Dentin Sensitivity
Conditions
Brief summary
Subjects will be enrolled into 3 balanced groups each using a different strength toothpaste. Dental hypersensitivity (DHS) will be assessed at study start, midway and study end.
Detailed description
This study is a double-blind, randomized, placebo-and positive-controlled, stratified parallel group clinical trial. The three groups will be randomly assigned to use one of three test toothpastes having an identical base formulation but containing respectively either 0% nano-hydroxyapatite (HAP) (placebo), 15% nano-HAP or 5% KNO3 (positive control). All dental examinations for data collection will be conducted by the same Clinical Examiner.
Interventions
0% nano-HAP toothpaste
Toothpaste with identical base formulation as the placebo containing 15% nano-HAP
Toothpaste with identical base formulation as the placebo containing 5% KNO3
Sponsors
Study design
Eligibility
Inclusion criteria
* Males or females between the age of 20 and 80 years, of any socio-economic status * Diagnosed as having DHS, i.e. having at least one sensitive tooth with demonstrated cervical erosion/abrasion or gingival recession * Showing a sensitivity response to both tactile and cold air stimulus delivered by a Yeaple probe and a one-second blast of cold air respectively * Patients must be reliable, cooperative and of adequate intelligence to read and understand the rating scales and other study instructions * Patients must be able to read, comprehend, and sign the informed consent form * The teeth and sites to be tested should be on the buccal/labial surfaces of incisors, canines, premolars or molars where the affected sites are accessible * Teeth selected for testing should have a plaque index of ≤ 2
Exclusion criteria
* The sensitive tooth is associated with concomitant oral pain due to any other condition such as soft-tissue lesions, tooth-ache ascribable to dental caries, tooth fracture, or cracked tooth syndrome, or pain due to other surgical procedures or injuries. * The sensitive tooth is associated with a periodontal abscess as diagnosed from an X-ray or clinical examination of the tooth * The sensitive tooth is associated with mobility \>1 * The sensitive tooth is associated with gum pain from gingivitis, occlusal trauma, thermal or chemical burns * Patients having pain from periodontal-related causes but not DHS * Previous professional desensitizing treatment * Patients using medication which could interfere with the perception of pain * Medical histories marked by chronic use of anti-inflammatory agents, daily analgesics, anticonvulsants, antihistamines, antidepressants, sedatives and/or other psychotropic drugs * Pregnancy or breastfeeding * Allergies and idiosyncratic responses to toothpaste ingredients * Eating disorders or conditions associated with vomiting * Systemic conditions that are etiologic or predisposing to DHS * Excessive dietary or environmental exposure to acids * The sensitive tooth was restored in the preceding three months * The sensitive tooth is an abutment tooth for fixed or removable prostheses * The sensitive tooth has extensive restoration or restorations extending into the test area * Patients below 20 years or above 80 years of age * Smokers
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Measurement of Cold Air Stimulus | Week 0 (baseline), 4 weeks and 8 weeks | The primary efficacy outcome will be the decrease in cold air stimulus sensitivity (VAS score) from baseline to 8 weeks. Assessment of change in cold air sensitivity will be conducted using air delivered from a standard dental unit air syringe at room temperature (\ 70°F±3°F)(\ 21°C±2°C) and a pressure of 60psi (± 5psi). Assessment of sensitivity will be carried out using Visual Analog Scale (VAS). Tooth sensitivity was measured using a Cold Air Stimulus. When being assessed, participants rated their perception of the pain/discomfort experienced when cold air was directed at the exposed root of each tooth by marking a single vertical line on a Visual Analogue Scale (VAS) scale from 0 to 100 mm, where 0 = No Pain/Discomfort and 100 = Intense Pain/Discomfort. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Measurement of Tactile Stimulus | Week 0 (baseline), 4 weeks and 8 weeks | The secondary efficacy outcome will be the increase in tactile stimulus force from baseline to 8 weeks. Assessment of Change in tactile sensitivity will be assessed using the Yeaple Electronic Force Sensing Probe.The explorer tip will be applied perpendicular to the tooth surface and a pressure load applied starting at 10 g and increasing to 80g. The load at which the subject says yes will be recorded. (Baseline screening will begin at 30g). |
Countries
United States
Participant flow
Recruitment details
Subjects were consented and enrolled, then for one month there was a washout period. Baseline characteristic measurements were taken prior to washout for both Cold Air Sensitivity and Tactile Stimulus.
Participants by arm
| Arm | Count |
|---|---|
| Toothpaste 1 Toothpaste 1 containing 0% nano-hydroxyapatite (HAP) will be used by subjects to brush their teeth twice daily for 3 minutes in the morning and before bed each night using a 1 inch strip of toothpaste on a soft-bristled toothbrush.
Placebo: 0% nano-HAP toothpaste | 62 |
| Toothpaste 2 Toothpaste 2 containing 15% nano-HAP will be used by subjects to brush their teeth twice daily for 3 minutes in the morning and before bed each night using a 1 inch strip of toothpaste on a soft-bristled toothbrush.
15% nano-HAP toothpaste: Toothpaste with identical base formulation as the placebo containing 15% nano-HAP | 59 |
| Toothpaste 3 Toothpaste 3 containing 5% potassium nitrate (KNO3) will be used by subjects to brush their teeth twice daily for 3 minutes in the morning and before bed each night using a 1 inch strip of toothpaste on a soft-bristled toothbrush.
5% KNO3 toothpaste: Toothpaste with identical base formulation as the placebo containing 5% KNO3 | 62 |
| Total | 183 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 | FG002 |
|---|---|---|---|---|
| Treatment Period | Lost to Follow-up | 2 | 5 | 0 |
| Treatment Period | Physician Decision | 0 | 0 | 2 |
Baseline characteristics
| Characteristic | Toothpaste 1 | Toothpaste 2 | Toothpaste 3 | Total |
|---|---|---|---|---|
| Age, Continuous | 47 years STANDARD_DEVIATION 16 | 47 years STANDARD_DEVIATION 16 | 50 years STANDARD_DEVIATION 14 | 48 years STANDARD_DEVIATION 15 |
| Cold Air Sensitivity (VAS) | 69 units on a scale STANDARD_DEVIATION 20 | 67 units on a scale STANDARD_DEVIATION 16 | 65 units on a scale STANDARD_DEVIATION 18 | 67 units on a scale STANDARD_DEVIATION 18 |
| Race/Ethnicity, Customized Asian | 15 Participants | 4 Participants | 12 Participants | 31 Participants |
| Race/Ethnicity, Customized Black (not Hispanic) | 3 Participants | 2 Participants | 1 Participants | 6 Participants |
| Race/Ethnicity, Customized Hispanic | 30 Participants | 28 Participants | 26 Participants | 84 Participants |
| Race/Ethnicity, Customized White (not Hispanic) | 14 Participants | 25 Participants | 23 Participants | 62 Participants |
| Region of Enrollment United States | 62 participants | 59 participants | 62 participants | 183 participants |
| Sex: Female, Male Female | 44 Participants | 43 Participants | 43 Participants | 130 Participants |
| Sex: Female, Male Male | 18 Participants | 16 Participants | 19 Participants | 53 Participants |
| Tactile (g) | 15 grams STANDARD_DEVIATION 7 | 15 grams STANDARD_DEVIATION 7 | 16 grams STANDARD_DEVIATION 7 | 15.3 grams STANDARD_DEVIATION 7 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | 0 / 64 | 0 / 64 | 0 / 64 |
| other Total, other adverse events | 0 / 64 | 0 / 64 | 0 / 64 |
| serious Total, serious adverse events | 0 / 64 | 0 / 64 | 0 / 64 |
Outcome results
Measurement of Cold Air Stimulus
The primary efficacy outcome will be the decrease in cold air stimulus sensitivity (VAS score) from baseline to 8 weeks. Assessment of change in cold air sensitivity will be conducted using air delivered from a standard dental unit air syringe at room temperature (\ 70°F±3°F)(\ 21°C±2°C) and a pressure of 60psi (± 5psi). Assessment of sensitivity will be carried out using Visual Analog Scale (VAS). Tooth sensitivity was measured using a Cold Air Stimulus. When being assessed, participants rated their perception of the pain/discomfort experienced when cold air was directed at the exposed root of each tooth by marking a single vertical line on a Visual Analogue Scale (VAS) scale from 0 to 100 mm, where 0 = No Pain/Discomfort and 100 = Intense Pain/Discomfort.
Time frame: Week 0 (baseline), 4 weeks and 8 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Toothpaste 1 | Measurement of Cold Air Stimulus | Week 4 | 51.1 units on a scale | Standard Deviation 1.84 |
| Toothpaste 1 | Measurement of Cold Air Stimulus | Week 8 | 35.6 units on a scale | Standard Deviation 1.9 |
| Toothpaste 1 | Measurement of Cold Air Stimulus | Week 0 (Baseline) | 71.4 units on a scale | Standard Deviation 1.4 |
| Toothpaste 2 | Measurement of Cold Air Stimulus | Week 8 | 37.7 units on a scale | Standard Deviation 2.19 |
| Toothpaste 2 | Measurement of Cold Air Stimulus | Week 0 (Baseline) | 72.2 units on a scale | Standard Deviation 1.47 |
| Toothpaste 2 | Measurement of Cold Air Stimulus | Week 4 | 51.9 units on a scale | Standard Deviation 2.28 |
| Toothpaste 3 | Measurement of Cold Air Stimulus | Week 4 | 62 units on a scale | Standard Deviation 2 |
| Toothpaste 3 | Measurement of Cold Air Stimulus | Week 0 (Baseline) | 71.9 units on a scale | Standard Deviation 1.61 |
| Toothpaste 3 | Measurement of Cold Air Stimulus | Week 8 | 48.4 units on a scale | Standard Deviation 2.21 |
Measurement of Tactile Stimulus
The secondary efficacy outcome will be the increase in tactile stimulus force from baseline to 8 weeks. Assessment of Change in tactile sensitivity will be assessed using the Yeaple Electronic Force Sensing Probe.The explorer tip will be applied perpendicular to the tooth surface and a pressure load applied starting at 10 g and increasing to 80g. The load at which the subject says yes will be recorded. (Baseline screening will begin at 30g).
Time frame: Week 0 (baseline), 4 weeks and 8 weeks
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Toothpaste 1 | Measurement of Tactile Stimulus | 4 Weeks | 23.6 Grams | Standard Deviation 1.15 |
| Toothpaste 1 | Measurement of Tactile Stimulus | 0 weeks (Baseline) | 13.7 Grams | Standard Deviation 0.48 |
| Toothpaste 1 | Measurement of Tactile Stimulus | 8 weeks | 31.7 Grams | Standard Deviation 1.58 |
| Toothpaste 2 | Measurement of Tactile Stimulus | 4 Weeks | 23.2 Grams | Standard Deviation 1.37 |
| Toothpaste 2 | Measurement of Tactile Stimulus | 0 weeks (Baseline) | 14.1 Grams | Standard Deviation 0.57 |
| Toothpaste 2 | Measurement of Tactile Stimulus | 8 weeks | 28.7 Grams | Standard Deviation 1.77 |
| Toothpaste 3 | Measurement of Tactile Stimulus | 0 weeks (Baseline) | 14.8 Grams | Standard Deviation 0.57 |
| Toothpaste 3 | Measurement of Tactile Stimulus | 8 weeks | 22.9 Grams | Standard Deviation 1.27 |
| Toothpaste 3 | Measurement of Tactile Stimulus | 4 Weeks | 17.7 Grams | Standard Deviation 1.06 |