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Oral Care Scientic and Professional Affairs, Johnson & Johnson Consumer Services EAME Ltd, Foundation Park, Maidenhead, UK
Oral Care Research & Development, Johnson & Johnson Consumer & Personal Products Worldwide, Skillman, NJ, USA
keywords
abstract
Dentine sensitivity
Tooth sensitivity
Dentine hypersensitivity
Tubule occlusion
Nerve stabilisation
Potassium oxalate
Mouthrinse
Objectives: This review denes dentine sensitivity (DS), its prevalence, its aetiology, the
mechanism(s) responsible for DS, its diagnosis and its treatment. The review then examines
the modes of action of various treatments for DS including potassium salts, strontium salts,
bioglasses, arginine/calcium carbonate and professional treatments such as adhesives and
oxalates. The methods used to evaluate the various treatment modalities are discussed,
including laboratory studies and randomised controlled clinical trials.
Data sources and study selection: A literature search was conducted using PubMed, Ovid Medline
and Cochrane reviews for information on DS and its treatments, as well as laboratory and
clinical studies used to evaluate the efcacy of various DS treatments. With regard to efcacy
of treatments for DS only reports of clinical studies that were randomised, controlled and
blinded were reviewed. The authors offer new insights into the shortcomings of the recent
systematic review of the use of oxalates for DS.
Conclusions: The authors introduce the concept of a novel desensitising mouthrinse
containing 1.4% potassium oxalate: Listerine Advanced Defence Sensitive mouthrinse.
Readers of this supplement issue of the Journal of Dentistry are invited to review the
signicance of managing the clinical problem of DS. They are also invited to assess data from
laboratory and randomised controlled clinical studies in order to understand the advantages
offered by regular use of 1.4% potassium oxalate-containing mouthrinse, Listerine Advanced
Defence Sensitive, in particular its resistance to daily erosive and/or abrasive challenges.
2013 Elsevier Ltd. All rights reserved.
1.
Introduction
* Corresponding author at: Medical Device Governance Group, Johnson & Johnson Consumer & Personal Products Worldwide,
Division of Johnson & Johnson Consumer Companies, Inc., SF 305, 199 Grand View Road, Skillman, NJ 08558, USA. Tel.: 908-904-3067;
fax: 908-874-2739.
E-mail address: DSharma6@its.jnj.com (D. Sharma)
0300-5712/$ see front matter 2013 Elsevier Ltd. All rights reserved.
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Another factor that may explain the wide range in selfreported prevalence assessments is the subjective nature of
pain. The experience of a sensory event is highly subjective
and can vary substantially between individuals.4850 In the
case of pain, positive expectations can reduce the subjective
experience of pain evoked by a consistently noxious stimulus,
whereas negative expectations may result in the amplication
of pain.5154
Another major disadvantage of self-reported assessments
of DS is incorrect diagnosis of the pain by the respondent
(patient). One cannot emphasise enough that all other dental
diseases with a similar pain should be excluded before
conrming the diagnosis of DS, and this can only be done
by a clinician. Self-reported assessments of the prevalence
of DS need to be interpreted with caution by clinicians and
researchers.
Clinical examination studies usually evaluate DS using
various quantitative probes. The Yeaple probe and the
scratchometer55 measure tactile sensitivity. Subjective
probes, such as the Schiff Cold Air Scale, measure perception
of pain from an air-blast stimulus. Subjective sensitivity
measurements are often recorded using a visual analogue
scale. However, even those studies may be compromised by
the patients subjective perception of pain, which appears to
be altered by sensory factors, prompting a heightened pain
response.56
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5.1
Osmotic stimulation
5.2
5.3
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that are not of bacterial origin (Fig. 5).74,90 Acids can be extrinsic
or intrinsic. Extrinsic acid exposure is associated with dietary
acids, such as citrus fruit/drinks, carbonated drinks, etc.15,90
Intrinsic acids mainly comprise gastric acid, which moves
to the oral cavity as a result of gastro-oesophageal reux,29
vomiting syndromes, such as bulimia,91 or from vomiting
caused by drugs that act as irritants to the gastric mucosa. For
erosive toothwear to occur, a two-stage process is required:
rst the acids demineralise the tooth surface and soften it;
second, during this period the softened enamel is subject
to friction or abrasion, which can permanently remove it,
resulting in the erosive lesion.90 In normal conditions, these
softened surfaces remineralise through the action of saliva
and uoride, but the process can take up to 2 hours. It is
5.4
Bleaching sensitivity
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Diagnosis
Gingival recession
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Treatment
9.1
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Nerve stabilisation
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9.2
Tubule occlusion
9.2.1
Strontium
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9.2.2
Bioglasses
9.2.3
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Arginine
9.2.4
Professional treatments
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9.2.5
Oxalate
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9.3
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Conclusions
Conict of interest
Preparation of this article was sponsored by Johnson &
Johnson Consumer & Personal Products Worldwide. Maria
Mantzourani is an employee of Johnson & Johnson Consumer
Services EAME Ltd. Deepak Sharma is an employee of Johnson
& Johnson Consumer & Personal Products Worldwide, Division
of Johnson & Johnson Consumer Companies, Inc.
Acknowledgements
The authors thank Dr Pashley for critical review of the
manuscript. Editorial assistance was provided by Dr Julie
Ponting of Anthemis Consulting Ltd, funded by Johnson &
Johnson Consumer Services EAME Ltd.
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