. (2014) Evaluation of potassium binoxalate
gel and Nd:YAG laser in the management of
dentinal hypersensitivity: a split-mouth clinical
and ESEM study. Lasers in Medical Science
29, 6168.
Talioti, E., Hill, R. & Gillam, D., G. The Efficacy
of Selected Desensitizing OTC Products: A
Systematic Review. Volume 2014 (2014), Article
ID 865761, 14 pages http://dx.doi.org/10.1155/
2014/865761.
S301
Tengrungsun, T. & Sangkla, W. (2008) Comparative study in desensitizing efficacy using the
GaAlAs laser and dentin bonding agent. Journal of Dentistry 36, 392395.
Torwane, N. A., Hongal, S., Goel, P.,
Chandrashekar, B. R., Jain, M. & Saxena, E.
(2013) A clinical efficacy of 30% ethenolic
extract of Indian propolis and RecaldentTM in
management of dentinal hypersensitivity: a
comparative randomized clinical trial. European
Journal of Dentistry 7, 461468.
Tsai, W. S., Placa, S. J. & Panagakos, F. S.
(2012) Clinical evaluation of an in-office desensitizing paste containing 8% arginine and calcium carbonate for relief of dentin
hypersensitivity prior to dental prophylaxis.
Veitz-Keenan, A., Barna, J. A., Strober, B., Matthews, A. G., Collie, D., Vena, D., Curro, F.
A. & Thompson, V. P. (2013) Treatments for
hypersensitive noncarious cervical lesions: a
Practitioners Engaged in Applied Research and
Learning (PEARL) Network randomized clinical effectiveness study. Journal of the American
Dental Association 144, 495506.
Vieira, A. H., Passos, V. F., de Assis, J. S., Mendonca, J. S. & Santiago, S. L. (2009) Clinical
evaluation of a 3% potassium oxalate gel and
a GaAlAs laser for the treatment of dentinal
hypersensitivity. Photomedicine and Laser Surgery 27, 807812.
Vora, J., Mehta, D., Meena, N., Sushma, G., Finger, W. J. & Kanehira, M. (2012) Effects of
two topical desensitizing agents and placebo on
dentin hypersensitivity. American Journal of
Wara-aswapati, N., Krongnawakul, D., Jiraviboon, D., Adulyanon, S., Karimbux, N. & Pitiphat, W. (2005) The effect of a new toothpaste
containing potassium nitrate and triclosan on
gingival health, plaque formation and dentine
hypersensitivity. Journal of Clinical Periodontology 32, 5358.
West, N., Newcombe, R. G., Hughes, N., Mason,
S., Maggio, B., Sufi, F. & Claydon, N. (2013a)
A 3-day randomised clinical study investigating
the efficacy of two toothpastes, designed to
occlude dentine tubules, for the treatment of
dentine hypersensitivity. Journal of Dentistry
41, 187194.
West, N. X., Addy, M., Jackson, R. J. & Ridge,
D. B. (1997) Dentine hypersensitivity and the
placebo response. A comparison of the effect
of strontium acetate, potassium nitrate and
fluoride toothpastes. Journal of Clinical Periodontology 24, 209215.
West, N. X., Sanz, M., Lussi, A., Bartlett, D.,
Bouchard, P. & Bourgeois, D. (2013b) Prevalence of dentine hypersensitivity and study of
associated factors: a European populationbased cross-sectional study. Journal of Dentistry 41, 841851.
Yan, B., Yi, J., Li, Y., Chen, Y. & Shi, Z. (2013)
Arginine-containing toothpastes for dentin
hypersensitivity: systematic review and metaanalysis. Quintessence International 44, 709
723.
Yates, R., Owens, J., Jackson, R., Newcombe, R.
G. & Addy, M. (1998a) A split mouth placebocontrolled study to determine the effect of
amorphous calcium phosphate in the treatment
of dentine hypersensitivity. Journal of Clinical
Yates, R., West, N., Addy, M. & Marlow, I.
(1998b) The effects of a potassium citrate,
cetylpyridinium chloride, sodium fluoride
mouthrinse on dentine hypersensitivity, plaque
S302
West et al.
and gingivitis. A placebo-controlled study.

Journal of Clinical Periodontology 25,
813820.
Yilmaz, H. G., Kurtulmus-Yilmaz, S. & Cengiz,
E. (2011) Long-term effect of diode laser irradiation compared to sodium fluoride varnish in
the treatment of dentine hypersensitivity in
periodontal maintenance patients: a rando-
Clinical Relevance
Scientific rationale: Although many

agents have been used in the management of dentine hypersensitivity,
no clear agent appears to be superior. This systematic review assessed
all available treatment agents for
effectiveness.
Principal
findings:
Self-applied
agents such as toothpaste contain-
mised controlled clinical study. Photomedicine

and Laser Surgery 29, 721725.
Address:
Nicola West
Periodontology
Clinical Trials Unit
ing stannous fluoride, arginine, calcium sodium phosphosilicate and

strontium, are effective at reducing
the pain of dentine hypersensitivity,
being able to occlude dentine tubules
and resist occlusion removal by
dietary acid. Currently there is insufficient evidence to recommend a
specific professionally applied agent.
Bristol Dental School

Lower Maudlin Street
Bristol BS1 2LY
UK
E-mail: n.x.west@bristol.ac.uk
Practical implications: Self administered effective desensitizing toothpaste should be the first choice
treatment for this condition, followed by professionally applied
agents. Aetiological factors must
be
included
in
management
strategies.

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J Clin Periodontol 2015; 42 (Suppl. 16): S256S302 doi: 10.1111/jcpe.

Nicola X. West, Joon Seong and

West NX, Seong J, Davies M. Management of dentine hypersensitivity: efficacy of

Dentine hypersensitivity (DH) is a

and resolving on stimulus removal

Key words: dentine hypersensitivity;

2013b). Risk factors include gingival

Management of dentine hypersensitivity

method of pain evaluation and constituents of the agent as a whole, e.g.

The PRISMA checklist was followed

An extensive literature search was

(Heraeus Kulzer GmbH, IN 46614

Table 1. Searches completed in Pubmed 1421st July 2014

hypersensitivity OR sensitivity AND dentin AND arginine

Seal & Protect

hypersensitivity OR sensitivity AND dentin AND Seal & Protect

hypersensitivity OR sensitivity AND dentin AND stannous

(d)tested the efficacy of agents in

Titles derived from these broad

agreed upon by both authors were

2 weeks or more. These definitions

The methodological quality and risk

Data from the selected articles were

details of administration of the

Seal & Protect

1 (hypersensitivity[MeSH Terms] OR hypersensitivity[All Fields]) OR (sensitivity and specificity[MeSH Terms] OR (sensitivity[All

MeSH terms as entered into PubMed

Management of dentine hypersensitivity

MeSH terms as entered into PubMed

MeSH terms as entered into PubMed

Management of dentine hypersensitivity

Database: Medline 1950 to present

Cochrane Central Register of Controlled Trials:

describe the method by which dentine hypersensitivity is stimulated

Justification of the number of

All papers discussed are tabulated in

153 relevant original articles (per inclusion/

of the body of evidence, the balance

aspect of the study will not be

Studies including all of the above

This review included consideration of

Management of dentine hypersensitivity

based mouthrinse assessed long term

cantly more effective than a fluoride control, seven studies showing

to arginine in both the short and

This review included consideration

Table 4. Searches as they are grouped in the results

Arginine and Calcium

potassium, results being equivocal

This review included consideration

2012b, Pradeep et al. 2012, Elas

comparison to the positive control

Arginine and Calcium Carbonate (A/C)*

Table 5. Studies evaluated for all treatment modalities

1000 ppm sodium

86 subjects (35 males and 51 females) complied with the

A total of 303 patients were recruited by 65 participating

Management of dentine hypersensitivity

At the end of the 8-week period, the results showed a

8.0% arginine calcium

1000 ppm sodium

Subjects who brushed with the new dentifrice containing

Management of dentine hypersensitivity