Discussion
COLD, TOOTH SENSITIVITY
To relieve DH, various desensitizing modalities have been used at home or professionally applied. Toothpaste is an important agent for the relief of DH. The first desensitizing toothpastes claimed to either occlude dentinal tubules (those that contained strontium salts and fluorides) or destroy vital components within the tubules (those that contained formaldehyde). Currently, most desensitizing toothpastes contain potassium salts such as potassium nitrate, potassium chloride, and potassium citrate. In addition, recent studies reported that a remineralizing toothpaste containing sodium fluoride, bioactive glass (calcium sodium phosphosilicate), and calcium phosphates reduced DHIn this clinical trial, toothpastes containing different active components were evaluated for their DH relief efficacy. As a result, first null hypothesis was rejected. Well-balanced demographics and sufficient statistical power provided evidence of the results among the three groups. Based on this study, Group TP showed no significant difference in the performance of DH alleviation compared with Group SC in the air-blast test (p = 0.250). However, Group TP demonstrated significantly better efficacy of desensitization compared with Group N for air-blast stimuli (p = 0.0002). Furthermore, in response to cold, Group TP exhibited significantly better DH relief than Group N (p = 0.021). In the acidic sensitivity test, all groups showed a significant reduction in DH, especially with longer duration of toothpaste usage (0–2 week, p = 0.020; 0–4 week, p < 0.0001). However, there were no significant differences in the Schiff sensitivity scores among the three groups (p = 1.000). In the VAS score analysis, participants in Group TP reported better DH relief than those assigned to Groups SC (p = 0.012) and N (p = 0.048). Thus, the second hypothesis was also rejected.In this clinical trial, a greater reduction in DH was observed with a longer duration of toothpaste use in all groups (p < 0.0001). The third hypothesis was rejected. At 2 weeks, all groups exhibited significant desensitization of all stimuli from baseline (air, cold, p < 0.0001; acid, p = 0.020). At 4 weeks, all groups showed a significant reduction in DH in response to all stimuli (air-blast, cold, and acid) from the baseline (p ≤ 0.0001) and 2 weeks (p ≤ 0.0001), respectively.Strontium chloride was incorporated into the toothpaste assuming that it treated tooth sensitivity by occluding the dentin tubules. It has been used in desensitizing toothpaste because of its compatibility with fluoride. In this study, a positive control product containing 10% (w/w) strontium chloride hexahydrate, marketed as Sensodyne Original, was selected owing to its long-term usage and as a traditional active component since the development of desensitizing toothpaste. However, to date, the data available on its clinical efficacy of DH relief are inconsistent and highly debatedThe negative control, ‘Pleasia fluoride-free’, did not contain any active ingredients for DH relief. In this trial, considerable reduction was observed in the placebo group. Group N (negative control) showed a reduction of 48.52% for air stimuli and 28.34% for cold stimuli after 4 weeks of usage. Abrasive systems of various particle sizes, including precipitated silica particles and alumina, are present in commercially available toothpastes. The silica abrasive sizes in toothpastes were reported as 3.94–20.4 μmIn this clinical trial, Group TP exhibited better DH alleviation than the Group N against air-blast and cold stimuli. In addition, it showed similar effects to Group SC. TP is a biomaterial with a high potential for biological applicationsTP and SC exhibit synergistic DH alleviation with fluoride ionsAnother limitation of this study is that the concentration of the active ingredient for DH relief was not equal in both toothpastes (Group TP, 19% TP; Group SC, 10% SC) because commercial desensitizing toothpastes were evaluated in this study. Further studies with more controlled variables are required. There may be concerns regarding the four-week duration of our clinical trial. According to Bae et al.