Abstract
Aims: To determine the efficacy of topical Silver Diamine fluoride (SDF) on the reduction of pain due to hypersensitive cervical dentinal lesions. Settings and Design:A parallel arm split mouth randomised controlled trial was done among 30 residents, aged 20-60 years living in Bangalore City. Methods and Material: 60 teeth were randomly assigned using a split mouth technique to Group 1 (n=30, Experimental group using Topical SDF) and Group 2 (n=30, Control group). Visual Analogue Scale (VAS) was used to measure the pain due to cervical hypersensitivity at baseline, after 24 hours and after 7 days. Comparison of the mean VAS scores was done by using Wilcoxon sign test between the groups and within the group (test and control) at different time intervals using repeated measures ANOVA followed by Post-hoc Bonferroni. Results: There was a statistically significant reduction (p<0.05) in VAS scores in the experimental group after the application of SDF at baseline, 24 hours and 7 days when compared to the control group. Conclusions:The present study shows, SDF to be safe and an effective tooth desensitiser among the patients with cervical dentine hypersensitivity.
Introduction
Dental hypersensitivity (DH) can cause pain among people of various age groups with cervical dentinal lesions. It is clinically described as an exaggerated response to application of a stimulus to exposed dentine, regardless of its location. True hypersensitivity can develop due to pulpal inflammation and can present the clinical features of irreversible pulpitis, i.e., severe and persistent pain, as compared with typical short sharp pain of DH. Various desensitising agents are used for the management of DH. In this study, topical silver diamine fluoride (SDF) has been tested for its action as an effective desensitising agent.
Subjects and Methods:
About 160 candidates were screened from September to November 2019. The present study was a parallel arm split mouth randomised controlled trial. Ethical clearance for the present study was obtained from Institutional Ethical Committee of the institutional review board of Bangalore Institute of Dental Sciences, Bangalore.
The study was conducted in two residential homes in Bangalore City, an official permission was obtained from the Institution. 30 participants (age group 20 to 60 years) were included in the study. Written consent was taken from the participants. Personal details were obtained using a specially prepared questionnaire.
A total of 60 teeth (30 participants) with each participant having two non-carious cervical lesion of which each tooth, was allotted to two groups using a split-mouth model by lottery method. The teeth were grouped into SDF (Group 1) and Distilled water (Group 2). Evaporative stimuli was checked by one-second blast of air from the three way syringe the sensitivity was recorded using Visual Analogue Scale (VAS) scale at baseline.
The teeth were air dried and isolated by cotton pellets and suction. Both the agents were applied according to the grouping. The patients were instructed to avoid eating/ drinking for 2 hours and avoid brushing for 12 hours. This was a double-blind study. All the subjects were examined post intervention, at one day, and after seven days by recording visual analogue scale for assessing tooth sensitivity using the evaporative stimuli by the principle investigator.
Results
The total number of participants for the study was 30 with the age ranging from 26-76 years, the mean age of the participants was 63.80±11.22 (Table 1)
TABLE 1: MEAN AGE DISTRIBUTION OF THE SUBJECTS
The male to female ratio was 1:2 (Table 2)
TABLE 2: DISTRIBUTION OF THE SUBJECTS BASED ON GENDER
The VAS was used to measure the pain due to cervical hypersensitivity at baseline, after 24 hours and after 7 days. Comparison of the mean VAS scores was done by using Wilcoxon sign test between the groups. The baselines mean VAS score was same for the test group (6.77±. 898) and control group (6.70±1.208). The mean VAS score for the test group post intervention (3.73±0.868) was reduced from the baseline mean VAS score but found to be highly statistically significant from the mean VAS score of the control group post intervention (6.00±1.259). The mean VAS score for the test group after 24 hours (3.80±0.610) had a slight increase in VAS score compared to post intervention but was found to be highly statistically significant from the mean VAS score of the control group after 24 hours (6.53±1.252) of intervention.The mean VAS score for the test group after 7 days (4.00±0525) was slightly higher than post intervention and 24 hours of intervention but was found to be highly statistically significant from the mean VAS score of the control group after 7 days (6.67±1.213). (Table 3)
Free for members
Keep reading — it's free
The rest of this article is open to DentalReach members. Create a free account, or sign in, and every article on the site opens in full.