There are a number of oral care conditions where resolution may rely on patients’ actions between dental appointments, as opposed to treatment in the dental chair. Dentine hypersensitivity is one such condition. Although there are potential in-surgery management options, the first line of non-invasive treatment tends to be the recommended use of a desensitising toothpaste twice daily (Canadian Advisory Board on Dentin Hypersensitivity, 2003).The dentine hypersensitivity pain cycle
The use of a desensitising toothpaste has been a recognised treatment option for the condition of dentine hypersensitivity since the launch of brands, such as Sensodyne, in the 1960s. The recommendation is for twice daily use to stop the pain of the condition, either through an occlusive mode of action or by nerve depolarisation. However, over the years patients are often observed stopping treatment when the pain subsides, only for it to return some time later.
So how can we engage patients to comply with the recommendations for the management of dentine hypersensitivity with a daily desensitising toothpaste?A review from the patient’s perspective
A review paper undertaken by Jing Jin et al (2008) at the University of Newcastle in New South Wales, Australia, sought to explore and evaluate the most common factors causing therapeutic non-compliance from studies across a number of countries, including different diseases and different patient populations. Some of these learnings can provide useful insights to consider for recommendations in practice.
Factors that influence levels of compliance were found to include:
Misconceptions about the disease or treatment have been shown to have a negative effect on compliance. One example is where patients feel that continued use of a treatment will diminish the effectiveness of that therapy.
The review was based on 102 articles and although they were often amongst patients with more significant health concerns, there are insights that could be applied when recommending the use of a daily specialist toothpaste for DH sufferers:
Whilst not life threatening, there is evidence that dentine hypersensitivity can significantly impact a patient’s quality of life (Baker et al, 2013; GSK data on file RH01897, August 2014). A daily recommendation of a specialist toothpaste can make a genuine difference and, when used correctly, reduce the impact of triggers such as cold food and drinks. There is an opportunity to consider the factors that influence compliance to help improve outcomes for patients with dentine hypersensitivity. It is therefore important to stress the need to continue treatment at each visit.
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