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Tooth wear and new technology to manage dentin hypersensitivity

SEM images showing the exposed dentinal tubules before Pro-Argin application, left, and the occlusion of the dentinal tubules post Pro-Argin application (under 10,000x magnification).
Fotinos Panagakos

Fotinos Panagakos

Wed. 17 March 2010


Dentin hypersensitivity is growing in incidence and can be a major concern for patients. The dentin is normally covered by enamel or cementum. As a result of a number of factors — e.g., abrasion or periodontal disease causing gingival recession, or erosion, the underlying dentin and dentin tubules can become exposed (See Figure 1).

An external stimulus, such as a change in external temperature, air movement, or physical stimulus can cause discomfort for the patient. The Hydrodynamic Theory explains that the pain is transmitted when the stimulus — i.e., pressure or ionic changes in the fluid flow exists in the dentin tubules.

Treatment and prevention methods
The treatment and prevention of dentin hypersensitivity has focused on eliminating the ability of the causative agent to stimulate discomfort via occlusion of the dentin tubules or desensitizing agents that interfere with transmission of nerve impulses.

Occluding agents act by physically covering or “plugging” the open, exposed dentin tubules, thus preventing the effect of thermal changes or physical stimuli caused by the movement of dentin fluid due to pressure changes. These agents can be applied professionally in the dental office or by the patient through the use of home care products.

Desensitizing agents work by altering the levels of charged molecules in the dentin fluid. The most commonly used agent is potassium nitrate, usually delivered in a dentifrice that is applied daily by the patient during regular tooth brushing. The potassium ions must pass from external dentin surface, through the dentin tubule to the pulp in order to reduce the excitation. Most of these products require continued use over a 4 to 8 week period before significant relief may be realized by the patient. In addition, use of the product often needs to be continued in order to maintain the relief afforded by the potassium ions/salts.

The breakthrough Pro-Argin technology to treat dentin hypersensitivity
Colgate-Palmolive introduced the new Pro-Argin technology for the treatment of dentin hypersensitivity. It is available as Colgate Sensitive Pro-Relief in-office desensitizing paste and Colgate Sensitive Pro-Relief toothpaste, both based on the Pro-Argin technology. The Pro-Argin technology consists of arginine, a naturally occurring amino acid, and an insoluble calcium compound, in the form of calcium carbonate. The arginine and calcium carbonate physically occlude the exposed dentin tubules, thus preventing the further movement of dentinal fluid in the tubules (see Figure 2).

Colgate Sensitive Pro-Relief in-office desensitizing paste with the Pro-Argin technology brings comfort to dental patients without compromising treatment efficacy. It is clinically proven to provide instant sensitivity relief that lasts for four weeks after a single application. It can be used before or after dental procedures, such as prophylaxis and scaling. When applied prior to a professional dental cleaning, this desensitizing paste will provide a significant reduction in dentin hypersensitivity measured immediately following the dental cleaning as compared to a control prophylaxis paste.

Colgate Sensitive Pro-Relief in-office desensitizing paste are delivered in a prophy paste containing a mild abrasive system, and can be applied with a prophylaxis cup to teeth that exhibit dentin hypersensitivity (See Figure 3).

Mechanism of action studies have shown that this technology physically seals dentin tubules with a plug that contains arginine, calcium, carbonate, and phosphate. This plug, which is resistant to normal pulpal pressures and to acid challenge, effectively reduces dentin fluid flow and, thereby, reduces sensitivity.

Colgate Sensitive Pro-Relief toothpaste with Pro-Argin technology is the first and only toothpaste clinically proven to deliver instant and lasting sensitivity relief. Colgate Sensitive Pro-Relief toothpaste effectively plugs the channels that lead to sensitive tooth nerves, thereby blocking the transmission of heat, cold, air and pressure. Colgate Sensitive Pro-Relief toothpaste can also be directly applied to a sensitive area of a tooth, using the finger tip by massaging gently for one minute, to deliver instant relief from sensitivity as proven in clinical study. And regular brushing with Colgate Sensitive Pro-Relief toothpaste builds a long-lasting protective barrier that acts like a seal against sensitivity (See Figure 4).

Clinicians encounter patients with dentin hypersensitivity on a regular basis. While every patient is different, dentin hypersensitivity is an indication that can be managed. Colgate Sensitive Pro-Relief in-office desensitizing paste and Colgate Sensitive Pro-Relief toothpaste with Pro-Argin technology are the newest treatment options for dentin hypersensitivity.

Fotinos Panagakos, DMD, PhD, is director of clinical research relations and strategy at Colgate-Palmolive Co.

Attend Dr Fotinos Panagakos’s CE accredited lecture!
On 17 April 2010, Dr Fotinos Panagakos will give a 90-minute lecture to a live audience at IDEM in Singapore (11 a.m. to 12:30 p.m. local Singapore time). At the same time, DTSC will broadcast his lecture live online, for those who cannot make the trip to Singapore (on 16 April, from 11 p.m. to 12:30 a.m. EST; 17 April, from 5 to 6:30 a.m. German time).

Dr Panagakos will share his expertise on “Tooth Wear and New Technology to Manage Dentin Hypersensitivity.” Participants will learn that dentinal hypersensitivity is a common and growing problem. It is an acute condition that is most typically associated with exposure of the root surface through recession of the gum line. There are two primary approaches to treating sensitive teeth. Find out what these are on April 17!

In this presentation, an overview of dentinal hypersensitivity will be provided. The various treatment options for managing dentinal hypersensitivity will be reviewed and a new in-office dentinal hypersensitivity treatment with clinically documented efficacy, Pro Argin, containing arginine and calcium, will be introduced.

Join us to find out about Tooth Wear and New Technology to Manage Dentin Hypersensitivity! You will find us at IDEM at J30 and online under

Participants will receive one ADA CERP C.E. credit. Attendance, for both live attendees visiting IDEM, as well as online attendees, is FREE. The archived lecture will be made available thereafter, for a fee, to review at your convenience. Please register under > Online Courses > Symposia at IDEM.

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