Effectiveness of various toothpastes on dentine tubule occlusion W.H. Arnold * , M. Prange, E.A. Naumova Department of Biological and Material Sciences in Dentistry, Witten/Herdecke University, Witten, Germany 1. Introduction As the demographics of the human population change and as the human population ages, more teeth remain in the mouths of elderly people due to effective caries prevention and periodontal disease management. Thus, dentine hypersensi- tivity is becoming an increasing problem in dentistry. 1,2 Dentine hypersensitivity and a possible cause for this condition were described first by Gysi in 1900. 3 Since then, the mechanisms causing this type of pain have remained controversial. Pulpal nerves from the plexus of Raschkow extend into approximately 15% of the dentine tubule length. 4 These nerves do not innervate the peripheral dentine. Odontoblast processes may function as sensory receptors; however, odontoblast destruction does not cause insensitive j o u r n a l o f d e n t i s t r y x x x ( 2 0 1 5 ) x x x – x x x a r t i c l e i n f o Article history: Received 22 December 2014 Received in revised form 29 January 2015 Accepted 31 January 2015 Available online xxx Keywords: Toothpaste Dentine Dentine tubules Root dentine Hypersensitivity a b s t r a c t Objective: Dentine hypersensitivity is an increasing problem in dentistry. Several products are available that claim to occlude open dentine tubules and to reduce dentine hypersensi- tivity. The aim of this study was to investigate the effectiveness of several different products on dentine tubule occlusion using qualitative and quantitative methods. Materials and methods: Dentine discs were prepared from extracted human premolars and molars. The dentine discs were brushed with 6 different experimental toothpastes, 1 positive control toothpaste and 1 negative control without toothpaste; the brushing simu- lated a total brushing time of 1 year. Half of the discs were etched with lemon juice after toothpaste application. Standardized scanning electron microphotographs were taken and converted into binary black and white images. The black pixels, which represented the open dentine tubules, were counted and statistically evaluated. Then, half of the dentine discs were broken, and the occlusion of the dentine tubules was investigated using energy dispersive X-ray spectroscopy (EDS). Results: The number of open dentine tubules decreased significantly after brushing with 5 of the 6 tested toothpastes. A significant effect was observed after acid erosion for 3 of the 6 tested toothpastes. EDS revealed partly closed dentine tubules after brushing with 3 tooth- pastes; however, no partly closed dentine tubules were observed after acid erosion. Conclusions: Some toothpastes are capable of partial dentine tubule occlusion. This occlu- sion is unstable and can be removed with acid erosion. Clinical significance: Desensitizing toothpastes are the most common products that are used against dentine hypersensitivity, and these toothpastes affect dentine tubule occlusion. # 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). * Corresponding author at: Department of Biological and Material Sciences in Dentistry, Alfred Herrhausenstrasse 44, 58455 Witten, Germany. Tel.: +49 2302926658; fax: +49 2302926661. E-mail address: [email protected](W.H. Arnold). JJOD-2418; No. of Pages 10 Please cite this article in press as: Arnold WH, et al. Effectiveness of various toothpastes on dentine tubule occlusion. Journal of Dentistry (2015), http://dx.doi.org/10.1016/j.jdent.2015.01.014 Available online at www.sciencedirect.com ScienceDirect journal homepage: www.intl.elsevierhealth.com/journals/jden http://dx.doi.org/10.1016/j.jdent.2015.01.014 0300-5712/# 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http:// creativecommons.org/licenses/by-nc-nd/4.0/).
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JJOD-2418; No. of Pages 10
Effectiveness of various toothpastes on dentinetubule occlusion
W.H. Arnold *, M. Prange, E.A. Naumova
Department of Biological and Material Sciences in Dentistry, Witten/Herdecke University, Witten, Germany
j o u r n a l o f d e n t i s t r y x x x ( 2 0 1 5 ) x x x – x x x
a r t i c l e i n f o
Article history:
Received 22 December 2014
Received in revised form
29 January 2015
Accepted 31 January 2015
Available online xxx
Keywords:
Toothpaste
Dentine
Dentine tubules
Root dentine
Hypersensitivity
a b s t r a c t
Objective: Dentine hypersensitivity is an increasing problem in dentistry. Several products
are available that claim to occlude open dentine tubules and to reduce dentine hypersensi-
tivity. The aim of this study was to investigate the effectiveness of several different products
on dentine tubule occlusion using qualitative and quantitative methods.
Materials and methods: Dentine discs were prepared from extracted human premolars and
molars. The dentine discs were brushed with 6 different experimental toothpastes, 1
positive control toothpaste and 1 negative control without toothpaste; the brushing simu-
lated a total brushing time of 1 year. Half of the discs were etched with lemon juice after
toothpaste application. Standardized scanning electron microphotographs were taken and
converted into binary black and white images. The black pixels, which represented the open
dentine tubules, were counted and statistically evaluated. Then, half of the dentine discs
were broken, and the occlusion of the dentine tubules was investigated using energy
dispersive X-ray spectroscopy (EDS).
Results: The number of open dentine tubules decreased significantly after brushing with 5 of
the 6 tested toothpastes. A significant effect was observed after acid erosion for 3 of the 6
tested toothpastes. EDS revealed partly closed dentine tubules after brushing with 3 tooth-
pastes; however, no partly closed dentine tubules were observed after acid erosion.
Conclusions: Some toothpastes are capable of partial dentine tubule occlusion. This occlu-
sion is unstable and can be removed with acid erosion.
Clinical significance: Desensitizing toothpastes are the most common products that are used
against dentine hypersensitivity, and these toothpastes affect dentine tubule occlusion.
# 2015 The Authors. Published by Elsevier Ltd. This is an open access article under the CC
Fig. 3 – Boxplot graphics of the quantitative determination of open dentine tubules after tooth brushing. Comparison with
the reference toothpaste (positive control). Significant differences were observed between the controls and toothpastes 2, 3,
4, 5 and 6.
Fig. 4 – Boxplot graphics of the quantitative determination of open dentine tubules after tooth brushing and acid etching.
Comparison with the negative control (without toothpaste). Significant differences were observed between the control and
toothpastes 1, 2, 4, and 6.
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Please cite this article in press as: Arnold WH, et al. Effectiveness of various toothpastes on dentine tubule occlusion. Journal of Dentistry (2015),http://dx.doi.org/10.1016/j.jdent.2015.01.014
Fig. 6 – Cross-sections of dentine discs with dentine tubule occlusion. The toothpastes are identified by EDS silicon mapping
(pink). Ca is mapped in blue. A weak positive signal for silicon is visible on the surface but not in the tubule openings after
treatment with toothpastes 1, 2 and 7. No signal could be detected after treatment with toothpastes 3, 5, and 6. Several
dentine tubules were occluded after treatment with toothpaste 4.
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Please cite this article in press as: Arnold WH, et al. Effectiveness of various toothpastes on dentine tubule occlusion. Journal of Dentistry (2015),http://dx.doi.org/10.1016/j.jdent.2015.01.014
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A relatively new method is arginine-calcium carbonate
technology (Pro-Argin technology), which was introduced in
2002.68 Several in vitro studies demonstrated a good occluding
effect of Pro-Argin technology on open dentine tubules.34,69–72
Clinical studies of Pro-Argin technology supported the in vitro
results and showed instant relief of dentine hypersensitivi-
ty.24,73
Currently, no in vitro or in vivo studies regarding the
occluding effects of zinc-carbonate hydroxyapatite on dentine
tubules are available; only reports regarding the effects of
zinc-carbonate hydroxyapatite on enamel have been pub-
lished. Several occluded dentine tubules could be found in the
dentine cross-sections after zinc-carbonate hydroxyapatite
treatment (toothpaste # 4) in the present study. This finding
was supported by the surface scan results, and this occluding
effect was not resistant to acid challenge with lemon juice.
5. Conclusion
Taken together, these results indicate that certain toothpastes
occlude dentine tubules. This occlusion is superficial and may
be dissolved with acids. Dentine tubule occlusion is dependent
on the active ingredient and is not complete in any of the
tested toothpastes.
Acknowledgments
The authors would like to thank Mrs. Susanne Haußman for
her technical assistance preparing the SEM specimens. Elmex
toothpaste was provided by CP Gaba, Hamburg, Germany.
r e f e r e n c e s
1. Addy M, West NX. The role of toothpaste in the aetiologyand treatment of dentine hypersensitivity. Monographs inOral Science 2013;23:75–87.
2. Cummins D. Dentin hypersensitivity: from diagnosis to abreakthrough therapy for everyday sensitivity relief. Journalof Clinical Dentistry 2009;20:1–9.
3. Gysi A. An attempt to explain the sensitivness of dentine.British Journal of Dental Science 1900;43:865–8.
4. Byers MR, Dong WK. Autoradiographic location of sensorynerve endings in dentin of monkey teeth. The AnatomicalRecord 1983;205:441–54.
5. Hirvonen TJ, Narhi MV. The effect of dentinal stimulation onpulp nerve function and pulp morphology in the dog. Journalof Dental Research 1986;65:1290–3.
6. Lilja J, Nordenvall KJ, Branstrom M. Dentin sensitivity,odontoblasts and nerves under desiccated or infectedexperimental cavities. A clinical, light microscopic andultrastructural investigation. Swedish Dental Journal 1982;6:93–103.
7. Byers MR, Kish SJ. Delineation of somatic nerve endings inrat teeth by radioautography of axon-transported protein.Journal of Dental Research 1976;55:419–25.
8. Brannstrom M, Astrom A. The hydrodynamics of thedentine; its possible relationship to dentinal pain.International Dental Journal 1972;22:219–27.
9. Brannstrom M, Linden LA, Johnson G. Movement of dentinaland pulpal fluid caused by clinical procedures. Journal ofDental Research 1968;47:679–82.
Please cite this article in press as: Arnold WH, et al. Effectiveness of variouhttp://dx.doi.org/10.1016/j.jdent.2015.01.014
10. Matthews B, Vongsavan N. Interactions between neural andhydrodynamic mechanisms in dentine and pulp. Archives ofOral Biology 1994;39:87S–95S.
11. Markowitz K, Pashley DH. Discovering new treatments forsensitive teeth: the long path from biology to therapy.Journal of Oral Rehabilitation 2008;35:300–15.
12. Petersson LG. The role of fluoride in the preventivemanagement of dentin hypersensitivity and root caries.Clinical Oral Investigations 2013;17:S63–71.
13. Petrou I, Heu R, Stranick M, Lavender S, Zaidel L, CumminsD, et al. A breakthrough therapy for dentin hypersensitivity:how dental products containing 8% arginine and calciumcarbonate work to deliver effective relief of sensitive teeth.Journal of Clinical Dentistry 2009;20:23–31.
14. Absi EG, Addy M, Adams D. Dentine hypersensitivity. Thedevelopment and evaluation of a replica technique to studysensitive and non-sensitive cervical dentine. Journal ofClinical Periodontology 1989;16:190–5.
15. Peacock JM, Orchardson R. Effects of potassium ions onaction potential conduction in A- and C-fibers of rat spinalnerves. Journal of Dental Research 1995;74:634–41.
16. Pashley DH, Matthews WG. The effects of outward forcedconvective flow on inward diffusion in human dentinein vitro. Archives of Oral Biology 1993;38:577–82.
17. Gedalia I, Brayer L, Kalter N, Richter M, Stabholz A. Theeffect of fluoride and strontium application on dentin:in vivo and in vitro studies. Journal of Periodontology1978;49:269–72.
18. Kun L. Etude biophysique des modifications des tissuesdentaires provoquees par l’application totale de Strontium.Schweiz Monatschr Zahnheilk 1976;86:661–7.
19. Ross MR. Hypersensitive teeth: effect of strontium chloridein a compatible dentifrice. Journal of Periodontology1961;32:49–53.
20. Gillam DG, Newman HN, Davies EH, Bulman JS. Clinicalefficacy of a low abrasive dentifrice for the relief of cervicaldentinal hypersensitivity. Journal of Clinical Periodontology1992;19:197–201.
21. Pearce NX, Addy M, Newcombe RG. Dentinehypersensitivity: a clinical trial to compare 2 strontiumdensensitizing toothpastes with a conventional fluoridetoothpaste. Journal of Periodontology 1994;65:113–9.
22. Silverman G, Berman E, Hanna CB, Salvato A, FratarcangeloP, Bartizek RD, et al. Assessing the efficacy of threedentifrices in the treatment of dentinal hypersensitivity. TheJournal of the American Dental Association 1996;127:191–201.
23. Lavender SA, Petrou I, Heu R, Stranick MA, Cummins D,Kilpatrick-Liverman L, et al. Mode of action studies on a newdesensitizing dentifrice containing 8.0% arginine, a highcleaning calcium carbonate system and 1450 ppm fluoride.American Journal of Dentistry 2010;23:14A–9A.
24. Ayad F, Ayad N, Zhang YP, DeVizio W, Cummins D, MateoLR. Comparing the efficacy in reducing dentinhypersensitivity of a new toothpaste containing 8.0%arginine, calcium carbonate, and 1450 ppm fluoride to acommercial sensitive toothpaste containing 2% potassiumion: an eight-week clinical study on Canadian adults. Journalof Clinical Dentistry 2009;20:10–6.
25. Docimo R, Montesani L, Maturo P, Costacurta M, BartolinoM, Zhang YP, et al. Comparing the efficacy in reducingdentin hypersensitivity of a new toothpaste containing 8.0%arginine, calcium carbonate, and 1450 ppm fluoride to abenchmark commercial desensitizing toothpastecontaining 2% potassium ion: an eight-week clinical studyin Rome, Italy. Journal of Clinical Dentistry 2009;20:137–43.
26. Fu Y, Li X, Que K, Wang M, Hu D, Mateo LR, et al. Instantdentin hypersensitivity relief of a new desensitizingdentifrice containing 8.0% arginine, a high cleaning calciumcarbonate system and 1450 ppm fluoride: a 3-day clinical
s toothpastes on dentine tubule occlusion. Journal of Dentistry (2015),
j o u r n a l o f d e n t i s t r y x x x ( 2 0 1 5 ) x x x – x x x 9
JJOD-2418; No. of Pages 10
study in Chengdu, China. American Journal of Dentistry2010;23:20A–7A.
27. Que K, Fu Y, Lin L, Hu D, Zhang YP, Panagakos FS, et al.Dentin hypersensitivity reduction of a new toothpastecontaining 8.0% arginine and 1450 ppm fluoride: an 8-weekclinical study on Chinese adults. American Journal of Dentistry2010;23:28A–35A.
28. Schiff T, Delgado E, Zhang YP, DeVizio W, Cummins D,Mateo LR. The clinical effect of a single direct topicalapplication of a dentifrice containing 8.0% arginine, calciumcarbonate, and 1450 ppm fluoride on dentinhypersensitivity: the use of a cotton swab applicator versusthe use of a fingertip. Journal of Clinical Dentistry 2009;20:131–136.
29. Addy M, Mostafa P. Dentine hypersensitivity. I. Effectsproduced by the uptake in vitro of metal ions, fluoride andformaldehyde onto dentine. Journal of Oral Rehabilitation1988;15:575–85.
30. Blong MA, Volding B, Thrash WJ, Jones D. Effects of a gelcontaining 0.4% stannous fluoride on dentinalhypersensitivity. Dental Hygiene 1985;59:489–92.
31. Thrash WJ, Dodds MW, Jones DL. The effect of stannousfluoride on dentinal hypersensitivity. International DentalJournal 1994;44:107–18.
32. Earl JS, Leary RK, Muller KH, Langford RM, Greenspan DC.Physical and chemical characterization of dentin surfacefollowing treatment with NovaMin technology. Journal ofClinical Dentistry 2011;22:62–7.
33. Cummins D. Advances in the clinical management of dentinhypersensitivity: a review of recent evidence for the efficacyof dentifrices in providing instant and lasting relief. Journalof Clinical Dentistry 2011;22:100–7.
34. Joshi S, Gowda AS, Joshi C. Comparative evaluation ofNovaMin desensitizer and Gluma desensitizer on dentinaltubule occlusion: a scanning electron microscopic study.Journal of Periodontal & Implant Science 2013;43:269–75.
35. LaTorre G, Greenspan DC. The role of ionic release fromNovaMin (calcium sodium phosphosilicate) in tubuleocclusion: an exploratory in vitro study using radio-labeledisotopes. Journal of Clinical Dentistry 2010;21:72–6.
36. Layer TM. Development of a fluoridated, daily-usetoothpaste containing NovaMin technology for thetreatment of dentin hypersensitivity. Journal of ClinicalDentistry 2011;22:59–61.
37. Du Min Q, Bian Z, Jiang H, Greenspan DC, Burwell AK, ZhongJ, et al. Clinical evaluation of a dentifrice containing calciumsodium phosphosilicate (novamin) for the treatment ofdentin hypersensitivity. American Journal of Dentistry2008;21:210–4.
38. Litkowski L, Greenspan DC. A clinical study of the effect ofcalcium sodium phosphosilicate on dentin hypersensitivity– proof of principle. Journal of Clinical Dentistry 2010;21:77–81.
39. Pradeep AR, Sharma A. Comparison of clinical efficacy of adentifrice containing calcium sodium phosphosilicate to adentifrice containing potassium nitrate and to a placebo ondentinal hypersensitivity: a randomized clinical trial. Journalof Periodontology 2010;81:1167–73.
40. Salian S, Thakur S, Kulkarni S, LaTorre G. A randomizedcontrolled clinical study evaluating the efficacy of twodesensitizing dentifrices. Journal of Clinical Dentistry2010;21:82–7.
41. Greenhill JD, Pashley DH. Effects of desensitizing agents onthe hydraulic conductance of human dentine in vitro.Journal of Dental Research 1981;60:686–98.
42. Suge T, Kawasaki A, Ishikawa K, Matsuo T, Ebisu S. Effectsof pre- or post-application of calcium chloride on occludingability of potassium oxalate for the treatment of dentinhypersensitivity. American Journal of Dentistry 2005;18:121–5.
Please cite this article in press as: Arnold WH, et al. Effectiveness of variouhttp://dx.doi.org/10.1016/j.jdent.2015.01.014
43. Addy M, Dowell P. Dentine hypersensitivity: effect ofinteractions between metal salts, fluoride andchlorhexidine on the uptake by dentine. Journal of OralRehabilitation 1986;13:599–605.
44. Pashley DH, Galloway SE. The effects of oxalate treatmenton the smear layer of ground surfaces of human dentine.Archives of Oral Biology 1985;30:731–7.
45. Pashley DH, Livingston MJ, Reeder OW, Horner J. Effects of thedegree of tubule occlusion on the permeability of humandentine in vivo. Archives of Oral Biology 1978;23:1127–33.
46. Pashley DH, O’Meara JA, Kepler EE, Galloway SE, ThompsonSM, Stewart FP. Dentin permeability. Effects of desensitizingdentifrices in vitro. Journal of Periodontology 1984;55:522–5.
47. Cuenin MF, Scheidt MJ, O’Neal RB, Strong SL, Pashley DH,Horner JA, et al. An in vivo study of dentin sensitivity: therelation of dentin sensitivity and the patency of dentintubules. Journal of Periodontology 1991;62:668–73.
48. Cunha-Cruz J, Stout JR, Heaton LJ, Wataha JC. Dentinhypersensitivity and oxalates: a systematic review. Journal ofDental Research 2011;90:304–10.
49. Naumova EA, Gaengler P, Zimmer S, Arnold WH. Influenceof individual saliva secretion on fluoride bioavailability. TheOpen Dentistry Journal 2010;4:185–90.
50. Kovtun A, Kozlova D, Ganesan K, Biewald C, Seipold N,Gaengler P, et al. Chlorhexidine-loaded calcium phosphatenanoparticles for dental maintenance treatment:combination of mineralising and antibacterial effects. RSCAdvances 2012;2:870–5.
51. Tian L, Peng C, Shi Y, Guo X, Zhong B, Qi J, et al. Effect ofmesoporous silica nanoparticles on dentinal tubuleocclusion: an in vitro study using SEM and image analysis.Dental Materials Journal 2014;33:125–32.
52. Wang R, Wang Q, Wang X, Tian L, Liu H, Zhao M, et al.Enhancement of nano-hydroxyapatite bonding to dentinthrough a collagen/calcium dual affinitive peptide fordentinal tubule occlusion. Journal of Biomaterials Applications2014;29:268–77.
53. Canadian Advisory Board on Dentin Hypersensitivity.Consensus-based recommendations for the diagnosis andmanagement of dentin hypersensitivity. Journal of theCanadian Dental Association 2003;69:221–6.
54. Gillam DG, Bulman JS, Jackson RJ, Newman HN. Comparisonof 2 desensitizing dentifrices with a commercially availablefluoride dentifrice in alleviating cervical dentine sensitivity.Journal of Periodontology 1996;67:737–42.
55. West NX, Addy M, Jackson RJ, Ridge DB. Dentinehypersensitivity and the placebo response. A comparison ofthe effect of strontium acetate, potassium nitrate andfluoride toothpastes. Journal of Clinical Periodontology1997;24:209–15.
56. Orchardson R, Gillam DG. Managing dentinhypersensitivity. The Journal of the American Dental Association2006;137:990–8. quiz 1028–9.
57. Pashley DH, Tay FR, Haywood VB, Collins MC, Drisco CL.Dentin hypersensitivity: consensus-basedrecommendations for the diagnosis and management ofdentin hypersensitivity. Inside Dentistry 2008;4:1–35.
58. Poulsen S, Errboe M, Lescay Mevil Y, Glenny AM. Potassiumcontaining toothpastes for dentine hypersensitivity.Cochrane Database of Systematic Reviews 2006;3:CD00176.
59. Lee SY, Kwon HK, Kim BI. Effect of dentinal tubule occlusionby dentifrice containing nano-carbonate apatite. Journal ofOral Rehabilitation 2008;35:847–53.
60. Tschoppe P, Zandim DL, Martus P, Kielbassa AM. Enameland dentine remineralization by nano-hydroxyapatitetoothpastes. Journal of Dentistry 2011;39:430–7.
61. Addy M, Mostafa P. Dentine hypersensitivity. II. Effectsproduced by the uptake in vitro of toothpastes onto dentine.Journal of Oral Rehabilitation 1989;16:35–48.
s toothpastes on dentine tubule occlusion. Journal of Dentistry (2015),
j o u r n a l o f d e n t i s t r y x x x ( 2 0 1 5 ) x x x – x x x10
JJOD-2418; No. of Pages 10
62. Mason S, Hughes N, Sufi F, Bannon L, Maggio B, North M, et al.A comparative clinical study investigating the efficacy of adentifrice containing 8% strontium acetate and 1040 ppmfluoride in a silica base and a control dentifrice containing1450 ppm fluoride in a silica base to provide immediate reliefof dentin hypersensitivity. Journal of Clinical Dentistry 2010;21:42–8.
63. Karim BF, Gillam DG. The efficacy of strontium andpotassium toothpastes in treating dentine hypersensitivity:a systematic review. International Journal of Dentistry2013;2013:573258.
64. Minkoff S, Axelrod S. Efficacy of strontium chloride in dentalhypersensitivity. Journal of Periodontology 1987;58:470–4.
65. He T, Barker ML, Biesbrock AR, Miner M, Qaqish J, Sharma N.A clinical study to assess the effect of a stabilized stannousfluoride dentifrice on hypersensitivity relative to a marketedsodium fluoride/triclosan control. Journal of Clinical Dentistry2014;25:13–8.
66. Sharma N, Roy S, Kakar A, Greenspan DC, Scott R. A clinicalstudy comparing oral formulations containing 7.5% calciumsodium phosphosilicate (NovaMin), 5% potassium nitrate,and 0.4% stannous fluoride for the management of dentinhypersensitivity. Journal of Clinical Dentistry 2010;21:88–92.
67. Pereira JC, Segala AD, Gillam DG. Effect of desensitizingagents on the hydraulic conductance of human dentinsubjected to different surface pre-treatments – an in vitrostudy. Dental Materials 2005;21:129–38.
Please cite this article in press as: Arnold WH, et al. Effectiveness of variouhttp://dx.doi.org/10.1016/j.jdent.2015.01.014
68. Kleinberg I. SensiStat. A new saliva-based composition forsimple and effective treatment of dentinal sensitivity pain.Dentistry Today 2002;21:42–7.
69. Cummins D. The efficacy of a new dentifrice containing8.0% arginine, calcium carbonate, and 1450 ppm fluoridein delivering instant and lasting relief of dentinhypersensitivity. Journal of Clinical Dentistry 2009;20:109–14.
70. Parkinson CR, Butler A, Willson RJ. Development of an acidchallenge-based in vitro dentin disc occlusion model. Journalof Clinical Dentistry 2010;21:31–6.
71. Parkinson CR, Willson RJ. An in vitro investigation of twocurrently marketed dentin tubule occlusion dentifrices.Journal of Clinical Dentistry 2011;22:6–10.
72. Patel R, Chopra S, Vandeven M, Cummins D. Comparison ofthe effects on dentin permeability of two commerciallyavailable sensitivity relief dentifrices. Journal of ClinicalDentistry 2011;22:108–12.
73. Nathoo S, Delgado E, Zhang YP, DeVizio W, Cummins D,Mateo LR. Comparing the efficacy in providing instant reliefof dentin hypersensitivity of a new toothpaste containing8.0% arginine, calcium carbonate, and 1450 ppm fluoriderelative to a benchmark desensitizing toothpaste containing2% potassium ion and 1450 ppm fluoride, and to a controltoothpaste with 1450 ppm fluoride: a three-day clinicalstudy in New Jersey, USA. Journal of Clinical Dentistry2009;20:123–30.
s toothpastes on dentine tubule occlusion. Journal of Dentistry (2015),