ABSTRACT
Introduction:
To identify gender-based differences in pulpal sensory thresholds in human teeth utilizing various conducting media.
Materials and Methods:
The study involved 50 participants of both genders equally distributed. The maxillary central incisors were the teeth selected for the intervention. The three conducting media that were put to the test were Colgate Sensitive Pro-Relief Enamel Repair Toothpaste (CS), Himalaya herbals sensitivity toothpaste (HS), and Lignox 2% gel (LG). Subject’s sensory threshold readings as well as the Visual analogue scale (VAS) scores were noted at the tiniest sensation they experienced. Following an ANOVA, a post hoc analysis was performed to confirm the significance between the three media.
Results:
Lox 2% Jelly significantly reduced sensory threshold values compared to the other conducting media (P < 0.001). Comparing the sensory threshold values of the sexes showed that men have greater values. Male and female readings differed significantly in the Lox 2% Jelly group (P = 0.021), whereas Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, Himalaya herbals sensitivity toothpaste (P < 0.001) groups showed highly significant variances. All the three conducting media had a highly significant variance for the VAS scores. (P < 0.001).
Conclusion:
The conducting material used and gender affect the pulpal sensory thresholds to electric impulses produced by EPT.
KEYWORDS: Gender, pulp test, sensory, toothpaste, tooth sensitivity
INTRODUCTION
The employment of preventative measures in illness management is made possible by early disease detection.[1] To make an accurate diagnosis of endodontic disease, it is required to conduct a precise analysis of the vitality, or lack thereof, of the pulp.[2] To achieve the same, it is helpful to conduct a comprehensive patient history, clinical examination, and radiographic examination. Examining the amount of blood that flows to the tooth is the most reliable method for determining the tooth’s overall state of health. This is accomplished by a technique that is known as “Pulpal Testing.”[3] Thermal and electrical pulp sensibility tests are used to evaluate the status of the dental pulp’s nerves and, in turn, to infer the health of the pulp. These tests are used to determine whether or not the dental pulp is healthy.[4] Even though research demonstrates that cold tests and “Electric Pulp Tests (also known as EPT)” are capable of diagnosing the vitality of the pulp in the majority of situations with comparable accuracy, EPT does have a few disadvantages.[5,6] A positive reaction indicates the presence of living sensory fibers in the pulp; however, information regarding the health or integrity of the pulp is still unclear at this time.[7]
MATERIALS AND METHODS
The prospective observational study was piloted at the department of conservative dentistry at a tertiary care center. Ethical approval was taken. After receiving informed consent, the college’s undergraduate dental students were enrolled as participants. Fully erupted teeth, those free of cavities, restorations, periodontal disorders, and those without a history of trauma were among the inclusion criteria. Individuals taking painkillers or other medications, as well as those with any kind of cardiac pacemakers, were excluded from the study.
RESULTS
It was observed that when the sensory threshold was compared between the genders, the mean value was the lowest for the Lox 2% Jelly group for both the genders and the difference was significant (P = 0.021). The highest sensory threshold was depicted by Himalaya herbals sensitivity toothpaste. The difference was highly significant for both the Colgate Sensitive, Himalaya herbals, when compared between the genders (P < 0.001) Table 1. Similarly when compared between the genders, all the three conducting media had a highly significant variance for the VAS scores (P < 0.001). However, there least mean VAS score for the in the Lox 2% Jelly, and the highest was observed for the Himalaya herbals Table 2. The Post hoc analysis for the sensory threshold between the three media showed a highly significant variance between Colgate Sensitive and Protect and Lox 2% Jelly (P < 0.001); Himalaya herbals and Lox 2% Jelly have a very significant difference (P < 0.001), although Colgate Sensitive and Protect and Himalaya herbals don’t differ significantly (P = 0.69) Table 3. The Post hoc analysis for the VAS scores between the three media showed a significant variance between Colgate Sensitive and Protect and Lox 2% Jelly (P = 0.026). Himalaya herbals and Lox 2% Jelly have a significant variance (P = 0.031), although Colgate Sensitive and Protect and Himalaya herbals don’t differ significantly (P = 0.457) Table 4.
Table 1.
Assessment of the sensory threshold for the three conducting media
| Type of the media | Male (Mean±SD) | Female (Mean±SD) | P |
|---|---|---|---|
| LG | 0.655±0.0947 | 0.588±0.0897 | 0.021 |
| CS | 0.984±0.1124 | 0.7881±0.112 | <0.001 |
| HS | 1.2458±0.1247 | 0.91024±0.893 | <0.001 |
CS=Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, HS=Himalaya herbals sensitivity toothpaste, LG=Lignox 2% gel
Table 2.
Assessment of the VAS for the three conducting media
| Type of the media | Male (Mean±SD) | Female (Mean±SD) | P |
|---|---|---|---|
| LG | 4.963±1.596 | 2.654±1.741 | <0.001 |
| CS | 5.741±1.6412 | 2.1458±1.001 | <0.001 |
| HS | 5.236±1.14785 | 2.451±1.102 | <0.001 |
CS=Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, HS=Himalaya herbals sensitivity toothpaste, LG=Lignox 2% gel
Table 3.
Post hoc analysis for the sensory threshold between the three media
| Type of the media | LG | CS | HS |
|---|---|---|---|
| LG | <0.001 | <0.001 | |
| CS | <0.001 | 0.69 | |
| HS | <0.001 | 0.69 |
CS=Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, HS=Himalaya herbals sensitivity toothpaste, LG=Lignox 2% gel
Table 4.
Post hoc analysis for the VAS scores between the three media
| Type of the media | LG | CS | HS |
|---|---|---|---|
| LG | 0.026 | 0.031 | |
| CS | 0.026 | 0.457 | |
| HS | 0.031 | 0.457 |
CS=Colgate Sensitive Pro-Relief Enamel Repair Toothpaste, HS=Himalaya herbals sensitivity toothpaste, LG=Lignox 2% gel
DISCUSSION
Two different toothpastes and a topical anesthetic gel were used as test materials in the current research since they are commonly seen in dental offices and can be easily accessed there. Because there is not yet any research that has been published that compares the electrical conductivity of herbal toothpastes that are popularly used in the Indian subcontinent, the testing medium for this study was the Himalaya herbals toothpaste. The findings of this study indicate that the pulpal sensory thresholds for the several conducting media that are utilized in EPT are noticeably distinct from one another.[8] As a result, the initial null hypothesis, which stated that the pulpal sensory thresholds that would be obtained by utilizing a variety of conducting media would not differ significantly from one another, was shown to be false and was therefore rejected. The sensory threshold value of Himalaya herbals toothpaste was the greatest, while the sensory threshold value of Lox 2% Jelly was the lowest. Hence, it can be said that the greatest electric conductivity among all the media used in this study was given put by Lox 2% gel.[9,10] These findings lend credence to the conclusions of a more recent investigation, which concluded that aqua-based products convey impulses more effectively than dense agents like those used in the current study 10. In the current investigation, lidocaine’s better impulse conduction was due to its increased ionic nature. A recent in vivo investigation yielded a comparable conclusion. Contrarily, it has also been shown that the threshold reaction does not alter according to gender in the study by Jespersen JJ et al.[11] The following can be used to explain why male sensory threshold and VAS scores significantly increased: The impulse must be administered for a lengthier period of time to reach the pulpal sensory neurons due to the thicker dentin that accounts for larger crown dimensions. Hence, male sensory threshold and VAS scores were raised.
CONCLUSION
When utilized as a conducting medium for electrical pulp testing, water-based Lignox 2% Gel outperformed toothpaste within the constraints of the current study. Men have a substantially higher sensory threshold to electrical stimulation than their female counterparts, according to EPT. Thus, the conducting material employed and the gender affects the pulpal sensory thresholds to electric impulses produced by electric pulp testing.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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