Short-term Clinical Evaluation of Four Desensitizing Agents

Abstract

To evaluate the effectiveness of four topical desensitizing agents in providing short-term relief of dentin hypersensitivity. One hundred sixteen hypersensitive teeth with a positive response to intraoral testing for dentin hypersensitivity were included in this study. The four desensitizing agents tested were Duraphat, 2% fluoride iontophoresis, copal varnish (CV), and Gluma Comfort Bond Plus Desensitizer. Following a specific regimen randomly determined desensitizing agents were applied in an alternating order when patients presented in a clinical setting with a complaint of hypersensitive teeth. A visual analogue scale was used to determine the degrees of hypersensitivity at three points in time. The first being just before the treatment to establish a baseline, then at 24 hours post-treatment, and the last at seven days post-treatment. Differences in the mean pain scores (MPS) between the baseline and post-treatment evaluation periods were used to determine the reduction in dentin hypersensitivity. At baseline the MPS for teeth treated with CV was 5.34 (SD: 2.39), Duraphat was 4.66 (SD: 1.82), Gluma was 6.03 (SD: 2.37), and iontophoresis was 5.76 (SD: 1.37). At 24 hours post-treatment the MPS for CV was 2.1 (SD: 0.95), Duraphat was 1.38 (SD;1.86), Gluma was 0.79 (SD;1.45), and iontophoresis was 1.62 (SD1.97). The reduction in dentin hypersensitivity at 24 hours (difference between baseline MPS and 24 hour MPS) was 5.28 for Gluma, 4.14 for iontophoresis, 3.28 for Duraphat, and 3.24 for CV which were all statistically significant (p<0.05). At seven days, the MPS for CV was 1.55 (SD: 1.44), Duraphat was 1.0 (SD;1.89), Gluma was 0.10 (SD;0.44), and iontophoresis was 0.3 (SD;0.98). Reduction of hypersensitivity between 24 hours and one week was 1.32 for iontophoresis, 0.69 for Gluma, 0.55 for CV, and 0.38 for Duraphat. Only the reductions for iontophoresis and Gluma were statistically significant at seven days (p<0.05). All agents caused a statistically significant reduction in dentin hypersensitivity within 24 hours of treatment. Gluma performed best at 24 hours while iontophoresis appeared to have an edge at seven days. Long-term studies are needed to determine why this difference exists. Dentin hypersensitivity presents as an emergency condition requiring an effective means of providing immediate relief in the clinician's treatment armamentarium.