CDA Essentials 2018 • Volume 5 • Issue 2

Evolution of Tubule Occlusion Products The body has a natural defense mechanism for surface demineralization and erosion of enamel by delivering a supersaturated solution of calcium (Ca) and phosphorous (P) in saliva. It has been demonstrated that supplying an additional Ca and P load in the form of amorphous calcium phosphate (ACP) slows the process and may block open tubules. However the ACP could not remain at the surface for sufficient time for definitive reactions to proceed. To improve substantivity and surface retention, Casein Phosphopeptide- Amorphous Calcium Phosphate (CPP-ACP) was added. NovaMin (calcium sodium phosphosilicate) is one of the latest technologies for enhanced bonding of minerals to the surface. NovaMin demonstrated surface substantivity and bonding by delivering and retaining both calcium and phosphate to the sensitive area. NovaMin Technology NovaMin is a glass ceramic replacement material, developed for bones that were damaged due to traumatic injury (e.g. accidents, weapon trauma, cancer, etc.). 8 As such it was formulated to bond to both bone and soft tissue and was used in dentistry as a particulate for periodontal pocket bone regeneration. 9 Modification of the particulate size enhanced the ability of the material to penetrate the tubules, interact with the dentinal fluid and form a seal over and within the tubules effectively stopping fluid flow. 10 The hydroxy-apatite like occluding layer is harder than the underlying dentin and is resistant to acid challenges to the tooth surface. 11 Incorporating NovaMin with fluoride into a stable toothpaste formulation can effectively deliver desensitizing effects while maintaining the anti-cavity benefits. Making a recommendation in line with preventative dental practice Sarah needs ongoing protection against the pain of sensitive teeth. She can achieve this by consistently using a toothpaste that repairs* the sensitive areas of her teeth, by releasing calcium and phosphate, the building blocks of teeth. 12 Sensodyne is a dentist recommended dentifrice containing 5%w/wNovaMin, to † : • Provide clinically-proven long-lasting protection against DH 12 • Starts working from week 1 12 • Offers effective protection against the pain of sensitive teeth, and with continued use, helps prevent it from coming back 12 • Effectively clean teeth to help maintain gingival health 12 • Provide fresh minty taste to leave mouth feeling fresh and clean 12 To help Sarah receive continued protection against the pain and recurrence of sensitive teeth, recommend brushing with Sensodyne Repair & Protect twice daily. 12 1. Holland, G. R., Narhi, M. N., Addy, M., et al. Guidelines for the design and conduct of clinical trials on dentine hypersensitivity. J Clin Periodontol. 1997. 24:808-13. 2. Canadian Advisory Board on Dentin, H. Consensus- based recommendations for the diagnosis and management of dentin hypersensitivity. J Can Dent Assoc. 2003. 69:221-6. 3. Addy, M. Dentine hypersensitivity: New perspectives on an old problem. International Dental Journal. 2002. 52:367-375. 4. Schiff, T., Delgado, E., Zhang, Y. P., et al. Clinical evaluation of the efficacy of an in-office desensitizing paste containing 8% arginine and calcium carbonate in providing instant and lasting relief of dentin hypersensitivity. Am J Dent. 2009. 22 Spec No A:8A-15A. 5. Schiff, T., Delgado, E., Zhang, Y. P., et al. The clinical effect of a single direct topical application of a dentifrice containing 8.0% arginine, calcium carbonate, and 1450 ppm fluoride on dentin hypersensitivity: the use of a cotton swab applicator versus the use of a fingertip. J Clin Dent. 2009. 20:131-6. 6. Markowitz, K. The original desensitizers: strontium and potassium salts. J Clin Dent. 2009. 20:145-51.7. Litkowski, L. J. (personal communication). The Science of Sensitivity Relief: Next Generation in Desensitization.2017. Toronto Academy of Dentistry, W. C. Toronto. 8. Earl, J. S., Leary, R. K., Muller, K. H., et al. Physical and chemical characterization of dentin surface following treatment with NovaMin technology. J Clin Dent. 2011. 22:62-7. 9. Efflandt, S. E., Magne, P., Douglas, W. H., et al. Interaction between bioactive glasses and human dentin. J Mater Sci Mater Med. 2002. 13:557-65. 10. LaTorre, G. and Greenspan, D. C. The role of ionic release from NovaMin (calcium sodium phosphosilicate) in tubule occlusion: an exploratory in vitro study using radio-labeled isotopes. J Clin Dent. 2010. 21:72-6. 11. Parkinson, C. R. and Willson, R. J. A comparative in vitro study investigating the occlusion and mineralization properties of commercial toothpastes in a four-day dentin disc model. J Clin Dent. 2011. 22:74-81. 12. GlaxoSmithKline Consumer Healthcare. CSS Sensodyne Repair and Protect (5% NovaMin and Sodium Fluoride) GCSAE/CHSEO/0030/15. 2015 *Forms a protective layer over the sensitive areas of the teeth. Brush twice a day for lasting sensitivity protection. † Benefits observed with twice daily brushing. REVISIT SARAH Trademarks are owned by or licensed to the GSK group of companies. ©2018 GSK group of companies or its licensor. SPONSORED CONTENT 29