Supporting young people's cognition and communication in the courtroom: A scoping review of current practices.

BACKGROUND: A recent meta-analysis suggested that the majority of young people in contact with the criminal justice system have cognitive and/or communication impairments. Over the past 20 years, recognition of these complex needs has resulted in support measures being put in place in courtrooms across the globe. It is therefore timely to review evidence for the efficacy of these measures. AIMS: This scoping review evaluates evidence on support measures employed to facilitate access to court proceedings for individuals with cognition and communication impairments, and considers how this evidence might inform future research and practice. METHODS: Research databases were searched for studies that: directly or indirectly involved a population with a form of functional impairment and/or diagnosed neurodevelopmental disorder; and refer to support delivered to remove barriers or support access to courtroom processes. RESULTS: Searches identified 3,318 distinct articles. Following review, 37 papers were identified for inclusion. The papers were published between 1993 and 2019, with the majority being published since 2010 (n = 23). The majority of papers were from the United Kingdom (n = 26); other countries represented were Australia (n = 1), Canada (n = 3), New Zealand (n = 2), UK papers don't necessarily state which countries involved (n = 2) Scotland specifically state Scotland only and the United States (n = 3). No papers met the criteria for an experimental research design. CONCLUSIONS: Whilst the high level of need in this population is well established, which support measures are most effective in enabling engagement in court processes is not currently clear. More robust evaluative research is therefore required to establish the most effective methods of support. Despite this lack of evidence regarding outcomes, both young people and professionals generally view support measures favourably. There is an increasing onus on professionals to adapt their practice rather than to support/enhance the cognition and communication skills of young people.

Executive function mediates the prospective association between neurostructural differences within the central executive network and anti-social behavior after childhood traumatic brain injury.

BACKGROUND: Despite increasing evidence of a link between early life brain injury and anti-social behavior, very few studies have assessed factors that explain this association in children with traumatic brain injury (TBI). One hypothesis suggests that childhood TBI elevates risk for anti-social behavior via disruption to anatomically distributed neural networks implicated in executive functioning (EF). In this longitudinal prospective study, we employed high-resolution structural neuroimaging to (a) evaluate the impact of childhood TBI on regional morphometry of the central executive network (CEN) and (b) evaluate the prediction that lower EF mediates the prospective relationship between structural differences within the CEN and postinjury anti-social behaviors. METHODS: This study involved 155 children, including 112 consecutively recruited, hospital-confirmed cases of mild-severe TBI and 43 typically developing control (TDC) children. T1-weighted brain magnetic resonance imaging (MRI) sequences were acquired sub-acutely in a subset of 137 children [TBI: n = 103; TDC: n = 34]. All participants were evaluated using direct assessment of EF 6 months postinjury, and parents provided ratings of anti-social behavior 12 months postinjury. RESULTS: Severe TBI was associated with postinjury volumetric differences within the CEN and its putative hub regions. When compared with TD controls, the TBI group had significantly worse EF, which was associated with more frequent anti-social behaviors and abnormal CEN morphometry. Mediation analysis indicated that reduced EF mediated the prospective association between postinjury volumetric differences within the CEN and more frequent anti-social behavior. CONCLUSIONS: Our longitudinal prospective findings suggest that detection of neurostructural abnormalities within the CEN may aid in the early identification of children at elevated risk for postinjury executive dysfunction, which may in turn contribute to chronic anti-social behaviors after early life brain injury. Findings underscore the potential value of early surveillance and preventive measures for children presenting with neurostructural and/or neurocognitive risk factors.

Topical Oral and Intranasal Antiviral Agents for Coronavirus Disease 2019 (COVID-19).

With the largest viral loads in both symptomatic and asymptomatic patients with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) present in the oral and nasal cavities, agents that act on these two areas have the potential for large therapeutic and prophylactic benefit. A literature review was conducted to elucidate the possible agents useful in treatment of SARS-CoV-2. These agents were evaluated for their current applications, adverse reactions, their current state of study, and any future considerations in their management of coronavirus disease 2019 (COVID-2019). Our review has found that, while there are many promising agents with proven efficacy in their in-vitro efficacy against SARS-CoV-2, more clinical trials and in-vivo studies, as well as safety trials, must be conducted before these agents can be effectively implemented.

Language impairment and comorbid vulnerabilities among young people in custody.

BACKGROUND: While the prevalence of language and communication difficulties among young people in custody is well established, holistic understanding of the complexity and co-occurrence of additional vulnerabilities among this population are rare. METHODS: Ninety-three young people in a young offenders institution in England were assessed using the Comprehensive Health Assessment Tool, the Test of Word Knowledge, and a range of additional assessments of communication, cognition, and neurodevelopmental difficulties. RESULTS: Forty-seven percent of the young people demonstrated an aspect of language skills significantly below the population average, with more than one in four identified as having impairment. Only one in four of those with an impairment had previously accessed speech and language services. Language needs were associated with difficulties with social communication and nonverbal cognition, as well as higher risk of self-harm and substance misuse. CONCLUSIONS: Earlier identification of language difficulties requires routine assessment of young people at risk of engagement in offending behavior. Where language difficulties are identified, holistic assessments of needs should be undertaken. There is a need for speech and language therapy provision within youth justice services, as well as in other services accessed by young people at risk of engagement in offending.

Three randomized clinical trials to assess the short-term efficacy of anhydrous 0.454% w/w stannous fluoride dentifrices for the relief of dentin hypersensitivity.

PURPOSE: To assess the short-term efficacy of dentifrices containing 0.454% weight/weight (w/w) stannous fluoride applied using a focused brushing methodology for the relief of dentin hypersensitivity (DH). METHODS: Three randomized, examiner blind, controlled, two treatment arm, parallel group studies were conducted utilizing a novel application method in which, prior to brushing the whole mouth, the stannous fluoride dentifrice was applied to two sensitive teeth by focused brushing. DH was assessed with an evaporative (air) stimulus (with the Schiff Sensitivity Scale and a Visual Analogue Scale [VAS, Studies 1 and 3 only]) and a tactile stimulus (using a Yeaple Probe). Clinical assessments were made at baseline, immediately after first use of study dentifrice and after 3 and 14 days of twice daily brushing. Study 1 compared a marketed 0.454% w/w stannous fluoride dentifrice indicated for short-term DH relief to a marketed standard fluoride dentifrice (negative control). Studies 2 and 3 compared a novel anhydrous 0.454% w/w stannous fluoride dentifrice to the same negative control. RESULTS: For Studies 1, 2 and 3, 118, 113 and 120 subjects respectively were randomized to treatment and included in the intent-to-treat populations. Study 1 showed significant DH improvements in all measures for the test dentifrice compared to the negative control at Day 14. Study 2 showed significant differences in favor of the test dentifrice for all measures at all time points (Immediate, Days 3 and 14). In Study 3, treatment with both test and control dentifrices resulted in significant improvements over baseline, but there were no significant between-treatment differences. While these studies provide evidence for relief of DH with 0.454% w/w stannous fluoride dentifrices after short-term use (14 days) using a novel focused brushing methodology, the evidence, especially at the earliest time points, is inconclusive and further testing is needed. Study dentifrices were well tolerated. ClinicalTrials.gov trial registration numbers: Study 1 NCT01494649; Study 2: NCT01592851; Study 3: NCT01724008; funded by GSK Consumer Healthcare.

The prevalence of traumatic brain injury among young offenders in custody: a systematic review.

OBJECTIVES: To examine the prevalence of traumatic brain injury (TBI) among young people in custody and to compare this with estimates within the general youth population. DESIGN: Systematic review of research from various national contexts. Included studies were assessed for the relevance of the definition of TBI and the research population, and the quality of the study design. RESULTS: Ten studies were identified for inclusion in the review. Four of these studies included control groups. No studies examining comorbidity of TBI and other neurodevelopmental disorders among incarcerated young people were identified. CONCLUSION: Reported prevalence rates of brain injury among incarcerated youth range from 16.5% to 72.1%, with a rate of 100% reported among a sample of young people sentenced to death. This suggests considerable levels of need among incarcerated young people. Where control groups or directly comparable studies within the general population exist, there is strong and consistent evidence of a prevalence of TBI among incarcerated youth that is substantially greater than that in the general population. This disparity is seemingly more pronounced as the severity of the injury increases.

Prevalence and predictors of externalizing behavior in young adult survivors of pediatric traumatic brain injury.

OBJECTIVES: To investigate rates of clinically significant externalizing behavior (EB) in young adult survivors of pediatric traumatic brain injury (TBI) and evaluate the contribution of pre- and postinjury risk and resilience factors to EB outcomes 16 years after injury. SETTING: Melbourne, Australia. PARTICIPANTS: Fifty-five young adults (mean age = 23.85 years; injury age: 1.0-12 years) admitted to an emergency department following TBI between 1993 and 1997. DESIGN: Longitudinal prospective study with data collected at the acute, 10-year, and 16-year postinjury time points. MAIN MEASURES: Severity of TBI, adaptive functioning, family functioning, full-scale IQ, executive functioning, social communication, and symptoms of EB. RESULTS: One of every 4 young people with a history of pediatric TBI demonstrated clinical or subthreshold levels of EB in young adulthood. More frequent EB was associated with poorer preinjury adaptive functioning, lower full-scale IQ, and more frequent pragmatic communication difficulty. CONCLUSION: Pediatric TBI is associated with an elevated risk for externalizing disorders in the transition to adulthood. Results underscore the need for screening and assessment of TBI among young offenders and suggest that early and long-term targeted interventions may be required to address risk factors for EB in children and young people with TBI.

Contextual design requirements for decision-support tools involved in weaning patients from mechanical ventilation in intensive care units.

Weaning patients from ventilation in intensive care units (ICU) is a complex task. There is a growing desire to build decision-support tools to help clinicians during this process, especially those employing Artificial Intelligence (AI). However, tools built for this purpose should fit within and ideally improve the current work environment, to ensure they can successfully integrate into clinical practice. To do so, it is important to identify areas where decision-support tools may aid clinicians, and associated design requirements for such tools. This study analysed the work context surrounding the weaning process from mechanical ventilation in ICU environments, via cognitive task and work domain analyses. In doing so, both what cognitive processes clinicians perform during weaning, and the constraints and affordances of the work environment itself, were described. This study found a number of weaning process tasks where decision-support tools may prove beneficial, and from these a set of contextual design requirements were created. This work benefits researchers interested in creating human-centred decision-support tools for mechanical ventilation that are sensitive to the wider work system.

Effectiveness of Online Programmes for Family Carers of People with Intellectual Disabilities: Systematic Review of the International Evidence Base.

This systematic literature review examines the evidence base on the effectiveness of online programmes on the mental health and well-being of family carers of people with intellectual disabilities. Databases (ERIC, Medline, PsycINFO and CINAHL) were searched for intervention studies that considered online interventions for family carers of people with intellectual disabilities. Data were extracted using standardised data extraction tools. Bias was assessed using the Cochrane risk of bias tool for randomised trials (RoB 2). Screening, extraction and assessment of bias were completed independently by two members of the research team. Given the low number of included studies and different outcomes assessed within them, it was not possible to conduct a meta-analysis; therefore, data are presented narratively. Two studies met the criteria to be included in the review. Both studies utilised a feasibility randomised controlled trial methodology. One study found a significant decrease in parental stress, while the other found a significant increase in psychological well-being. Caution must be taken in drawing firm conclusions, given the small sample sizes and low retention rates in both studies. Online programmes seem to offer potential benefits to family carers of people with intellectual disabilities. However, further investigation is needed to examine these programmes, adopting a collaborative approach with family carers.

Randomised controlled feasibility study protocol of the Carers-ID online intervention to support the mental health of family carers of people with intellectual disabilities.

BACKGROUND: Family carers play a crucial role in supporting the health and well-being of people with intellectual disabilities. Given their role and responsibilities, many family carers experience significant and ongoing stress and mental health difficulties. Programmes and interventions which provide training and support to family carers have been shown to have a positive impact on levels of stress and quality of life. However, these are often face to face which can create barriers to full participation. Online interventions have been shown to offer flexibility in delivery compared with traditional face-to-face approaches. The primary objective of this study is to determine the feasibility of delivering the Carers-ID online intervention, while the secondary outcome is improved mental health in family carers of people with intellectual disabilities. METHODS: Family carers (n = 120) will be randomised to receive the intervention (n = 60) or assigned to a wait-list control (n = 60) group. The intervention ( www.Carers-ID.com ) consists of 14 modules which cover topics including the following: promoting resilience, providing peer support, reducing anxiety, managing stress, accessing local supports and managing family conflict and information for siblings who are carers. The intervention has been co-produced with voluntary sector organisations and family carers and tested for acceptability. Primary outcomes for this study include acceptability and feasibility of the outcome measures, recruitment, participation and retention rates and effect sizes. Secondary outcomes will be completed at three time points (baseline, following intervention completion and 3 months after completion). These include the following: the Depression, Anxiety and Stress Scale, the Warwick-Edinburgh Mental Well-being Scale, the Resilience Scale and the Social Connectedness Scale Revised. Participants (n = 12) who have taken part in the intervention arm of the research will be invited to participate in semi-structured interviews as part of the process evaluation. DISCUSSION: The Carers-ID intervention provides an online resource for family carers to support their mental health and well-being and promote their resilience. It represents an affordable and accessible means of delivering such support. Testing the feasibility of the intervention and related trial procedures is required to determine whether a full-scale randomised controlled trial to evaluate the intervention's effectiveness is warranted. TRIAL REGISTRATION: ClinicalTrials.gov : NCT05737823.

The efficacy of an experimental dentifrice containing 0.454% w/w stannous fluoride in providing relief from the pain of dentin hypersensitivity: an 8-week clinical study.

PURPOSE: To compare the efficacy of a 0.454% w/w stannous fluoride containing anhydrous dentifrice and a negative control dentifrice containing 1,000 ppm fluoride (as sodium monofluorophosphate) at reducing dentin hypersensitivity over an 8-week period, following twice daily brushing. METHODS: This was a randomized, examiner blind, two-treatment arm, stratified (by maximum baseline Schiff sensitivity score), parallel design, single-site study in 118 subjects, who had at least two sensitive teeth, and met all the criteria at the screening and baseline visit. The study was conducted in Las Vegas, NV, USA. Tactile threshold (Yeaple Probe) and evaporative (air-blast) sensitivity (with Schiff sensitivity scale) were employed as clinical measures to compare the efficacy of the test dentifrice containing 0.454% w/w stannous fluoride to the negative control (Colgate Cavity Protection) at reducing sensitivity at Weeks 4 and 8. RESULTS: 117 subjects completed the clinical study. At the 4- and 8-week time points, between treatment analyses demonstrated the test dentifrice to be significantly better at relieving subjects' sensitivity, for both validated clinical measures, compared to the negative control (at 4 weeks Schiff P < 0.0001 tactile threshold P < 0.0001; at 8 weeks Schiff P < 0.0001; tactile threshold P < 0.0001).

A randomized clinical study investigating the staining profile of an experimental stannous fluoride dentifrice.

PURPOSE: The primary objective of this study was to investigate the staining profile of an experimental test dentifrice containing 0.454% w/w stannous fluoride compared to that of a marketed control dentifrice containing 0.76% w/w sodium monofluorophosphate (Colgate Cavity Protection) following regular and repeat use, with twice daily brushing over 8 weeks. As an exploratory objective, the staining profile of the test dentifrice was compared to that of a marketed comparator dentifrice containing 0.454% w/w stannous fluoride (Crest Pro-Health - Clean Mint). METHODS: This was a single-center, examiner-blind, randomized, three arm, parallel group study, stratified by pre-baseline stain score [total Lobene Stain Index (LSI) (area x intensity) score < 31, > or = 31] and smoking status. Following initial screening, 137 healthy subjects, aged 18 years and above, with 12 gradable anterior teeth returned for baseline assessments. At the baseline visit, subjects received an oral soft tissue (OST) examination and an assessment of extrinsic dental stain using the LSI on the facial and lingual surfaces of the 12 anterior teeth, LSI area, LSI intensity and LSI area x intensity (the LSI area x intensity score was termed the pre-baseline LSI score). Subjects who met study requirements received a dental prophylaxis of the anterior teeth to remove all visible stain from their tooth surfaces such that an LSI (area x intensity) score of 0 was achieved. Randomized subjects brushed with their assigned dentifrice at home twice daily for 1 timed minute and returned after 4 and 8 weeks for an OST examination and dental stain assessment of the anterior teeth using LSI. RESULTS: There were no statistically significant differences in dental stain build-up between the test dentifrice containing 0.454% w/w stannous fluoride and a marketed control dentifrice (Colgate Cavity Protection), after 4 and 8 weeks of twice daily brushing, in terms of LSI area x intensity, LSI area or LSI intensity scores. Exploratory analysis indicated that the marketed stannous fluoride dentifrice (Crest Pro-Health) exhibited more dental stain build-up at 4 and/or 8 weeks compared to the other two study dentifrices. However, post-hoc analysis revealed an imbalance in LSI baseline stain levels between the treatment groups, with higher stain levels in the marketed comparator group, which made it difficult to draw robust conclusions from the exploratory data. This imbalance was not considered to impact the other study analyses. Study treatments were well tolerated.

School-based interventions for children and adolescents following traumatic brain injury: A systematic review.

BACKGROUND: Childhood traumatic brain injury (TBI) can result in impairments in learning, cognition, and behaviour; all of which can adversely influence educational outcomes. Schools can play a crucial role in rehabilitation, therefore it is important that evidence-based supports are available in these settings. OBJECTIVE: The aim of this systematic review was to evaluate the effectiveness of school-based supports and interventions available following childhood TBI. METHODS: A comprehensive search strategy involved eight research databases, grey literature, and backward reference searching. RESULTS: The search identified 19 studies, reporting on sixteen distinct interventions, which used a variety of person-centred and systemic approaches, and typically contained multiple components, including: psychoeducation, behavioural scripts, and attention training. While offering some indication for future directions in intervention, the evidence base for individual interventions was typically limited, and does not take account of cost or issues in sustainability. CONCLUSION: While there appears to be great potential to support students who may otherwise not gain access to services, there is insufficient evidence to guide widespread policy or practice change without further research. Greater collaboration between researchers, clinical practitioners, and educators is necessary to ensure that all interventions developed are robustly evaluated and disseminated.

Risk of Criminal Justice System Interactions in Young Adults with Attention-Deficit/Hyperactivity Disorder: Findings From a National Birth Cohort.

OBJECTIVE: To examine criminal justice system (CJS) interactions and pathways through the justice system for young adults with ADHD compared to young adults without ADHD. METHOD: Nationwide 3-year birth cohort study using linked health and CJS data. Cox proportional hazards models were employed to examine associations between ADHD and police proceedings, court charges, court convictions, and incarcerations. RESULTS: Young adults with ADHD were significantly more likely to interact with the CJS including police proceedings (hazard ratio [HR], 2.1 95% CI [2.0, 2.2]) court charges (HR, 2.2 95% CI [2.1, 2.3]), court convictions (HR, 2.3 95% CI [2.2, 2.4]), and incarceration (HR, 4.8 95% CI [4.3, 5.4]). CONCLUSIONS: Young adults with ADHD are overrepresented at all stages of the CJS. Results highlight the importance of early identification and responsivity to ADHD within the CJS and suggest that the NZ justice system may require changes to both areas to ensure that young individuals with ADHD receive equitable access to, and treatment within, the CJS.

Criminal justice system interactions among young adults with and without autism: A national birth cohort study in New Zealand.

LAY ABSTRACT: Sensationalist headlines and highly publicised criminal cases lead many in the public to believe that people with autism are more likely to engage in criminal behaviour. However, recent studies present an unresolved debate, and indicate this may not necessarily be the case. The aims of this study were to examine the prevalence of criminal justice system interactions among young adults with and without autism, and determine whether offence types differ between these groups. We tracked a national birth cohort until their 25th birthday, detecting criminal justice system interactions from age 17 onwards. Linked health and criminal justice system data were used to identify those with autism and detect interactions with the criminal justice system. We found that young people with autism interacted with the criminal justice system at lower rates compared to those without autism. However, there were considerable differences in the types of offences these young people were charged with. For example, among those charged with an offence, people with autism were more likely to be charged with a serious offence, punishable by 2 or more years in prison. We conclude that although young people with autism are not over-represented in the criminal justice system, disparities in offence types and incarceration rates among those charged with an offence suggest the importance of identification and appropriate response to autism within the criminal justice system.

Understanding the complexity of neurodevelopmental profiles of females in prison.

PURPOSE: This paper aims to examine the relationship between patterns of functioning in four domains (attention and concentration; social and communication; coordination and organisation; and literacy and numeracy) in women in prison. Also, to consider potential associations between functioning and previous Neurodevelopmental Disorder (NDD) diagnoses, previous mental health diagnoses and history of head injury, self-harm and attempted suicide. DESIGN/METHODOLOGY/APPROACH: Women in one Scottish prison were invited to participate; 87 consented. Women were screened for functional difficulties and asked about their relevant educational and medical history. FINDINGS: Half of participants reported difficulties in one or more domains. All possible combinations of functional difficulties were found. Only eight women reported previous NDD diagnoses. Functional difficulties were significantly associated with history of self-harm, history of attempted suicide and mental health diagnoses. In total, 32% of women reported at least one head injury, but this was not significantly associated with functional difficulties. RESEARCH LIMITATIONS/IMPLICATIONS: The sample was comparatively small and questions were self-report. Analyses were based on within-cohort comparisons due to a lack of appropriate general population data. PRACTICAL IMPLICATIONS: There is a clear need for timely, practical and comprehensive profiling of females in the Justice System. Current systems do not appear to adequately identify women with functional difficulties or other adversity. Greater use of interdisciplinary working and shared training is indicated, as is a move from categorical diagnostic systems towards dimensional approaches. ORIGINALITY/VALUE: This study is the first to investigate associations between difficulties associated with NDDs, mental health difficulties and head injury in women in prison.

Brushing abrasion of dentin: effect of diluent and dilution rate of toothpaste.

PURPOSE: To determine whether toothpaste diluent type and dilution rate influence abrasion of dentin. METHODS: Slabs of human root dentin (4 x 3 x 2 mm) were embedded in epoxy resin, ground and polished. Adhesive tape was placed on the specimen's surface leaving an exposed central area of 1 x 4 mm. Specimens (n = 15) were then brushed for 1,000 strokes in a reciprocal action brushing simulator using toothpaste that had been diluted in a carboxymethylcellulose-based artificial saliva (CMC) or deionized water (DW) from 1:1 to 1:4 (toothpaste:diluents, in weight). Control groups were brushed with undiluted toothpaste, CMC-based saliva or DW only. Brushing simulation was run at 300 g load at 37 degrees C. After brushing, adhesive tape was removed and wear analyzed by optical profilometry. RESULTS: One-way ANOVA (P < 0.0001) and Tukey's test revealed that, in general, wear depth (microm) declined with increasing dilution, regardless of the diluent. Brushing with CMC- or DW-only caused the least abrasion.

Evidence for the efficacy of an 8% strontium acetate dentifrice for instant and lasting relief of dentin hypersensitivity.

An 8% strontium acetate, 1040 ppm sodium fluoride-based dentifrice has been demonstrated in in vitro and in situ studies to provide deep and acid-resistant tubule occlusion. Clinical efficacy studies have shown instant and lasting dentin hypersensitivity relief from this dentifrice, which has recently been launched by GlaxoSmithKline Consumer Healthcare as Sensodyne Rapid Relief.

A comparative clinical study investigating the efficacy of a dentifrice containing 8% strontium acetate and 1040 ppm fluoride in a silica base and a control dentifrice containing 1450 ppm fluoride in a silica base to provide immediate relief of dentin hypersensitivity.

OBJECTIVE: The objective of this clinical study was to evaluate and compare the efficacy of a dentifrice containing 8% strontium acetate and 1040 ppm fluoride (from sodium fluoride) in a silica base (test dentifrice) to a control dentifrice containing 1450 ppm fluoride (from sodium fluoride) in a silica base, to reduce dentin hypersensitivity immediately after a single dab-on self-application, and after subsequent twice-daily brushing for three days. METHODS: This was a randomized, examiner-blind, two-arm parallel group, three-day clinical study with seventy-nine subjects, stratified based on baseline tooth sensitivity. Tooth sensitivity was determined through subject responses to both evaporative (Schiff and Visual Analogue Scale [VAS]) and tactile stimuli (Yeaple probe), prior to and immediately after subjects self-applied a single pea-sized amount of either the test or control dentifrice to qualifying sensitive teeth, massaging the toothpaste onto the sensitive area for one minute. Tooth sensitivity was further assessed in response to the same stimuli after subjects brushed twice daily for an additional three days. Subject assessments were performed by the same examiner throughout the study. RESULTS: Seventy-nine subjects completed this clinical study. Both subject groups exhibited reductions in dentin hypersensitivity directly after a single dab-on application. These reductions were significant across all measures for the test dentifrice. Between-treatment analyses showed the test dentifrice to be significantly better at relieving subjects' sensitivity across all measures (Schiff p = 0.0003, tactile p = 0.0003, and VAS p = 0.0077) compared to the control. After the additional three days of twice-daily brushing, between-treatment analyses showed the test dentifrice to be significantly better at relieving subjects' sensitivity across all measures (Schiff p = 0.0102, tactile p = 0.0493, and VAS p = 0.0067) than the control dentifrice. CONCLUSION: The 8% strontium acetate, 1040 ppm fluoride dentifrice provided significant within-treatment reductions in dentin hypersensitivity for all measures at both time points (immediate and three-day brushing). Compared to the control dentifrice, significant between-treatment reductions in sensitivity were observed after a single dab-on application for all measures, and following the additional twice-daily brushing for three days in favor of the 8% strontium acetate, 1040 ppm fluoride dentifrice.

A comparative clinical study investigating the efficacy of a test dentifrice containing 8% strontium acetate and 1040 ppm sodium fluoride versus a marketed control dentifrice containing 8% arginine, calcium carbonate, and 1450 ppm sodium monofluorophosphate in reducing dentinal hypersensitivity.

OBJECTIVE: The objective of this clinical study was to evaluate and compare the efficacy in reducing dentin hypersensitivity of an 8% strontium acetate, 1040 ppm sodium fluoride dentifrice to a marketed control 8% arginine, calcium carbonate, 1450 ppm sodium monofluorophosphate dentifrice after twice-daily brushing for two, four, and eight weeks. METHODS: This was a randomized, examiner-blind, two-arm parallel group, eight-week longitudinal clinical study with seventy-nine subjects, stratified based on baseline tooth sensitivity (Schiff score, Yeaple). Subjects brushed with either an 8% strontium acetate-based dentifrice or a marketed 8% arginine calcium carbonate dentifrice twice daily for approximately one minute. At screening, baseline, weeks two, four, and eight, subjects' tooth sensitivity was determined through both evaporative (Schiff and Visual Analogue Scale [VAS]) and tactile stimuli (Yeaple probe). Subject assessments using each stimulus were performed by the same examiner throughout the study. RESULTS: Seventy-seven subjects completed this clinical study. Both subject groups exhibited significant cumulative reductions from baseline to Days 14, 28, and 56 in dentin hypersensitivity as measured by Schiff, Yeaple, and VAS (for the 8% strontium acetate group, p < or = 0.0001 for all time points; for the 8% arginine calcium carbonate group, p = 0.0031 for Yeaple at Day 14, p = 0.0015 for VAS at Day 14, and p < 0.0001 for all remaining measures and time points). No significant differences (p > 0.05) were observed between treatments for any of the time points and measures except for tactile sensitivity at Day 56, for which the 8% strontium acetate-based dentifrice was statistically superior (p = 0.0391) to the control 8% arginine calcium carbonate dentifrice. CONCLUSION: The 8% strontium acetate, 1040 ppm sodium fluoride dentifrice provided significant reductions in dentin hypersensitivity (p < 0.0001) after two, four, and eight weeks of product use. Comparisons to a control 8% arginine calcium carbonate dentifrice showed no significant differences (p > 0.05) apart from tactile (Yeaple) sensitivity at week 8, where the 8% strontium acetate-based dentifrice showed significant improvement over the control (p = 0.0391).