Abstract
Objective:This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH).Methodology:In total, 138 RCTs and their tested toothpastes were included. Searches were updated up to August 19, 2021. Formulations, reported brands, active ingredients over time, and type of fluoride (ionizable or ionic fluoride) and abrasive (calcium or silica-based) were analyzed (PROSPERO #CRD42018086815).Results:Our trials assessed 368 toothpaste formulations, including 34 placebo (9%), 98 control toothpastes with fluoride (27%), and 236 (64%) with active ingredients to treat DH. We tested the following active ingredients: potassium compounds (n=68, 19%), calcium sodium phosphosilicate (CSP) (n=37, 10%), strontium compounds (n=28, 8%), arginine (n=29, 8%), stannous fluoride (SnF2) (n=21, 6%), hydroxyapatite (n=9, 2%), potassium combined with another active ingredient (n=19, 5%), inorganic salt compounds (n=11, 3%), citrate (n=5, 1%), formaldehyde (n=3, 1%), herbal (n=4, 1%), copolymer (n=1, 0.5%), and trichlorophosphate (TCP) (n=1, 0.5%). The number of toothpaste formulations increased since 1968, with the greatest increment after 2010. Most toothpastes described their type of fluoride as sodium monofluorphosphate (MFP) (n=105, 29%) and NaF (n=82, 22%), with silica-based (n=84, 23%) and calcium-based (n=64, 17%) abrasives.Conclusion:Patients and dentists enjoy an increasing number of brands and active ingredients to decide what desensitizing toothpaste to use. The most common types of fluoride are MFP and NaF.
Highlights
Formulations of desensitizing toothpastes for dentin hypersensitivity: a scoping review
This study aimed to review evidence from randomized controlled trials (RCTs) to describe: 1) the active ingredients and desensitizing toothpaste brands; 2) the evaluation of these active ingredients over time, and 3) the fluoride and abrasive content in the formulations designed to treat dentin hypersensitivity (DH)
Trials included 368 toothpastes assessed between 1968 and 2021: 236 (64%) had active ingredients against DH, 98 (27%) were fluoride toothpastes used as control, and 34 (9%) were placebo toothpastes
Summary
Toothpaste brands have added several active ingredients to their products, depending on their purpose: anti-caries, antiplaque, antigingivitis, anti-malodor, antitartar, and whitening agents. Other purposes include, among others, adding more efficacious active ingredients to decrease pain from dentin hypersensitivity (DH). A recent systematic review of 125 randomized clinical trials (RCTs), which included a network meta-analysis (NMA) of 90 RCTs, concluded that calcium sodium phosphosilicate (CSP), stannous fluoride (SnF2) and potassium compounds in combination with hydroxyapatite or SnF2 were the most effective active ingredients against tactile and air stimuli with a high to moderate certainty of evidence.. Ongoing studies with published data available were considered in updating this review on Clinical Trials and ICRTIP. An Excel form, previously created and assessed from our prior reviews, was used to extract data, regarding: year of publication, number of trials, number of toothpastes evaluated, type of active ingredient, concentration, brands, and type of fluoride and abrasive. The corresponding brands reported by the trials, were ranked according to their effectiveness, as per our previous systematic review. Ionizable fluoride can usually be combined with calcium-based or silicabased formulations; and ionic fluoride can be combined with silica-based abrasives, but not with calcium-based formulations which would prevent the inactivation of the fluoride.
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