Hydroxyapatite in Oral Care Products—A Review

Calcium phosphate compounds form the inorganic phases of our mineralised tissues such as bone and teeth, playing an important role in hard tissue engineering and regenerative medicine. In dentistry and oral care products, hydroxyapatite (HA) is a stable and biocompatible calcium phosphate with low solubility being used for various applications such as tooth remineralisation, reduction of tooth sensitivity, oral biofilm control, and tooth whitening. Clinical data on these products is limited with varied results; additionally, the effectiveness of these apatite compounds versus fluoride, which has conventionally been used in toothpaste, has not been established. Therefore, this review critically evaluates current research on HA oral care, and discusses the role and mechanism of HA in remineralisation of both enamel and dentine and for suppressing dentine sensitivity. Furthermore, we position HA’s role in biofilm management and highlight the role of HA in dental applications by summarising the recent achievement and providing an overview of commercialised HA dental products. The review also indicates the existing limitations and provides direction for future research and commercialisation of apatite-based oral care products.

Tooth desensitizing calcium phosphate composite gelatin-based gel

Dentine sensitivity is a dental problem common in individuals aged between 20 and 50 years. The most effective treatment method involves occluding the exposed dental tubules. This study focused on the synthesis of calcium phosphate nanoparticles in the form of gel to use as a proof of concept for home-treatment of sensitive teeth. In this study, calcium phosphate nanoparticles were prepared using emulsion method, in which oleic fatty acid was employed as an external phase, and sodium dodecyl sulphate (SDS) was used as a surfactant to form water-in-oil nanodroplets. Finally, in order to facilitate gel formation, the gelatin solution was introduced at the final step. The amount of gelatin varied from 5 to 15 percent by weight, which was found to have an effect on the gels’ properties and the size of calcium phosphate nanoparticles embedded in gel. Based on the characterization, the calcium phosphate nanoparticles were spherical in shape, though the size decreased as the amount of gelatin increased. The gel embedding smallest nanoparticle, that is, gel-15%G, was successfully proven to be non-toxic and able to fully occlude the dentine tubules only after overnight application. According to acid challenge, the occluded materials can resist to acid solution via redissolvation and reprecipitaion process.

A Survey of Dentists in the Management of Dentine Hypersensitivity: A Questionnaire-based Study

Objective Previous studies have indicated that dentists may be uncertain about the etiology, diagnosis, and effective management of dentine sensitivity/dentine hypersensitivity (DH). The purpose of the present study was to evaluate the knowledge and understanding of Greece-based dental professionals in treating DH. Materials and Methods A 26-item questionnaire was sent to a representative sample of Greek dentists. Results Two hundred thirty questionnaires were originally provided to the participants and of the 210 questionnaires that were returned, 191 questionnaires (90 M; 86 F; mean age 36.26 years [standard deviation: 11.34]) were included for analysis, a response rate of 83% was observed. 39.8% of dentists indicated that 1 in 10 of their patients experienced discomfort from DH with 76.4% of dentists indicating that their patients initiated the conversation on DH. In contrast, 44% of the dentists indicated that they initiated the relevant conversation. 34.9% of dentists indicated that the duration of discomfort lasted up to 3 weeks and 76.4% indicated that DH had an impact on their patients’ quality of life. Incorrect tooth brushing was considered to be a major etiological factor (68.6%) with “air blast” (37.3%) and “probing” (15%) as the main methods for identification. 83.6% of dentists indicated that they were confident in recommending over-the-counter products for home use. Conclusion The results of this study suggest that in terms of knowledge and understanding of DH, there is still confusion concerning some aspects of the diagnosis and management of the condition.

Dental Pain: Dentine Sensitivity, Hypersensitivity and Cracked Tooth Syndrome

Dentine hypersensitivity is a frequently encountered patient complaint that can present with a number of associated factors including erosion and abrasion. The hydrodynamic mechanism responsible for dentine hypersensitivity is intimately related to the anatomical and physiological composition of teeth. Alterations to the integrity of the enamel and dentine through processes of trauma, decay and toothwear can increase dentine permeability. This gives rise to symptoms of sensitivity as dentinal fluid movement in response to thermal, chemical and mechanical cues stimulate the pulpal Aδ fibres. Restorative procedures can also rapidly change the architecture of the protective enamel and dentine layers leading to pulpal inflammation and increased thermal sensitivity of the tooth. Patient-reported symptoms of dentine hypersensitivity can be attributed to a number of possible causes and a definitive diagnosis can therefore be difficult. A full history including social and medical factors such as occupation, diet and/or medication is likely to provide significant information to aid a diagnosis. Consideration of occlusal factors should not be overlooked as these may contribute to symptoms arising from a cracked tooth. Management strategies are linked to the diagnosis – from topically applied desensitising pastes and resin bonding agents to direct restorations and possibly more advanced restorative procedures such as root canal treatment. Management should, however, be staged to enable more conservative strategies to prevail prior to considering irreversible dental interventions.

Enhancing Fluoride Mediated Dentine Sensitivity Relief through Functionalised Tricalcium Phosphate Activity

Background. To assess the clinical efficacy of a dentifrice containing fluoride and functionalised tricalcium phosphate (fTCP) in reducing dentine sensitivity. Methods. A 10-week parallel blind randomised control trial was conducted. Subjects were assigned to one of four groups and instructed to brush twice daily: A: Colgate Cavity Protection (1000 ppmF-MFP); B: Sensodyne Total Care (1000 ppmF-NaF + 19300 ppmK+-KNO3); C: Clinpro Tooth Crème (950 ppmF-NaF + fTCP); and D: Clinpro Tooth Crème (brushing + additional topical application). Seventy-one patients were assessed at baseline, 6 weeks, and 10 weeks for cold, tactile, and hypertonic sensitivity using the NRS-11 pain rating scale. A combined modalities sensitivity score (CMS) was calculated. Results. At 6 weeks, patients reported the following reduction in CMS: A (20%); B (30%); C (42%); D (52%). At 10 weeks, patients reported the following reduction in CMS: A (18%), B (40%), C (24%), and D (54%). The only CMS comparisons to show a significant difference (P<0.05) were between Groups A and D (6 and 10 weeks). Conclusions. Addition of fTCP to a dentifrice enhances the ability of dentifrice fluoride in reducing dentine sensitivity. Using Clinpro Tooth Crème twice daily for brushing can be as effective to reduce dentine sensitivity as twice daily brushing using Sensodyne Total Care. However, additional nightly topical application of fTCP, in addition to twice daily brushing, showed an enhanced reduction in dentine sensitivity.