The prevalence of dentine hypersensitivity is reported to be between 1.3% to 92% (Dental Elf – 23rd Jan 2019). Dentine hypersensitivity typically presents as a short sharp pain from exposed dentine as a result of a thermal, tactile osmotic chemical or evaporative stimulus that is not attributable to any other dental pathology. A wide variety of agents have been used to treat hypersensitivity including a broad range of desensitising toothpastes. Bioactive toothpastes use a bioactive glass which precipitates calcium and phosphate ions which may block dentinal tubules.
The aim of this review was to assess the effectiveness of toothpastes containing bioactive glass, applied either at-home or in-office for the treatment of dentine hypersensitivity.
Methods
The review was registered with PROSPERO and followed PRISMA guidelines. Searches were conducted in the Medline/PubMed, CENTRAL, Web of Science and LILACS database. This was supplemented by searches of ProQuest Dissertations & Theses Database and Clinical Trials , the National Research Register, OpenGrey, the World Health Organization’s International Clinical Trials Registry Platform, and at the Brazilian Registry of Clinical Trials . Randomised controlled trials (RCTs) comparing bioactive toothpastes against placebo or another desensitising agent were considered. Two reviewers independently screened and selected studies extracted data and assessed study quality using the Cochrane domains-based tool. Owing to study heterogeneity a narrative summary was presented.
Results
- 15 studies involving a total of 1,099 patients were included
- 7 studies were considered to be at low risk of bias, 4 at moderate risk and 4 at high risk.
- Studies used Biosilicates in concentrations of 1 to 10% and Novamin®(45S5/Bioglass) in two broad ranges 5-15% and 2.5 to 7.5%.
- Follow up times ranged from 1-24 weeks.
Conclusions
The authors concluded: –
bioactive compounds at low concentrations (2.5 – 7.5%) can be used as treatment of dentine hypersensitivity both at-home and in-office.
Comments
We have blogged about several systematic reviews of treatments for dentine hypersensitivity. (Dental Elf- Dentine Hypersensitivity blogs). A 2018 review of desensitising toothpastes by Hu et al (Dental Elf – 20th Jul 2018) also included calcium sodium phosphosilicate (CSPS) toothpastes including 6 studies 4 of which are included in this current review. A meta-analysis was conducted for CSPS toothpastes by Hu et al and they found that all toothpastes with desensitising agents improved hypersensitivity. This review included more studies that the earlier review but there was marked variation in the length of follow up, and the concentration of the bioactive material. While the reviewers assessed only 4 studies as being at high risk of bias 8 of the 15 had at least one domain being assessed as being at high risk of bias. The marked variation in teh studies and th elimited quality mean that the findings should be viewed very cautiously. Generally, reviews of dentine hypersensitivity have found that there is a lack of high-quality studies so future studies need to be conducted according to SPIRIT and CONSORT guidance and have an common follow up periods and outcome standards (COMET Initiative).
Links
Primary Paper
Freitas SAA, Oliveira NMA, de Geus JL, Souza SFC, Pereira AFV, Bauer J. Bioactive toothpastes in dentin hypersensitivity treatment: A systematic review. Saudi Dent J. 2021 Nov;33(7):395-403. doi: 10.1016/j.sdentj.2021.04.004. Epub 2021 Apr 27. PMID: 34803279; PMCID: PMC8589619.
Other references
Dental Elf – 23rd Jan 2019
Dental Elf – 24th Sep 2019
Dental Elf – 20th Jul 2018
Dentine hypersensitivity: Effectiveness of desensitising toothpastes
Dental Elf – Dentine hypersensitivity blogs
