Assessment of Pain Intensity in Patients with Dentin Hypersensitivity After Application of Prophylaxis Paste Based on Calcium Sodium Phosphosilicate Formula.

BACKGROUND: One of many functions of the pulp-dentin complex is sensory function. Acute, situated, receding pain after the cessation of the stimulus action is called dentin pain. Dentin hypersensitivity has been described as one of the most painful and least successfully treated chronic ailments of teeth. The aim of this research was the clinical evaluation of the effectiveness of professional polishing paste containing calcium sodium phosphosilicate formula (NovaMin) in eliminating dentin hypersensitivity after a single application. MATERIAL AND METHODS: The study comprised 92 teeth with dentin hypersensitivity diagnosed on the basis of history and clinical examination. The pain reaction of exposed dentine was induced by tactile and dehydrating stimuli, asking patients to assess the severity of pain on the VAS scale. Clinical trial and survey were carried out twice: before and 1 week after the application of the polishing paste. RESULTS: After the application of the examined paste, the percentage of teeth reacting with a severe pain to the touch of the probe decreased from 16.3% to 4.3%, and with a moderate pain from 42.4% to 12%. Examination after applying dehydrating stimulus a week after carrying out the application showed a decrease in the proportion of teeth with strong pain from 28.3% to 0% and moderate pain from 38% to 15.2%. The lack of pain increased from 12% to about 50%. CONCLUSIONS: The use of prophylactic professional paste with NovaMin formula in in-office procedure provides the reduction of dentin hypersensitivity noticeable by 1 week after application.

Rasch analysis of the Geriatric Oral Health Assessment Index.

The aim of this study was to perform a psychometric analysis on the Geriatric Oral Health Assessment Index (GOHAI) using Rasch analysis, a modern statistical approach for examining rating scale data. Eighty-five subjects, long-term residents of a nursing home, were analysed using the GOHAI. The mean GOHAI score (range 0-48) was 11. Two of the five rating categories (1 = seldom; 3 = often) did not comply with the Rasch criteria for category functioning. After collapsing rating categories into a three-level rating scale (0 = never; 1 = sometimes; 2 = often/always), the new model met the set criteria. Item 12 'sensitivity to hot, cold or sweets' was misfitting. Rasch analysis showed both the unidimensionality of (at least) 11 of the 12 items of GOHAI, and the possibility of simplifying the structure of its rating scale.

An audit of dentine hypersensitivity treatments in six general dental practices in Scotland.

AIMS: This investigation sought to: (a) determine the agents used by nine dentists to treat dentine hypersensitivity and measure their effectiveness; (b) evaluate the adoptive ease and apparent success of the most effective treatment when used by all nine dentists; and (c) validate a novel categorical ranking score for dentine hypersensitivity. METHODS: A clinical audit methodology was used in the setting of general dental practice. In the initial data-collection round, patients presenting with dentine hypersensitivity were treated using the dentist's favoured regimen. Evaluation of agent effectiveness was made by patient completion of a pre- and post-treatment visual analogue scale (VAS) for the frequency (f) and severity (s) of hypersensitivity. A four-point categorical ranking scale (CRS) was also used to assess the impact of hypersensitivity upon lifestyle (L) (1=No sensitivity/effect on what I eat/drink; 2=Sometimes sensitive, rarely interfering with what I eat/drink; 3=Sometimes sensitive, occasionally interfering with what I eat/drink; 4=Always sensitive, always interfering with what I eat/drink). The most successful treatment was determined and used by all participating dentists. Its effectiveness was then assessed using the same criteria. RESULTS: Four agents were routinely used to treat hypersensitivity: (Duraphat (D) (Colgate), Duraphat & Sensodyne (DS) (GlaxoSmithKline), Sensodyne (S) (GlaxoSmithKline), Seal & Protect (SP) (De Trey, Dentsply). All produced statistically significant (P<0.001) reductions in VAS (Tukey) and CRS (Kruskal-Wallis) scores, except for DS and S. Of these, the greatest percentage reduction was seen for SP (f=72.01%, s=71.19%, L=45.98%). When SP was applied by all dentists, similar percentage reductions were seen (f=68.74%, s=75.85%, L=38.33%). The CRS, in both data-collection rounds, correlated well with the corresponding VAS scores (Spearman R for f=0.77 (P<0.001) and for s=0.80 (P<0.001). CONCLUSION: For the dentists in this audit, the use of SP was found to be reliable and predictable. The CRS provided a simple and reliable measure of dentine hypersensitivity. Subject to validation in a larger study, this could be used in a future audit as an alternative to multiple VAS scores.

A pilot assessment of alternative methods of quantifying dental pain with particular reference to dentine hypersensitivity.

OBJECTIVE: The overall aim of this pilot study was to establish the usefulness and comparability of selected verbal and non-verbal methods in the quantification of sensory and affective aspects of dental pain associated with dentine hypersensitivity (DH). DESIGN: The assessment of dental pain was conducted during an eight week clinical study. Patients were asked to rate their perception of dental pain using selected methods of quantification following tactile (Yeaple Probe-an electronic pressure-sensitive probe) and evaporative (cold air from a dental air syringe) stimulation; together with an overall assessment of perception to daily stimuli (e.g., cold air/water, toothbrushing, sweet and sour foods). The assessment methods used to quantify pain arising from DH were a continuous visual analogue scale (VAS), a 0-10 numerical rating VAS scale (NRS), and a separate intensity verbal descriptor (IVD) and unpleasantness verbal descriptor (UVD) word scales. SETTING: A specialist department at a postgraduate dental institute and hospital in London, UK. SUBJECTS: Twenty-five adult patients (8M + 17F) with a mean age of 42.6 years (95 per cent C.I. 38.8 to 46.4 years) attending the department for a clinical study evaluating the efficacy of a desensitising toothpaste agreed to participate. OUTCOME MEASURES: The study compared a continuous visual analogue scale (VAS), a 0-10 numerical rating visual analogue scale (NRS), and a separate intensity (IVD) and unpleasantness verbal descriptor (UVD) scales to quantify sensory and affective aspects of pain. An unweighted moving average technique was used to construct graphs of the relative frequency of reported severity gradings over a range of 0-10. RESULTS: The results of the study indicated that cold air appeared to cause greater discomfort to the patient than tactile sensitivity, with the air intensity curve for both IVD and 0-10 VAS peaking at a severity score of 5 while continuous VAS peaked at a score of 3-4. All methods peaked at score 2 for tactile sensitivity. The UVD scale peaked at score 2-3 and again at 6 for air sensitivity, but conformed to the other scales by peaking at score 2 for tactile sensitivity. NRS and IVD scales therefore appeared to provide acceptable alternatives to continuous VAS, but the UVD scale, probably because of the imprecise nature of the words used in the scale, did not. CONCLUSIONS: This study partially confirms previous conclusions that both verbal and non-verbal techniques quantify sensory and affective aspects of pain. However, the imprecise nature of UVD words provided misleading information in terms of both accuracy and sensitivity (except at very low levels of discomfort), when assessing pain arising from dentine hypersensitivity. In view of the highly subjective data arising from studies of this nature, the use of a moving average technique may be considered a more pragmatic method of analysis.