Dentine hypersensitivity. I. Effects produced by the uptake in vitro of metal ions, fluoride and formaldehyde onto dentine.

Dentine has been shown to possess affinity for a large number of varied compounds, many of which have been shown effective in clinical trials, for the treatment of dentine hypersensitivity. The mode of action of these compounds is unclear. The aim of this study was to investigate the uptake of metal ions, fluoride and formaldehyde in solution onto dentine in vitro and determine whether therapeutic effects could be mediated through occlusion of dentinal tubules. Etched dentine sections were exposed for 1 h to 1000 ppm solutions of fluoride and metal salts. Levels of fluoride and respective metals could be extracted and measured from the specimens. Saliva pretreatment had a variable but small effect on uptake of each ion, but post treatment washings reduced all levels of retained fluoride and metals. X-ray microanalysis indicated surface or immediate subsurface deposits of metals. However, surface changes were only consistently produced by zinc and more particularly tin salts. Both zinc and tin salts produced covering or obturation of tubules. The surface effects of zinc could largely be reversed by washing, but not those of tin. Formaldehyde alone or in the presence of saliva produced no effects. A 4-week study involving twice daily exposure of specimens to saliva and fluoride, metals or formaldehyde yielded essentially the same results. It is unlikely that, except for tin, the compounds tested achieve their apparent clinical effects mediated by direct occlusion of dentinal tubules.