regardless of the type of stimulus , the only reaction of the pulp is pain . a dull and difficult to locate pain lasting longer than the acting stimulus is pulp pain , caused by c - fibers activation and frequently confirming pulpitis . acute , situated , receding pain after the cessation of the stimulus is dentin pain , caused by activation of nerve fibers a-   and is found in many different ailments , including dentin hypersensitivity [ 24 ] . in 1979 , merskey distinguished and characterized pain in several categories for the international association for the study of pain ( iasp ) . according to the current definition , pain is an unpleasant sensory or emotional experience , associated with actual or potential tissue damage or described in terms of such damage . because organs and tissues located in the oral cavity are well supplied with blood and nerve endings , all pathological processes in the region cause high - intensity pain . the perception of pain originating in the mouth is perceived as disproportionately severe in relation to the actual cause of the pain , as compared to the rest of the body . knowledge of the essence of pain , as well as its types or radiation , is often the basis for setting the correct diagnosis and treatment . in physiological conditions , when the pulp - dentin complex is protected by enamel and root cementum , such stimuli as cold , hot , sweet and acid foods , and tooth brushing or touching , do not induce pain in the pulp . when it comes to exposing the dentine and opening of outlets of dentinal tubules with maintaining their patency toward the pulp , harmless external stimuli ( thermal , dehydrative , tactile , chemical or osmotic ) cause excessive pain response in the pulp . the described clinical condition , which can not be attributed to another disease or tooth defect , has been defined as dentin hypersensitivity [ 3,911 ] . it has been described as one of the most painful and least successfully treated chronic ailments of the teeth . factors contributing to exposure of dentin are attrition , abrasion , erosion and abfraction , loss of cement in the cervical region following periodontal disease , or loss of organic matter of hard tissues of the tooth after teeth whitening [ 3,4,811,13 ] . according to the hydrodynamic theory explaining the formation of dentin hypersensitivity in pulp pain , the stimuli acting on the exposed dentine surface cause movement of the fluid in the dentinal tubules , stimulating pulp nerve receptors . the intensity of the pain varies from strong with high intensity to mild with moderate intensity , which may be because not all patients with hypersensitive dentin seek help from a dentist . the incidence of the disease in the adult population ranges from 8% to more than 50% . despite the presence on the market of many therapeutic agents to be used by patients at home and professional ones to be used in the dental office , there is no completely effective treatment that quickly and permanently eliminates dentin hypersensitivity [ 3,12,1518 ] . a remedy for this still - current problem is a new product based on inorganic amorphous calcium and sodium phosphosilicates belonging to the group of materials known as bioactive glass , with the brand name novamin . the novamin concentration in nupro sensodyne prophylaxis paste is 15% compared to 5% in a tooth paste . the aim of the study was the clinical evaluation of the effectiveness of the professional polishing paste nupro sensodyne prophylaxis paste in eliminating dentin hypersensitivity after a single application on the exposed , hypersensitive dentin . the research comprised 92 teeth with dentin hypersensitivity diagnosed based on history and clinical examination in 23 patients ( 14 women and 9 men ) aged 2166 years . before starting treatment , patients responded to questions contained in a specially prepared questionnaire , including questions about the duration and severity of pain . the survey included the type of pain - inducing stimuli ( cold , warm , touching , brushing , sweet , sour ) and the intensity according to patient subjective assessment . in this aspect , history - taking was performed twice : in survey 0 ( preliminary ) and in survey 1 ( 1 week after the application of nupro sensodyne prophylaxis paste , dentsply ) . in addition , the survey included questions about hygienic habits of patients : frequency of tooth brushing , the hardness of toothbrush , and the use of assistive oral hygiene and dietary habits . in the clinical trial , the number of lesions with exposed dentin on each tooth and their location , together with an indication of the likely causes and diagnosis , were assessed . dentin hypersensitivity mostly occurred in abrasion ( 49 teeth ) , post - treatment hypersensitivity mostly occurred after scaling and orthodontic treatment ( 34 teeth ) , erosion occurred in 8 teeth , and in 1 tooth attrition was diagnosed . the pain reaction of exposed dentine , with patient consent , was induced by touching with a blunt probe ( tactile stimulus ) and by the air flow emitted from the blower for 1 s at a distance of 1 cm ( dehydrating stimulus ) , asking patients to assess pain intensity on the vas scale . in each test before and 1 week after the application of paste , the assessment included the severity of induced pain according to the criteria : 0=no pain , 13 points = slight pain , 46 points = moderate pain , 79 points = strong pain , and 10 points = very severe pain . the nupro sensodyne prophylaxis paste was applied once onto the exposed sensitive dentin for 60 s using the preventive rubber cup on a low - speed handpiece as indicated by the manufacturer . in a preliminary study , before applying the nupro sensodyne prophylaxis paste , the examined teeth reacted with pain when applying both stimuli . tactile stimulus induced the highest levels of pain ( 10 points ) in 1.1% of cavities , in 16.3% strong pain ( 79 points ) , moderate pain in 42.4% ( in the range of 46 points ) , small in 29.3% ( 13 points ) , and 10.9% of teeth did not respond with pain to tactile stimulus ( table 2 ) . in case of dehydrating stimulus application in the initial test , severe pain was found ( range 79 points ) in 28.3% of studied cavities , in 38% moderate pain ( 46 points ) ; in 21.7% slight pain l ( 13 points ) , and 12% felt no pain with the application of this stimulus ( 0 points ) ( table 3 ) . one week after the application of the examined paste , the percentage of teeth reacting with a very strong pain decreased from 1.1% to 0 , from 16.3% to 4.3% with severe pain , and 42.4% to 12% with moderate pain . in contrast , the percentage of teeth with a slight feeling of pain increased from 29.3% to 30.4% , and with no symptoms of pain from 10.9% to over 50% of studied teeth ( table 4 ) . a study using dehydrating stimulus 1 week after carrying out the application showed a decrease in the proportion of teeth reacting with strong pain from 28.3% to 0% , by a moderate pain from 38% to 15.2% , an increase in the percentage of people experiencing little pain from 21.7% to 37% , and the absence of pain from 12% to about 50% ( table 5 ) . the reallocation in these groups is caused by moving the percentage of people experiencing pain from the 79 interval into the 13 interval according to the vas scale . prior to the study , the subjects responded to the questions included in the questionnaire . in 73% of respondents experiencing dentin hypersensitivity , the causative agent of pain onset was cold , in 55% it was tooth brushing , and 18% of patients reported that sweet or sour foods caused a pain response . all the respondents feeling hypersensitivity characterized the pain as short - term pain and 41% as acute pain . in 68% of respondents , sixty - four percent of the respondents reported tooth brushing twice a day , using a manual toothbrush in most cases ( only 3 people used a power toothbrush ) . in response to a question about eating habits , 45% of respondents indicated they had fresh fruit or fruit juice once a day , 32% had fresh fruit or fruit juice several times a day , 41% occasionally drank cola beverages , and 55% drank wine . contemporary reports show that the treatment of dentin hypersensitivity involves interruption of the neural response to pain stimulus by topical application of preparations containing potassium salts , because potassium ions cause depolarization of nerve receptors and reduce the conductivity . a second approach is by mechanical occlusion of outlets and the lumen of open dentinal tubules , and then the formation of insoluble precipitates with the participation of compounds of calcium , fluoride , strontium , arginine , the adhesive resins or lasers [ 24,10,13,15,1721 ] . researchers interested in the problem of elimination of dentin hypersensitivity suggest , among other things , that the treatment of this problem should mimic the natural process , leading to spontaneous occlusion of open dentinal tubules . in the natural process of tubule occlusion , saliva provides calcium and phosphorus ions , which gradually occlude the tubules by forming a superficial protective layer consisting of salivary glycoprotein aggregates , calcium , and phosphates . the natural process does not cause rapid occlusion of dentinal tubules and the elimination of pain occurring in the dentin hypersensitivity . to speed this process , additional amounts of calcium and phosphates must be delivered to the oral environment . the easiest and most natural way to do this is to use toothpaste that provides calcium and phosphates in a form providing clinical efficacy , despite the fact that saliva is a supersaturated solution of calcium and phosphate ions in relation to the hard tissue . for this purpose , compositions are applied that contain amorphous calcium phosphate , biphasic pastes with calcium sulfate , ammonium phosphate , sodium fluoride , di - potassium phosphate , and sodium bicarbonate and  biomaterials  containing phosphoro - silicate - calcium mixtures and bioactive glass particles . studies on the mechanism of closure of dentinal tubules have led to the development of a new formula based on bioactive glass particles , called novamin . originally , it was intended for the regeneration of bone tissue and recently was used in dentistry . the mechanism of elimination of dentin hypersensitivity by novamin technology is based on the formation of a mechanically and chemically resistant calcium phosphate layer , which gradually crystallizes as hydroxyapatite . in contact with a moist environment ( water and saliva ) , novamin releases particles of calcium and phosphorus ions protected by the glass particles so that they can be delivered to a specific location , but not into the liquid medium . the next reaction step is the exchange of sodium ions from the bioactive glass particles with hydrogen cations , which increases ph to 88.5 . alkaline ph promotes the release of calcium and phosphate ions , which , in the form of calcium phosphate , precipitate on the surface of the exposed dentine and in the light dentinal tubules gradually crystallize into a stable hydroxyapatite layer   that is resistant to repeated action of extrinsic and intrinsic acids . the formula is modeled on the natural process of closing of dentinal tubules developed by markowitz and pashley . there are currently 2 types of prophylactic pastes with novamin on the market : nupro sensodyne polish or stain removal versions , and pastes without fluoride content are also available . studies have confirmed the efficacy of calcium and sodium phospho - silicate at various concentrations both in vitro , in vivo , and in situ [ 23,25,2732 ] . wang et al .   proved the clinical efficacy of pastes with novamin in an in vitro study . samples of dentin with open dentine tubules were exposed to paste including bioactive glass ( novamin ) . occlusion of dentinal tubules and increase in mineral content after using novamin were demonstrated by scanning electron microscopy ( sem ) . the resulting layer of material also proved to be resistant to repeated attacks of extrinsic acids . earl et al . used modern imaging techniques , and analyses showed an in vitro conversion of 15% calcium and sodium phosphosilicate ( novamin ) with amorphous material to a crystalline material corresponding to hydroxyapatite , which occluded dentinal tubules in the environment of artificial saliva . chemical analysis of dentin surface after applying the tested paste showed an increase in calcium and phosphorus content . demonstrated a significantly higher reduction of dentine hypersensitivity reactions in patients using a toothpaste with 5% calcium and sodium phosphosilicate at home , compared to the paste containing 5% potassium nitrate . novamin also proved to be effective in eliminating dentin hypersensitivity when it was used in a concentration of 7.5% as an ingredient in a toothpaste , and compared with other formulations ( potassium nitrate , fluoride , and tin ) reduced the pain in a shorter time . neuhaus et al . also achieved a statistically significant reduction in pain sensation after a single prophylactic professional application of novamin paste ( 15% calcium and sodium phosphosilicate ) with and without fluoride , compared to controls . in patients with dentine hypersensitivity after scaling and polishing of the root surface , the use of novamin paste resulted in immediate reduction of pain sensations continuing for 28 days after the treatment administration . immediate reduction of pain caused by a standardized touch stimulus ( yeaple probe ) was 100.5% according to the average value in the group that used fluoride toothpaste and 119.1% in the group without fluoride . the average value immediately after the prophylactic treatment of the relative reduction of pain sensation from blower air flow was 44.6% for both of the test groups and increased to about 50% after 4 weeks . the authors reported no statistically significant difference in pain reduction when comparing groups , which used professional novamin toothpaste with fluoride and without fluoride . the results of the presented work confirm the effectiveness of the nupro sensodyne prophylaxis paste after a single professional application on the exposed hypersensitive dentine . it was noticeable as an increase of percentage of tested teeth without pain and with a slight pain after tactile and dehydrating stimulus . feeling of pain expressed as the mean value in the vas scale was reduced in the examined group by 94% . in - office use of professional prophylactic paste with novamin formula noticeably reduces dentin hypersensitivity 1 week after application .
backgroundone of many functions of the pulp - dentin complex is sensory function . 
 acute , situated , receding pain after the cessation of the stimulus action is called dentin pain . 
 dentin hypersensitivity has been described as one of the most painful and least successfully treated chronic ailments of teeth . 
 the aim of this research was the clinical evaluation of the effectiveness of professional polishing paste containing calcium sodium phosphosilicate formula ( novamin ) in eliminating dentin hypersensitivity after a single application.material/methodsthe study comprised 92 teeth with dentin hypersensitivity diagnosed on the basis of history and clinical examination . 
 the pain reaction of exposed dentine was induced by tactile and dehydrating stimuli , asking patients to assess the severity of pain on the vas scale . 
 clinical trial and survey were carried out twice : before and 1 week after the application of the polishing paste.resultsafter the application of the examined paste , the percentage of teeth reacting with a severe pain to the touch of the probe decreased from 16.3% to 4.3% , and with a moderate pain from 42.4% to 12% . 
 examination after applying dehydrating stimulus a week after carrying out the application showed a decrease in the proportion of teeth with strong pain from 28.3% to 0% and moderate pain from 38% to 15.2% . 
 the lack of pain increased from 12% to about 50%.conclusionsthe use of prophylactic professional paste with novamin formula in in - office procedure provides the reduction of dentin hypersensitivity noticeable by 1 week after application .