ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Tooth Pastes Containing Potassium Remain An Effective Standard In Reducing Dentin Hypersensitivity, Although Newer Products May Be More Effective
Clinical Question When treating patients with dentin hypersensitivity, how well do tooth pastes containing potassium nitrate relieve symptoms compared to other treatments?
Clinical Bottom Line Tooth pastes with potassium nitrate can effectively relieve the symptoms of dentin hypersensitivity in some patients; however, no clear research has proven it effective. Also newer products containing arginine, calcium carbonate and fluoride could be more immediate and effective.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 16855970Poulsen/2006Review of articles up till 2005Meta-Analysis
Key resultsTooth pastes containing 5% potassium nitrate significantly reduce sensitivity to tactile, air blast, and thermal stimuli (p < .05 in all categories) compared to tooth pastes without it, although no significant reduction was noted in subjective assessments of patient perception.
#2) 11203743Orchardson/2000Review of articlesSystematic Review of RCTs
Key resultsThere is evidence that tooth pastes containing potassium nitrate are more effective in reducing sensitivity than placebo pastes, however they are not proven to be more effective then other active pastes.
#3) 21284246Cummins/2010Review of articlesNarrative Review
Key resultsTooth pastes containing arginine, calcium carbonate and fluoride have been shown to relieve sensitivity more effectively and more quickly than pastes containing potassium nitrate or placebo.
Evidence Search ("Dentin Sensitivity"[Majr] AND "potassium nitrate"[Supplementary Concept]) AND Review[ptyp]
Comments on
The Evidence
All three articles reviewed randomized trials that showed potassium nitrate reduces sensitivity. The Poulsen article included a meta-analysis showing potassium nitrate to significantly (p<.05) reduce sensitivity in tactile, thermal, and air blast tests. The other two reviews included data from randomized trials, but the articles were more narrative in nature and would be weaker evidence than a meta-analysis.
Applicability This CAT applies to anyone treating a patient that suffers from dentin hypersensitivity.
Specialty/Discipline (General Dentistry)
Keywords Dentin sensitivity, Potassium, toothpaste
ID# 2209
Date of submission: 04/11/2012spacer
E-mail klingsporn@livemail.uthscsa.edu
Author Garrett Klingsporn
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Suman Challa, BDS, MS
Faculty mentor/Co-author e-mail challas@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
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by Jennifer Diep and Lili Paz (San Antonio, Tx) on 12/01/2017
A PubMed search conducted on 11/27/17 found three articles that support and clarify Klingsporn's original findings in 2012. Bae's systematic review and meta-analysis published in 2015 (PMID #25483802) reviewed 31 randomized control trials and found that there is sufficient evidence to support the use of potassium containing toothpastes for reducing dental hypersensitivity, which corroborates what Klingsporn found in 2012. While potassium nitrate is effective at reducing hypersensitivity, both Kakar and Elias Boneta's RCTs confirm that newer products such as arginine and calcium carbonate are indeed more effective than potassium nitrate. In Kakar's 2012 (PMID #22779216) RCT study, use of an arginine, calcium carbonate, and fluoride dentifrice showed greater efficacy of the arginine compound in patient hypersensitivity reduction when exposed to air blast and tactile stimuli compared a potassium nitrate dentifrice (control group) at 2, 4, and 8 weeks. Likewise, in a similar RCT by Elias Boneta in 2013 (PMID #23380274) in which 120 subjects were tested, an arginine toothpaste was again pitted against potassium nitrate and again resulted in greater hypersensitivity reduction and faster relief than potassium.
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