Photomedicine and Laser Surgery

Volume 28, Supplement 2, 2010

ª Mary Ann Liebert, Inc.
Pp. S69–S74
DOI: 10.1089/pho.2009.2640

Effects of the Combined Desensitizing Dentifrice

and Diode Laser Therapy in the Treatment
of Desensitization of Teeth with Gingival Recession

Alparslan Dilsiz, D.D.S., Ph.D., Tuğba Aydın, D.D.S., and Gülnihal Emrem, D.D.S.

Abstract

Objectives: The purpose of this study was to evaluate and compare clinically the efficacy of desensitizer
toothpaste alone and in combination with the diode laser in the management of dentin hypersensitivity (DH), as
well as both the immediate and late therapeutic effects on teeth with gingival recessions. Materials and
Methods: In total, 52 teeth diagnosed with DH in 13 (seven women, six men, aged 16–48 years) healthy adult
patients were included in this study, and teeth were randomly divided equally into two groups: the test group,
which received treatment with desensitizer toothpaste and GaAlAs (diode) laser, and the control group, treated
with desensitizer toothpaste. DH was assessed by means of an air stimulus, and a visual analogue scale (VAS)
was used to measure DH. The selected teeth in the test group received laser therapy for three sessions. Teeth
subjected to diode-laser treatment were irradiated at 100 mW for 25 sec at 808 nm, with continuous-emission,
noncontact mode, perpendicular to the surface, with scanning movements on the region of exposed root sur-
faces. Results: Significant reduction of DH occurred at all times measured during the three treatment sessions in
the test group. When compared with the means of the responses in the three treatment sessions of the two
groups, the test group showed a higher degree of desensitization in teeth with gingival recession than did the
control group ( p < 0.001). The immediate and late therapeutic effects of the diode laser were more evident
compared with those of desensitizer toothpaste. Conclusions: Within the limitations of the present study, a
significant effect of combined desensitizer toothpaste and diode laser therapy occurs in the treatment of de-
sensitization of teeth with gingival recession. Desensitizer toothpaste appears to have the therapeutic potential to
alleviate DH. Conversely, diode laser can be used to reduce DH.

Introduction gingival recession, incorrect toothbrushing habits, parafunc-

tional habits, abrasion due to brushing, dietary erosion, tooth

D ental hypersensitivity (DH) is one of the most painful

common problems, affecting between 4% and 73% of the
adult population in clinical dentistry. This problem is char-
abnormally positioned in the arch, chronic periodontal dis-
ease, periodontal surgery, root preparation, abfractive lesions,
occlusal wear, and aging.1–3 This condition may disturb the
acterized by a short, sharp, and severe pain arising from ex- patient’s daily habits of eating, drinking, brushing, and
posed dentin in response to stimuli typically thermal, sometimes even breathing. Despite extensive research, the
evaporative, tactile, osmotic or chemical, ceasing after their mechanisms and management of DH remain poorly under-
removal.1–5 DH may affect patients of any age, and it affects stood. The main theories about DH are discussed in detail.
women more often than men.2 The condition may affect any The most widely accepted theory is the hydrodynamic theory,
tooth, but it most often affects canines and premolars.6 DH which states that stimulus application induces pressure
occurs when dentin is exposed in the oral cavity, and dentinal changes across dentin. As a result of the pressure changes,
tubules are opened. The exposure of dentin and its sensitivity rapid shifts of fluids take place within the dentinal tubules,
may occur by one or both of two processes: either removal of followed by the excitation of sensory nerves in the pulp/
enamel, or denudation of the root surface by loss of the dentin border.7,8 Therefore, either physically blocking the
overlying cementum and periodontal tissues. DH can become exposed dentinal tubules or reducing the excitability of the
a concern because of the increased number of teeth with relevant sensory nerves would effectivelly treat DH.

Department of Periodontology, Faculty of Dentistry, Atatürk University, Erzurum, Turkey.

S-69
S-70 DILSIZ ET AL.

Various agents have been used as desensitizers for hy- Materials and Methods
persensitive teeth, including toothpastes containing arginine
The research protocol and consent form were initially
and potassium ions; formulations containing sodium floride,
submitted to the Ethics Committee, and The Institutional
silver nitrate, formaldehyde, strontium chloride, and potas-
Internal Review and Ethics Board at the Atatürk University,
sium salts; oxalates, resin-bonding agents, and abrasive
Faculty of Dentistry approved the study (AU-IIREB reference
dentifrices.9–14 Conventional therapy for hypersensitive teeth
code:021). All participants provided written informed con-
is based on using topically applied desensitizing agents, ei-
sent.
ther professionally or at home. However, most treatments
The study population consisted of 13 patients with 52
are either ineffective or last for only a short time.
hypersensitive teeth with Miller’s Class I or Class II gingival
A variety of lasers such as He-Ne, GaAlAs (diode), CO2,
recession (seven women and six men; aged 16–48 years;
Nd:YAG, and Er:YAG have been evaluated in DH treatment
mean age, 31.2  8.8 years) who visited the periodontology
in the past. The first laser use for treatment of DH was re-
department of the Faculty of Dentistry at Atatürk University.
ported by Matsumoto et al.3 with Nd:YAG and the 780-nm
diode lasers. The use of diode lasers in dental therapy has
increased dramatically in recent years. Diode laser has been Selection of subjects and test teeth
used as an efficient means for the treatment of DH by many Inclusion criteria. Patients in good systemic health with
investigators.15–26 Several wavelengths (ranging from 660 to clinically elicitable DH who were reliable in their response to
900 nm) of diode laser have been used for the treatment of test measurements were included in the study. All experi-
DH.3 It is postulated that this type of low-output power la- mental teeth had Miller’s Class I or Class II recessions.30
sers mediates an analgesic effect related to depressed nerve
transmission.3 According to physiological experiments using Exclusion criteria. Patients with chronic or debilitating
the diode laser at 830 nm, this effect is caused by blocking the disease with daily pain episodes; those who were taking any
depolarization of C-fiber afferents.20 GaAlAs laser emissions analgesic, anticonvulsive, antihistaminic, sedative, tranquil-
at 904 nm have an analgesic effect on the cat tongue, al- izing, or antiinflammatory medications in the 72 h preceding
though the mechanism remains unclear.25 Diode laser irra- treatment; those who had used any desensitizing toothpaste
diation at a maximum power of 60 mW does not affect or mouthwash in the last 3 months; and those who had been
the enamel or dentin surface morphologically, but a small given periodontal surgery in the last 6 months were excluded
fraction of the laser energy at 830-nm wavelength is trans- from the study. Teeth with cracked structures, carious le-
mitted through enamel or dentin to reach the pulp tissue.26 sions, restorations, nonvital///, and active periodontal dis-
The treatment-effectiveness rate of these lasers was depen- ease were excluded.
dent on the output power, and ranged from 30% to 100%.3 In
most of them, despite varieties in methods and kinds of laser,
Pain and DH assessment
a relative success was described.
Treatment of DH by the diode laser revealed that the laser A visual analogue scale (VAS) was used to measure DH.
interaction with the dental pulp causes a photobiomodulat- The VAS was administered in a standard manner, with the
ing effect, increasing the cellular metabolic activity of the initial explanation given by the same clinician. All patients
odontoblast and obliterating the dentinal tubules with the were asked to define their level of DH by using a VAS
intensification of tertiary dentin production.15,18 Diode lasers consisting of equal units from 0 to 10 (a line of 10 cm). On this
provide cold thermal low-energy wavelengths with a minor scale, 0 and 10 represented ‘‘no pain/discomfort’’ and ‘‘worst
temperature increase of <0.18C.19 These wavelengths are pain/discomfort imaginable,’’ respectively. All pain assess-
believed to stimulate circulation and cellular activity and to ments were performed in the morning in the same clinic, free
provide various effects such as antiinflammatory, vascular, of extraneous noise, music, or conversation. Patients were
muscle relaxation, analgesia, and tissue healing.19 However, asked to mark the degree of pain they experienced by di-
because of the great varieties in methods and types of lasers, recting an air blast to the root surface before and after
it is impossible to propose a definitive method to treat DH. treatment of DH. Before and after each session, we gave the
Toothpastes containing potassium ions have been shown patient a separate sheet of paper containing the printed in-
by several clinical studies to be effective in reducing DH.11–14 terval scale (a line of 10 cm) so that he or she could not be
Potassium ions are thought to act by blocking the action influenced by the previous results. Data from the VAS were
potential generated in intradental nerves and to raise the recorded by measuring in millimeters the distance between
pain threshold of pulpal nerves to hydrodynamic stimuli.27–29 zero point and the sign marked by the patient on the 10-cm
New treatments for DH therapy must be developed. Al- line. Reproducibility for the VAS was completed on two
though the individual desensitizing effects of diode laser and separate occasions by five patients. A strong correlation was
desensitizing dentifrice have been shown, the combined ef- found between the two responses in both procedures
fect of diode laser and desensitizing dentifrice on DH re- (Spearman’s rho >0.93; p < 0.001).
mains uncertain; this determination was the main aim of the DH was assessed by means of air stimulus. The clinician
present study. Furthermore, it also isimportant to compare directed an air blast (60 pounds per square inch, 228C) de-
the efficiency of the lasers with that of commonly used rived from a dental syringe to the root surface for 1 sec. He
agents. Therefore, the purpose of this study was to evaluate held the syringe perpendicularly 2–3 mm from the root sur-
and compare clinically the efficacy of desensitizer tooth- face. After this stimulation, the patient again scored the pain
paste alone and in combination with the diode laser in the by using the VAS. The air pressure, temperature, and dis-
management of DH, as well as both the immediate and late tance between the root surface and the tip of the air syringe
therapeutic effects to teeth with gingival recessions. were kept constant for all cases in both pretreatment and
ALTERNATIVE THERAPY FOR DENTIN HYPERSENSITIVITY S-71

posttreatment diagnosis of DH. All stimuli were given by were in use, protective eyewear of the appropriate optical
one investigator in the same dental chair with the same density was worn by the investigators and patients.
equipment, yielding similar air pressure and temperature The laser therapy was performed by one investigator, and
each time. the pain was assessed by another investigator.

Treatment Study design

After the baseline pain assessment, the teeth were ran- The treatments were carried out in three sessions, with
domly assigned to test group: desensitizing toothpaste, and intervals of 14 days between sessions, during a period of 30
diode laser, or the control group: desensitizing toothpaste. consecutive days. The measurements were performed before
Twenty-six test-group teeth, including six incisors, six ca- each treatment session and at 30 min after the laser applica-
nines, 11 premolars, and three molars, and 26 control-group tion to verify the capacity, the extent, and the duration of
teeth, including six incisors, seven canines, nine premolars, desensitization after irradiation. This result was named the
and four molars were subjected to one treatment modality in immediate effect. Additional measurements also were per-
each group. formed at 15, 30, and 60 days after the conclusion of treat-
All the patients received a dental prophylaxis and in- ment to assess the extent of desensitization obtained with the
struction in brushing technique, and they used a standard- different therapies. This result was called the late effect.
ized soft-filamented toothbrush and desensitizing toothpaste
(Sensodyne F; GlaxoSmithKline Ltd, UK) during the 3 Statistical analysis
months of the trial. In addition, the patients were instructed
Descriptive statistics including means and standard devi-
to cover the entire length of the filament section of the
ations were calculated for both groups. The data thus col-
toothbrush with the toothpaste and to brush their teeth twice
lected were assessed by using SPSS 16.0 statistical software
daily, in the morning and in the evening, for 3 min each time
(SPSS, Chicago, IL). The Mann–Whitney U test was used to
throughout the study. Sensodyne F is a toothpaste contain-
compare groups and controls, and the differences in the
ing a desensitizing agent [3.75% potassium chloride (KCl)],
mean VAS scores were calculated. The differences in mean
an anticaries agent [0.80% sodium monofluorphosphate
VAS scores between pretreatment and 30-min posttreatment
(SMFP)], and an antiplaque-antiinflammatory agent (0.30
were evaluated by using Wilcoxon’s signed-ranks test. The
triclosan) for DH, gingival health, and plaque formation,
Friedman test was used to assess the differences in mean
currently marketed in Turkey. All participants completed the
VAS scores for the late effects of treatment (at 15, 30, and
study and reported 100% compliance.
60 d).
Before laser therapy, all of the teeth received scaling, root
planing, polishing, and brushing with desensitizing tooth-
Results
paste. Afterward, relative isolation of the region was carried
out with the aid of a cotton roll and the drying of the buccal The mean VAS scores before and after treatment with DH
surface with gauze before each treatment session. The vital- to the test group and control group at different times are
ity of teeth was tested with a pulp tester (Digitest D626D; showed in Table 1 (Fig. 1).
Parkell, Farmingdale, ) before and after each treatment ses- The mean VAS score in pretreatment for session 1 for test
sion. The patients did not know what kind of therapy each group was 8.08  0.78. The corresponding score for the
tooth was receiving. control group was 8.04  0.59. These scores were not statis-
Lasing was performed by using Doctor Smile erbium & tically different ( p > 0.05). The mean VAS score for 30 min of
diode laser machine (Doctor Smile erbium&diode; Lambda session 1 for the test group was 7.23  0.75, and the corre-
Scientifica, Vicenza, Italy). Teeth subjected to diode laser sponding score for the control group was 7.50  0.84, which
treatment were radiated with a laser beam of 100 mW, 25 sec, were not statistically different ( p > 0.05).
(0.1W25 sec ¼ 2.5 J), 808 nm (Optical Fiber, diameter: Compared with the pretreatment for session 1, a signifi-
300 mm, 2 J/cm2), with continuous-emission form, noncontact cant decrease in mean VAS score in 30 min of session 1 oc-
mode (2 mm from the surface), perpendicular to the surface curred for the test and control groups (7.23  0.75 and
for scanning movements in the region of exposed root sur- 7.50  0.84, respectively; p < 0.01).
faces. The laser application was performed according to the The mean VAS score in pretreatment for session 2 for the
instructions given by the manufacturer. When the lasers test group was 6.31  0.95, and in 30 min of session 2, the

Table 1. Comparison of Mean VAS Scores in the Two Groups at Different Times (n ¼ 26) (Immediate Effect)

p Value
Test group Control group (Mann–Whitney U test)

Session 1 Pretreatment 8.08  0.78 8.04  0.59 >0.05

30 min 7.23  0.75c 7.50  0.84b >0.05
Session 2 Pretreatment 6.31  0.95 7.31  0.77 <0.001
30 min 5.27  1.26c 6.88  0.97b <0.001
Session 3 Pretreatment 5.12  1.28 6.54  1.25 <0.001
30 min 4.15  1.85a 6.38  1.21 <0.001
a
p < 0.05; bp < 0.01; cp < 0.001: significant differences between pretreatment and 30 min (Wilcoxon’s signed-ranks test).
S-72 DILSIZ ET AL.

of diode laser and desensitizing toothpaste in the treatment

of DH.
DH is a pain sensation and is difficult to quantify. In the
present study, VAS was used to assess DH. In previous
clinical studies, several investigators used VAS, because it is
simple to understand by patients, more sensitive in dis-
criminating between various treatments and changes in pain
intensity, and suitable for use in the evaluation of the irritant
response in hypersensitivity studies.12,16,22
The results of the present clinical trial demonstrated that a
significant decrease in DH in both groups over the 12-week
study period compared with the baseline. The results espe-
cially illustrate the effectiveness after cold air-blast stimula-
tion. In a previous clinical study, it was demonstrated that
the GaAlAs (diode) laser is also an effective device in re-
ducing DH with air spray.22 A significant reduction of the
VAS scores from 8.08  0.78 to 2.08  0.47 was shown in the
present study ( p < 0.001). Our findings confirm the data of
the earlier studies in this field.15–19,22–24
DH has a multifactorial etiology, and generally, more than
one factor is found to be associated and active in this painful
FIG. 1. Visual Analogue Scale index changes in the two
manifestation. Therefore, many products have been tested in
groups at different times.
DH, but the results have been variable. Currently available
treatment involves multiple agents with varying degrees of
effectiveness. Therefore, the evaluation of a further modality
mean VAS score was 5.27  1.26 ( p < 0.001). The corre- to substitute for or augment conventional dental therapy is
sponding scores for session 3 were 5.12  1.28 and 4.15  1.85 warranted. Research is now beginning to focus on the use of
( p < 0.05). In the control group, the corresponding scores lasers to manage DH.
were 7.31  0.77 and 6.88  0.97 for session 2 ( p < 0.01) and The laser parameters contributing to its effect are as fol-
6.54  1.25 and 6.38  1.21 for session 3, respectively lows: power (W), exposure time (seconds), energy density
( p > 0.05). ( J/cm2), pulsed versus continuous wave, contact or defo-
Table 2 shows the mean VAS scores for late effect in the cused irradiation, laser-beam divergence, and energy per
follow-up periods of 15, 30, and 60 days after the conclusion point and total.3 As a laser beam strikes a target-tissue sur-
of the treatment for DH to the test and the control group (Fig. 1). face, the light energy can be effected in four ways: reflected,
On the day 15, the test group had a mean VAS score of transmitted, absorbed, and scattered.3
2.12  1.01, compared with the control group with a VAS Various studies reported a lack of significant pulp damage
score of 5.27  1.08, which was statisticaly significant or thermal alterations after irradiation of the root sur-
( p < 0.001). In addition, the control group had a significant face.3,23,24 It has been reported that healthy pulp tissue is not
decrease in mean VAS score on day 60 ( p < 0.05). injured thermally if the laser equipment is used at a correct
The effects of treatment were demonstrated for both parameter, so that any temperature increase within the pulp
groups of testing sensitivity, and the effects were compara- remains <58C.3 Matsumoto et al.31 demonstrated that 780-
tively stronger. The vitality tests of the teeth were the same nm diode laser, 30 mW for 3 min, caused no thermal or other
before and after laser treatment. damage to pulp tissues in monkeys. In addition, according to
Arrastia et al.,32 GaAlAs laser irradiation at the parameters of
Discussion 30 mW at 780-nm wavelength, 60 mW at 830-nm wave-
DH is a frequently encountered enigma in dentistry. It can length, and 10 W (pulsed) at 900-nm wavelength do not
be a major problem for periodontal patients, who frequently cause significant intrapulpal temperature increases. In our
have gingival recession and exposed root surfaces. This study, none of the teeth treated with laser showed collateral
study provides information about the clinical effectiveness effects, which confirms the safety of this type of treatment.
In clinical research by Sicilia et al.,23 they used a diode
laser with a wavelength of 810 nm at an output power of
2.5 mW for 60 sec for the root surfaces of selected teeth, and
Table 2. Comparison of Mean VAS Scores in the Two
they reported a significant reduction in DH after diode laser
Groups at Different Times (n ¼ 26) (Late Effect)
treatment. In a previous study, Pesevska et al.24 used an 670-
p Value nm low-level diode laser at 100 mW of power, contact mode
Test group Control group (Mann–Whitney U test) for 20 sec (0.1 W20 sec ¼ 2 J), and they reported that low-
level diode laser treatment can be successfully used for
15 days 2.12  1.01 5.27  1.08 <0.001 treatment of DH after scaling and root planing. In the current
30 days 2.12  0.51 5.12  1.15 <0.001 study, we used diode laser with a wavelength of 808 nm, and
60 days 2.08  0.47 4.15  1.17a <0.001
the laser energy was applied at 100-mW power for 25 sec, for
a
p < 0.05. Significant differences between 15, 30, and 60 days a total dose of 2.5 J. The results of the present study indicate
(Friedman test). that noncontact-applied GaAlAs laser is effective in reducing
ALTERNATIVE THERAPY FOR DENTIN HYPERSENSITIVITY S-73

DH. Marsilio et al.18 performed a double-blind study on the clinically advantageous methods to reduce DH because of
effect of GaAlAs laser application at the maximum (5 J/cm2) their rapid clinical effectiveness, with no adverse reactions
and minimum energy densities (3 J/cm2) recommended by observed. As such, they could be suitable for routine clinical
the manufacturer for the treatment of DH. They reported that treatment for DH. The diode laser treatment seems to be
the GaAlAs laser was effective in reducing the initial DH. No benefical and can be an alternative treatment for DH.
significant difference was found between minimum and However, the laser is found in only some clinics because of
maximum applied energy density. GaAlAs laser has been its high cost. Laser devices in dental clinics may become
tested with different output-power levels, combining wave- more widely used to relieve of several disorders of the oral
lengths ranging from 660 to 900 nm, and application periods and maxillofacial region.
from 60 to 150 sec.3 The treatments performed with lasers at
different bands of red and infrared wavelength demon- Conclusions
strated a certain degree of desensitizing capacity. Ladalardo
et al.16 performed a double-blind study on the effect of two Within the limitations of the present study, a significant
types of diode-laser application for the treatment of DH. effect of combined desensitiser toothpaste and diode laser
They reported that the immediate and late therapeutic effects therapy occurs in the treatment of desensitization of teeth
of the 660-nm red-diode laser were more evident compared with gingival recession. Desensitizer toothpaste appears to
with those of the 830-nm infrared-diode laser. Matsumoto have therapeutic potential to alleviate DH. Conversely, diode
et al.33 reported good results in patients treated with red and laser can be used to reduce DH. Further studies are needed
infrared lasers who initially had light and moderate pain to evaluate the long-term stability of the obtained positive
levels. The treatment was not effective in the cases that had results.
shown maximum initial levels of pain. The results of the
present study are in agreement with the results of previous Author Disclosure Statement
studies.19,34,35 We can conclude that both red- and infrared-
wavelength diode lasers have been effective in the treatment No competing financial interests exist.
of DH.
In the control group, the mean VAS scores showed a de- References
crease from pretreatment to posttreatment at all treatment
durations, which was statistically significant. These findings 1. West, N.X. (2008). Dentine hypersensitivity: preventive and
therapeutic approaches to treatment. Periodontology 48, 31–
are similar to results obtained by Pereira and Chava,12 who
41.
used the desensitizing dentifrice and achieved a reduction in
2. Orchardson, R., and Gillam, D.G. (2006). Managing dentin
DH with air by 5.06 to 1.44. Similar observations were made
hypersensitivity. J. Am. Dent. Assoc. 137, 990–998.
by several investigators.11,13,14 The results obtained in the 3. Kimura, Y., Wilder-Smith, P., Yonaga, K., and Matsumoto,
present study seem to suggest that desensitization of teeth K. (2000). Treatment of dentine hypersensitivity by lasers: a
with gingival recession with the combination of diode laser review. J. Clin. Periodontol. 27, 715–721.
and desensitizing dentifrice was more evident. 4. Addy, M. (1990). Etiology and clinical implications of den-
It has been assumed that DH may be reduced by different tine hypersensitivity. Dent. Clin. North Am. 34, 503–514.
mechanisms during two treatments tested in the present 5. Rees, J.S., and Addy, M. (2002). A cross-sectional study of
study. For desensitizing toothpaste whose active ingredient dentine hypersensitivity. J. Clin. Periodontol. 29, 997–1003.
is potassium chloride, potassium ions are thought to act by 6. Addy, M., Mostafa, P., and Newcombe, R.G. (1987). Dentine
blocking the action potential generated in intradental nerves hypersensitivity: the distribution of recession, sensitivity
and to increase the pain threshold of pulpal nerves to hy- and plaque. J. Dent. 15, 242–248.
drodynamic stimuli.27–29 Recently, the GaAlAs (diode) laser 7. Brannstorm, M. (1986). The hydrodynamic theory of den-
was introduced in treating DH by means of inducing chan- tinal pain: sensation in preparations, caries, and the dentinal
ges in neural transmission networks within the dental pulp, crack syndrome. J. Endodont. 12, 453–457.
which may stimulate the normal physiologic cellular func- 8. Brannstorm, M. (1966). Sensitivity of dentin. Oral Surg. Oral
tions.15,17 In addition, these lasers stimulated the production Med. Oral Pathol. 21, 517–526.
of sclerotic dentin, thus promoting the internal obliteration of 9. Ayad, F., Ayad, N., Zhang, Y.P., DeVizio, W., Cummins, D.,
dentin tubules.36 A previous study reported that GaAlAs and Mateo, L.R. (2009). Comparing the efficacy in reducing
(diode) laser blocks the depolarization of C-fiber afferents.20 dentin hypersensitivity of a new toothpaste containing 8.0%
arginine, calcium carbonate, and 1450 ppm fluoride to a
Moreover, besides the immediate analgesic effect, the laser
commercial sensitive toothpaste containing 2% potassium
therapy may stimulate the normal physiologic cellular
ion: an eight-week clinical study on Canadian adults. J. Clin.
functions.21 It would be interesting to study the long-term
Dent. 20, 106.
effects of reducing DH from diode-laser treatment, because 10. Schiff, T., Delgado, E., Zhang, Y.P., Cummins, D., DeVizio,
the mechanism induces the sclerotic dentin layer. In the test W., and Mateo, L.R. (2009). Clinical evaluation of the effi-
group, the mean VAS score showed a decrease from pre- cacy of an in-office desensitizing paste containing 8% argi-
treatment to posttreatment at all treatment durations, which nine and calcium carbonate in providing instant and lasting
was statistically significant. Our findings confirm the data of relief of dentin hypersensitivity. Am. J. Dent. 22, 8A–15A.
the earliest studies in this field.15–20 11. Wara-aswapati, N., Krongnawakul, D., Jiraviboon, D.,
Research is now beginning to focus on the use of lasers to Adulyanon, S., Karimbux, N., and Pitiphat, W. (2005). The
manage DH on the grounds that laser treatment is more effect of a new toothpaste containing potassium nitrate and
comfortable and faster than conventional methods. Never- triclosan on gingival health, plaque formation and dentine
theless, the diode laser and desensitizing dentifrice could be hypersensitivity. J. Clin. Periodontol. 32, 53–58.
S-74 DILSIZ ET AL.

12. Pereira, R., and Chava, V.K. (2001). Efficacy of a 3% potas- 26. Watanabe, H., Nakamura, Y., Wakabayashi, H., and Mat-
sium nitrate desensitizing mouthwash in the treatment of sumoto, K. (1991). Study on laser transmission through tooth
dentinal hypersensitivity. J. Periodontol. 72, 1720–1725. structures by 40 mW GaAlAs semiconductor laser. J. Jpn.
13. Silverman, G., Gingold, J., and Curro, F.A. (1994). Desensi- Endodont. Assoc. 12, 40–44.
tizing effect of a potassium chloride dentifrice. Am. J. Dent. 27. Peacock, J.M., and Orchardson, R. (1999). Action potential
7, 9–12. conduction block of nerves in vitro by potassium citrate,
14. Salvato, A.R., Clark, G.E., Gingold, J., and Curro, F.A. potassium tartrate and potassium oxalate. J. Clin. Period-
(1992). Clinical effectiveness of a dentifrice containing po- ontol. 26, 33–37.
tassium chloride as a desensitizing agent. Am. J. Dent. 5, 28. Peacock, J.M., and Orchardson, R. (1995). Effects of potas-
303–306. sium ions on action potential conduction in A- and C-fibers
15. Tengrungsun, T., and Sangkla, W. (2008). Comparative of rat spinal nerves. J. Dent. Res. 74, 634–641.
study in desensitizing efficacy using the GaAlAs laser and 29. Ajcharanukul, O., Kraivaphan, P., Wanachantararak, S.,
dentin bonding agent. J. Dent. 36, 392–395. Vongsavan, N., and Matthews, B. (2007). Effects of potas-
16. Ladalardo, T.C., Pinheiro, A., Campos, R.A., et al. (2004). sium ions on dentine sensitivity in man. Arch. Oral Biol. 52,
Laser therapy in the treatment of dentine hypersensitivity. 632–639.
Braz. Dent. J. 15, 144–150. 30. Miller, P.D., Jr., (1985). A classification of marginal tissue
17. Corona, S.A., Nascimento, T.N., Catirse, A.B., Lizarelli, R.F., recession. Int. J. Periodont. Restorative Dent. 5, 8–13.
Dinelli, W., and Palma-Dibb, R.G. (2003). Clinical evaluation 31. Matsumoto, K.,Wakabayashi, H., Funato, A., and Shirasuka,
of low-level laser therapy and fluoride varnish for treating T. (1985). Histopathological findings of dental pulp irradi-
cervical dentinal hypersensitivity. J. Oral Rehab. 30, 1183– ated by GaAIAs laser diode. Jpn. J. Conservat. Dent. 28,
1189. 1361–1365.
18. Marsilio, A.L., Rodrigues, J.R., and Borges, A.B. (2003). Ef- 32. Arrastia, A.M., Machida, T., Smith, P.W., and Matsumoto, K.
fect of the clinical application of the GaAlAs laser in the (1994). Comparative study of the thermal effects of four
treatment of dentine hypersensitivity. J. Clin. Laser Med. semiconductor lasers on the enamel and pulp chamber of a
Surg. 21, 291–296. human tooth. Lasers Surg. Med. 15, 382–389.
19. Gerschman, J.A., Ruben, J., and Gebart-Eaglemont, J. (1994). 33. Matsumoto, K., Nakamura, G., and Tomonari, H. (1986).
Low level laser therapy for dentinal tooth hypersensitivity. Study on the treatment of hypersensitive dentine by HeNe
Aust. Dent. J. 39, 353–357. laser irradiation. J. Conservat. Dent. 29, 312–317.
20. Wakabayashi, H., Hamba, M., Matsumoto, K., and Tachi- 34. Yamaguchi, M., Ito, M., Miwata, T., et al. (1990). Clinical
bana, H. (1993). Effect of irradiation by semiconductor laser study on the treatment of hypersensitive dentin by GaAlAs
on responses evoked in trigeminal caudal neurons by tooth laser diode using the double blind test. Aichi-Gakuin J. Dent.
pulp stimulation. Lasers Surg. Med. 13, 605–610. Sci. 28, 703–707.
21. Midda, M., and Renton-Harper, P. (1991). Lasers in den- 35. Kumazaki, M., Zennyu, K., Inoue, M., and Fujii, B. (1990).
tistry. Br. Dent. J. 120, 343–346. Clinical evaluation of GaAlAs-semiconductor laser in the
22. Dilsiz, A., Canakci, V., Ozdemir, A., and Kaya, Y. (2009). treatment of hypersensitive dentin. Jpn. J. Conservat. Dent.
Clinical evaluation of Nd:YAG and 685-nm diode laser 33, 911–918.
therapy for desensitization of teeth with gingival recession. 36. Walsh, L.J. (1997). The current status of low level laser
Photomed. Laser Surg. 27, 843–848. therapy in dentistry, part 2: hard tissue applications. Aust.
23. Sicilia, A., Cuesta-Frechoso, S., Suárez, A., Angulo, J., Por- Dent. J. 42, 302–306.
domingo, A., and DeJuan, P. (2009). Immediate efficacy of
diode laser application in the treatment of dentine hyper-
sensitivity in periodontal maintenance patients: a random- Address correspondence to:
ized clinical trial. J. Clin. Periodontol. 36, 650–660. Alparslan Dilsiz, D.D.S., Ph.D.
24. Pesevska, S., Nakova, M., Ivanovski, K., et al. (2009). Dent- Department of Periodontology
inal hypersensitivity following scaling and root planing: Faculty of Dentistry
comparison of low-level laser and topical fluoride treatment. Atatürk University
Lasers Med. Sci. Jun 1. [Epub ahead of print] 25240-Erzurum
25. Mezawa, S., Iwata, K., Naito, K., and Kamogawa, H. (1988). Turkey
The possible analgesic effect of soft-laser irradiation on heat
nociceptors in the cat tongue. Arch. Oral Biol. 33, 693–694. E-mail: aydilsiz@yahoo.com