Anti-sensitivity toothpaste is one of the simplest, most effective ways to offer your patient relief from dentin hypersensitivity — that is, if they use it as directed. When making a recommendation, choosing a sensitivity toothpaste that offers additional oral health benefits can go a long way towards improving patient compliance, outcomes, and satisfaction.
In a healthy tooth, dentin is covered by enamel and cementum. The dentin surface has a smear layer of organic deposits that “plug” the narrow channels, or dentin tubules, that lead to the pulp. When enamel and/or cementum is lost, the dentin can be exposed and the smear layer compromised, leaving the dentin tubules open.
The most widely accepted explanation for dentin hypersensitivity is that, when dentin is exposed in this manner, external stimuli can affect the properties and behavior of the fluid inside the tubules. This stimulates the nerve fibers in the pulpal chamber, causing the characteristic short, sharp pain of dentin hypersensitivity.
Sensitivity toothpastes use occlusive ingredients, desensitizing ingredients, or a combination of both. Occlusives block the open dentin tubules to prevent stimulation of the fluid within, while desensitizing agents depolarize the nerve to interfere with the transmission of pain signals.
With consistent use of anti-sensitivity toothpastes, the symptoms of dentin hypersensitivity can often be well-managed. However, some patients may only use them short-term and find that their sensitivity returns, while others may not follow your recommendation at all.
One common reason for this is that the patient has other oral health or appearance goals that feel more pressing, e.g., whitening or caries protection, and may not perceive the consistent, long-term use of sensitivity toothpaste as a means to achieving them. By offering a multi-benefit sensitivity toothpaste, then, you can help them to meet all their goals with one toothpaste — without compromising on comfort and quality of life.
Caries prevention and periodontal health
An amino acid called arginine is proving to be effective in controlling bacterial biofilm, a key factor in the development of dental caries and periodontal disease. In a clinical cohort study, arginine was shown to favorably modulate the oral microbiota of individuals with active caries. In combination with fluoride, arginine was shown to significantly retard the demineralizing capability of saliva-derived oral biofilm.
In many regions, Colgate’s sensitivity and multi-benefit toothpastes now contain arginine in various formats.
Toothpastes with Pro-Argin Technology, such as Colgate Sensitive Pro-Relief Complete Protection, contain 8% arginine and calcium carbonate. This combination works to physically seal open dentin tubules, create an acid-resistant layer over the dentin surface, and guard against acid attacks and sensitivity pain. The Pro-Argin formula has been shown to offer rapid and superior relief from dentin hypersensitivity when compared to a toothpaste with 8% strontium acetate.
Arginine also features in Colgate’s Dual Zinc plus Arginine (DZA) Technology, as found in Colgate Total Toothpaste (UK) and Colgate Total Advanced Professional Clean Toothpaste (Canada). A randomized controlled trial found that toothpastes with DZA Technology and fluoride provided significant reductions in oral bacteria on the teeth, tongue, cheeks, and gums, as well as in saliva, compared to toothpaste with fluoride alone. In another trial, a DZA and fluoride toothpaste gave significantly greater reduction in dental plaque and gingivitis parameters compared to a regular fluoride toothpaste.
Calculus develops when calcium is deposited into biofilm, causing it to calcify. A sensitivity toothpaste focusing on calculus control may feature mineralization inhibitors such as:
Pyrophosphates. These compounds chelate calcium, slow the rate of crystal formation, and prevent it from being deposited in biofilm.
Zinc. Zinc citrate, zinc chloride, zinc lactate are commonly used to inhibit calculus by interfering with crystal formation and slowing growth.
Sensitivity can be a result of enamel erosion, caused by the progressive demineralization of the tooth enamel by non-biofilm acids. A sensitivity toothpaste that also contains remineralizing agents can help to restore enamel strength and offer protection from future sensitivity. The most common are:
Calcium phosphates, e.g., tricalcium phosphate.
For patients concerned about tooth yellowing or staining, sensitivity toothpastes with whitening agents can help them to achieve a brighter smile. Common ingredients include:
Calcium carbonate. This ingredient helps to gently polish and lift stains from the teeth, and is already found in Colgate Sensitive Pro-Relief products with Pro-Argin Technology.
Sodium/pentasodium triphosphate. This ingredient uses chemical rather than mechanical action, removing pigmented proteins from the tooth’s surface and preventing further adhesion.
Given the wide range of toothpaste ingredients and formulations available, this is by no means an exhaustive list of solutions. However, by exploring the many multi-benefit toothpastes available to your patients, you can help them to meet any oral health goal without the burden of dentin hypersensitivity.
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