Journal of Dental Sciences (2013) 8, 444e447

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SHORT COMMUNICATION

Clinical efficacy of toothpaste containing

8.0% arginine and calcium carbonate for
teeth hypersensitivity
Hui-Chieh Hsu a, Shiuan-Shinn Lee b, Yu-Chao Chang a,c*

a
Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
b
School of Public Health, Chung Shan Medical University, Taichung, Taiwan
c
School of Dentistry, Chung Shan Medical University, Taichung, Taiwan

Received 21 May 2013; Final revision received 25 June 2013

Available online 4 September 2013

KEYWORDS Abstract The prevalence of dentin hypersensitivity in Taiwan has been reported up to 38%.
arginine; The aim of this study was to evaluate the clinical efficacy of desensitizing toothpaste contain-
calcium carbonate; ing 8.0% arginine and calcium carbonate in treating dentin hypersensitivity. Forty-three partic-
dentin ipants with established two hypersensitive teeth were enrolled with informed consent. Air
hypersensitivity; blast sensitivity assessments were conducted at baseline and again after four and eight weeks
toothpaste of twice-daily product use. The use of desensitizing toothpaste was found to significantly
reduce dentin hypersensitivity (P < 0.001). The one-way analysis of variance analysis followed
by Tukey’s test indicated that this desensitizing toothpaste had a time-to-improvement distri-
bution (P < 0.05). Taken together, the toothpaste containing 8.0% arginine and calcium car-
bonate provides a significant reduction in dentin hypersensitivity.
Copyright ª 2013, Association for Dental Sciences of the Republic of China. Published by
Elsevier Taiwan LLC. All rights reserved.

Introduction

The prevalence of dentin hypersensitivity in Taiwan has

* Corresponding author. School of Dentistry, Chung Shan Medical
University, 110, Section 1, Chien-Kuo North Road, Taichung 402,
Taiwan.
E-mail address: cyc@csmu.edu.tw (Y.-C. Chang).
been reported to be up to 38% by Shen et al.1 Dentin
hypersensitivity is characterized by a short sharp pain
arising from exposed dentin in response to thermal, evap-
orative, tactile, osmotic, or chemical stimuli that cannot be
ascribed to any other form of dental defect.2 The

1991-7902/$36 Copyright ª 2013, Association for Dental Sciences of the Republic of China. Published by Elsevier Taiwan LLC. All rights reserved.
http://dx.doi.org/10.1016/j.jds.2013.06.008
Efficacy of arginine/calcium carbonate toothpaste
treatment for dentin hypersensitivity may include muco-
gingival surgery, pulpectomy, and application of resin, la-
sers, topical desensitizing agents, and desensitizing
toothpaste. Desensitizing toothpaste is considered the
simplest and most cost-effective treatment for most
patients.
Arginine, an essential amino acid, has been identified as
an ingredient with potential oral health benefits. Kleinberg3
demonstrated in an early work that the combination of
arginine bicarbonate and calcium carbonate can be depos-
ited on exposed dentin surfaces to physically block and seal
open dentin tubules. This concept has recently been devel-
oped as toothpaste containing 8.0% arginine and calcium
carbonate by the Colgate-Palmolive Company (New York, NY,
USA). In vitro mechanism of action studies have shown that
this technology works by occluding dentin tubules.4
The objectives of this clinical study are to compare the
dentin hypersensitivity reduction efficacy of toothpaste
containing 8.0% arginine and calcium carbonate (Colgate
Sensitive Pro-Relief) with twice daily tooth brushing over an
8-week period.
Materials and methods
Patient selection
This study was reviewed and approved by the Institutional
Review Board, Chung Shan Medical University Hospital.
Forty-three patients (18 males and 25 females with a mean
age of 44.6  12.0 years) with cervical exposed hypersen-
sitive dentin of caries-free teeth were selected. Two hy-
persensitive teeth had a qualifying dentin hypersensitivity
response to air blast stimuli applied for 1 second to the
cervical surface (gingivo-facial 1/3) as defined by a score of
2 or 3 on the air blast sensitivity scale by Schiff et al.5
Participants were required to be in good general health
without known allergies to the products being tested, and
able to read and understand the consent form and be
willing to sign it.
Exclusion criteria included: (1) gross oral pathology,
chronic disease, or history of allergy to test products; (2)
advanced periodontal disease or treatment for periodontal
disease (including surgery) within the past 12 months; (3)
sensitive teeth with mobility greater than one; (4) teeth
with extensive/defective restorations (including prosthetic
crowns), suspected pulpitis, caries, cracked enamel, or used
as abutments for removable partial dentures; (5) current use
of anticonvulsants, antihistamines, antidepressants, seda-
tives, tranquilizers, anti-inflammatory drugs, or daily use of
analgesics; (6) participation in a desensitizing dentifrice
study or regular use of a desensitizing dentifrice within the
past 3 months; (7) current participation in any other clinical
study; (8) pregnant or lactating women; (9) allergies to
arginine, oral care products, personal care consumer prod-
ucts, or their ingredients; (10) a medical condition that
prohibits not eating/drinking for 4 hours.
Air blast sensitivity assessment
Air blast sensitivity was assessed by directing a 1-second
blast of air onto the exposed buccal root surface of the
445
sensitive tooth, from a distance of 1 centimeter, using the
air component of a dental air/water syringe. Sensitivity was
recorded in accordance with the air sensitivity scale
described as follows5:
0 Z tooth/participant sensitivity does not respond to air
stimulation;
1 Z tooth/participant responds to air stimulus, but does
not request discontinuation of stimulus;
2 Z tooth/participant responds to air stimulus, and re-
quests discontinuation or moves from stimulus;
3 Z tooth/participant responds to stimulus, considers
stimulus to be painful, and requests discontinuation of
the stimulus.
All prospective individuals who met the inclusion/
exclusion criteria and signed an informed consent form
received an air blast hypersensitivity evaluation, along with
an oral soft and hard tissue assessment. For each individual
who qualified for participation in the study, two hyper-
sensitive teeth that satisfied the air blast hypersensitivity
enrollment criteria were identified for evaluation
throughout the study. Participants who met the criteria
were provided with their assigned dentifrice (Colgate Sen-
sitive Pro-Relief toothpaste, containing 8.0% arginine and
calcium carbonate; Colgate-Palmolive Company) and a
soft-bristled adult toothbrush for home use twice per day.
Toothpaste was applied to the entire length of the brush.
Oral soft and hard tissue assessments, as well as air blast
sensitivity follow-up evaluations of baseline-designated
study teeth, were conducted after 4 weeks and 8 weeks
of product use. All examinations were performed by the
same dental examiner, using the same procedures as
employed at baseline. Participants were also interviewed
with respect to the presence of adverse events and the use
of concomitant medications.
Statistical analysis
Air blast sensitivity scores were analyzed using the Wil-
coxon signed rank test. A P value  0.05 was taken to be
significant. For time-to-improvement distribution, com-
parisons between means were analyzed by one-way anal-
ysis of variance (ANOVA) along with Tukey’s test at a
P < 0.05 significance level.
Results
Throughout the study, there were no adverse events on the
oral soft or hard tissues of the oral cavity observed by the
examiner or reported by the participants when questioned.
In the present study, 42 (97.7%) participants reported
reduced dentin hypersensitivity after using the desensitiz-
ing toothpaste containing 8.0% arginine and calcium car-
bonate after 8 weeks. The mean value of the air blast
sensitivity score at baseline was 2.6, whereas the mean
value of air blast sensitivity scores after the use of desen-
sitizing toothpaste at the end of the 4 week and 8 week
periods were 1 and 0.57, respectively (Table 1). The use of
Colgate Sensitive Pro-Relief toothpaste was found to
significantly reduce dentin hypersensitivity (P < 0.001). As
446
Table 1 Summary of air sensitivity scores at baseline and
after using Colgate Sensitive Pro-Relief toothpaste con-
taining 8.0% arginine and calcium carbonate for 4 weeks and
8 weeks.
Air sensitivity scoresa P paste showed an effective reduction of cervical dentin
Median Range Mean  SD
Baseline 3 2e3 2.6  0.49
4 weeks 1 0e3 1  0.92 <0.0001*
8 weeks 0 0e3 0.57  0.7 <0.0001**
* Statistically significant between baseline and 4 weeks.
** Statistically significant between 4 weeks and 8 weeks.
SD Z standard deviation.
a
Air sensitivity scores were analyzed using the Wilcoxon
signed rank test. A level of significance of 0.05 was used for
each comparison.
shown in Fig. 1, the reduction rate of the air blast sensi-
tivity score was 61.5% after 4 weeks and 78.1% after 8
weeks as compared with the baseline value, respectively.
One-way ANOVA followed by Tukey’s test indicated that
Colgate Sensitive Pro-Relief toothpaste had a time-to-
improvement distribution (P < 0.05).
Discussion
The mechanism of arginine and calcium carbonate desen-
sitization is occlusion, based on the naturally occurring
biological process of tubule occlusion by salivary glycopro-
teins. Saliva transports calcium and phosphate in proximity
to dentin tubules to induce occlusion and formation of a
protective salivary glycoprotein with the calcium and
phosphateda process favored under alkaline pH condi-
tions. The results of the present clinical trial demonstrated
Figure 1 The use of Colgate Sensitive Pro-Relief toothpaste
was found to significantly reduce dentin hypersensitivity after
4 weeks and 8 weeks of product use. Comparisons between
means analyzed by one-way analysis of variance (ANOVA) along
with Tukey’s test indicated that Colgate Sensitive Pro-Relief
toothpaste had a time-to-improvement distribution (P < 0.05).
H.-C. Hsu et al
that desensitizing of hypersensitive dentin with Colgate
Sensitive Pro-Relief toothpaste was effective for 8 weeks.
The results of this clinical study, together with the results
of four similar studies conducted in Canada,6 Italy,7 and
China8,9 confirm that Colgate Sensitive Pro-Relief tooth-
hypersensitivity.
The reasons why the Colgate Sensitive Pro-Relief
toothpaste is expected to show efficiency in cervical
dentin hypersensitivity may be explained as follows.10 The
arginineecalcium carbonate technology blocks the pathway
to pain by occluding and sealing open dentin tubules. The
acid resistance of the occluded layer ensures that the relief
from sensitivity is lasting. In addition, two of its key com-
ponents, arginine and calcium, are found naturally in
saliva, and the arginine and calcium carbonate work
together to accelerate the natural mechanisms of occlu-
sion, to deposit a dentin-like mineral containing calcium
and phosphate within the dentin tubules and in a protective
layer on the dentin surface.
The present study has demonstrated that the Colgate
Sensitive Pro-Relief toothpaste seems to be a suitable tool
for successful reduction of dentine hypersensitivity. How-
ever, a limitation of the present study is the 8-week follow-
up time, which could be regarded as rather short. Further-
more, because case report(s) and case series were per-
formed without a control group, the interpretation is only
based on observation of the relevant case(s). Parallel
observation with Colgate Sensitive Pro-Relief toothpaste or
different types of desensitizing toothpastes as controls
should be performed in the future to specify the advantages
of this method in the reduction of dentin hypersensitivity.
Acknowledgments
This study was supported by a research grant from Chung
Shan Medical University (CSMU-100RD-33).
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