1. Non caries tooth loss Dental erosion Chu CH Faculty of Dentistry The University of Hong Kong

3. Abrasion is the loss of enamel and dentine by wear from surfaces other than teeth (e.g. tooth brushing).

5. Dental erosion Effects: Enamel thinning with exposure of dentin Unsightly appearance of teeth Tooth hypersensitivity Reduced chewing function. 5. Pulpal involvement in advanced cases

6. Dental erosion Significance: Aging population with more elderly retaining their teeth, Change in dietary habits (Cola drinks, red or white wine and fruit juices)

7. Dental erosion Prevalence Limited longitudinal data are available 5% Finnish (Jarvinen et al., 1991) 7% Nigerians (Oginni and Olusile, 2002) 13% Swedish (Lussi et al., 1991) 15% Norwegian (Myklebust et al., 2003) 46% Chinese adults (Hou et al., 2005) 6%Chinese prechildren (Luo et al., 2005) No data in Hong Kong

8. Dental erosion Questionnaire telephone survey (2008) Faculty of Dentistry & Social Science Research Center, University of Hong Kong Chinese adults Website http://hkupop.hku.hk/

9. Age Successful Samples：514

10. 92% Respondents aged 25-45 had symptoms of Dental Erosion Successful Samples：570; Age range: 25-45

11. 72% Respondents reported their teeth turned yellow Successful Samples：520 (multiple responses)

12. Q: How often would you consume non-water beverage and food like soft drinks, coffee, snacks, fruits, dessert, etc. in a day? 36% Successful Samples：494 36% Respondents* ate at least 6 times per day (Average 5.4 Times )

13. 68% Respondents had dental check-upat least once every year Q: On average, how often do you go for dental check up in a year ? Average: 0.92 times SD：0.03 Base：499 Successful Samples：519

14. Dental erosion 73% did not know symptoms of erosion 70% had never heard about erosion 53% could not differentiate erosion and caries This lack of public knowledge about erosion has also been reported in the UK (Dugmore and Rock, Community Dent Health; 20:223-7)

15. Dental erosion Sources: 1. endogenous (eg gastric) 2. exogenous (eg dietary)

16. Dental erosion Sources: endogenous Bullimia

17. Dental erosion Sources: endogenous GI reflux

18. Dental erosion Sources: exogenous Coke Zero over indulgence

19. Dental erosion Sources: exogenous Red wine drinker

20. Dental erosion Sources: exogenous Seafood lovers

21. Dental erosion Sources: exogenous Preserved Snacks

22. Dental erosion Sources: exogenous GI reflux

23. Dental erosion All carbonated drinks, including soda and some energy drinks, contain a lot of acid such as citric, phosphoric and carbonic acids which can rapidly dissolve enamel on teeth.

24. Early erosive tooth wear Prevention Patient Education

26. Reflux and referral to gastroenterologists

27. Preventing erosion

28. Fluoride

29. Dentine bonding agents

31. Fluoride toothpaste

32. Low abrasive toothpaste

33. Dentine bonding agents

35. Consider restorations only when concerns for appearance or sensitivity Composites, Onlays, Crowns

36. Severe erosion Refer to specialist

37. Dental erosion Regular Review is important

39. Dentine HypersensitivityOpportunities for an optimized, evidence based management

40. Definition of Dentine Hypersensitivity Dentine hypersensitivity is characterized by short, sharp pain arising from exposed dentine in response to external stimuli which cannot be ascribed to any other form of dental defect or disease. Correct differential diagnosis is key for management success! Addy M.,Int. Dent.J, 2002, Canadian Advisory Board, J of Can.Dent.Assoc., 2003

41. Aetiology - Mechanism of Hypersensitivity Explained by Brännström’s Hydrodynamic Theory Short sharp pain associated with A-beta and A-delta nerve fibers stimulation Two phases* development: Lesion Localisation Lesion Initiation GINGIVAL RECESSION LOSS OF ENAMEL LESION LOCALISATION Exposure of dentine LESION INITIATION Opening of dentine tubules (removal of cementum or smear layer) *Dababneh et all. Br Dent J, 1999

42. Aetiology - Mechanism of Hypersensitivity GINGIVAL RECESSION LOSS OF ENAMEL Abrasion Attrition Abfraction Erosion Fracture Incorrect tooth-brushing or flossing Periodontitis Periodontal procedures Gingival trauma (picking, hard foods) Crown preparation

43. Dentine Hypersensitivity treatment options Occluding the dentine tubules Desensitising the nerves

44. Desensitising of nerves – mechanism and clinical evidence* Buffering of membrane potential with potassium (K+) ions Symptomatic action Potassium salts delivered in at home products (toothpastes) Potassium nitrate (5%) Potassium citrate (5,5%) Potassium chloride (3,75%) Reduction in yield sensitivity measures – minimum 2 weeks of 2/day use Pain relief - 4-8 weeks of 2/day use Equivocal data on actual efficacy * Literature review in Cummins, J Clin Dent, 2009

45. Dentine tubule occlusion - mechanism and clinical evidence* At home use (Toothpaste) - precipitation of insoluble metal compounds. Strontium chloride – reported less effective than potassium salts** Stannous fluoride – secondary effects (staining)** In office use Established desensitisers with HEMA or oxalate seal Desensitising pastes with calcium sodium phosphosilicate or CPP-ACP technologies High fluoride containing products with sensitivity relief as secondary benefit only (varnishes, toothpastes and gels) *Literature review in Orchardson, JADA, 2006; ** Cummins, J Clin Dent 2009

46. Dentine Hypersensitivity treatment options - Current State 2 widely used mechanisms* ** desensitising toothpaste recognized as the “first option” recommendation – effective but slow (4-8 weeks) pain relief * ** In office treatment approached usually for “severe cases”* ** Stated need for new tested treatment options that should effectively occlude dentine tubules and mimic the natural desensitising process***. *Orchardsson, JADA, 2006, ** Cummins, J Clin Dent 2009, ***Markowitz, J of Oral Rehab., 2007

47. Dentine Hypersensitivity treatment options - Current Needs Efficacy – fast, reliable action and long term effect Action based upon natural process of desensitisation Compatible with other active compounds No staining or other side effects Good taste Safe

48. Introducing a new technology Over several decades, the State University of New York (SUNY) studied the role of saliva in oral health under the leadership of Dr. Israel Kleinberg. Arginine was identified as a key component of saliva and important to oral health Ortek Company, in collaboration with SUNY, developed a novel technology for dentine hypersensitivity associating arginine with calcium carbonate Colgate acquired the technology from Ortek in July 2007, and further developed the formulation by including sodium fluoride

52. How does Pro-Argin™ Technology work against Dentine Hypersensitivity? Arginine promotes precipitation of calcium and phosphate ions to form a calcium-rich layer that plugs and seals the opening of dentine tubules. The plug shields dentine fluid from exposure to external stimuli. - - - Graphical representation, for illustration purposes only Pro-Argin™ Technology thus addresses the cause of dentine hypersensitivity.

53. Pro-Argin™ Technology Documentation Mode of Action How the technology works In vitro tests Clinical Efficacy Hypersensitivity clinical studies Surface roughness study

55. Energy dispersive X-ray spectroscopy (EDX)Confocal Dye Binding Experiments Acid Resistance Hydraulic conductance Pro-Argin™ Technology – Mode of Action Documentation – Dentine Occlusion

56. Pro-Argin™ Technology – Mode of Action High powered microscope visualization Dentine tubules have diameter ~1 to 5 microns High powered microscopes are used to visualize the tubules Confocal Laser Scanning Microscope (CLSM) Scanning Electron Microscope (SEM)

57. Pro-Argin™ Technology – Mode of Action High powered microscope visualization Arginine and CaCO3 are required for efficacy Compared occlusion of CaCO3 8% Arginine/CaCO3/1450 ppm MPF 8% Arginine/Dical/1450 ppm MPF 8% Arginine/CaCO3

58. Pro-Argin™ Technology – Mode of Action High powered microscope visualization: Confocal LSM CaCO3 8% Arginine/dical/1450 ppm MPF 8% Arginine/CaCO3 8% Arginine/CaCO3/1450 ppm MPF

59. Pro-Argin™ Technology – Mode of Action High powered microscope visualization (SEM) Dentine Occlusion – 8.0% Arginine/CaCO3 Treated Baseline SEM Images – 10,000x Magnification

60. AFM used to evaluate dentine surface Untreated dentine shows tubule completely open and helical structure of dentine collagen Treated dentine shows no helical structure – sign of protective layer at the surface of dentine Collagen Open Tubule Pro-Argin™ Technology – Mode of Action Atomic Force Microscopy

61. Pro-Argin™ Technology – Mode of Action Atomic Force Microscopy Untreated Dentine Multiple Tubules Treated dentine Multiple Tubules Dentine tubule completely occluded and sealed by 8% Arg/CaCO3

62. Open Tubule Untreated Dentine– Single Tubule Pro-Argin™ Technology – Mode of Action Atomic Force Microscopy Treated Dentine– Single Tubule

63. Pro-Argin™ Technology – Mode of Action Chemical Analysis - ESCA ESCA is a surface analysis technique used for obtaining chemical information about the surfaces of solid materials Utilizes an x-ray beam to excite a solid sample resulting in the emission of photoelectrons Energy analysis of these photoelectrons provides chemical information about a sample surface ESCA has a sampling depth of approximately 30 Å

64. Pro-Argin™ Technology – Mode of Action Chemical Analysis - ESCA Elementary analysis (by ESCA) of surface layer showed: Before treatment: high levels of carbon, oxygen and nitrogen, and low levels of calcium and phosphorus, consistent with demineralization of dentine and exposure of collagen matrix. After treatment: Increase in calcium, phosphorus and carbonate content confirms the composition of occluding layer deposited after application of the Pro-Argin™ Technology Decrease in nitrogen is due to coverage of collagen-containing dentine surface by occluding layer Increase in silicon is evidence that some silica from Pro-Relief™ Desensitising Polishing paste formula is deposited at the surface of dentine

65. Pro-Argin™Technology– Mode of Action Chemical Analysis - ESCA 16 Legend 14 Before application 12 After application 10 Atomic % 8 6 4 2 0 CO3 Ca P N Silica Chemical Analysis of Coating – ESCA = Electron Spectroscopy for Chemical Analysis*

66. After evaluation of tubule occlusion by SEM, samples were analysed by EDX analysis in order to qualitatively determine the elemental composition of the occluding material as the sampling depth is higher than ESCA Analysis performed on occluded and a freeze-fractured face of the treated dentine disks Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX

67. Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX Energy dispersive X-ray spectroscopy

68. Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX Energy dispersive X-ray spectroscopy

69. Energy dispersive X-ray spectroscopy Pro-Argin™ Technology – Mode of Action Chemical analysis - EDX EDX analysis provided qualitative confirmation of the ESCA results Tubules occluded with arginine, calcium, carbonate, phosphate and silica Increase in silicon is evidence that some silica from Colgate® Sensitive Pro-Relief™ Desensitising Polishing Paste formula is deposited within the occluding layer

70. Confocal Laser Scanning Microscope has two modes of operation Reflectance Shows hard surfaces Fluorescence Discloses substrate that binds fluorescent dye Used FITC dye that binds to amines (Functional group on arginine) Pro-Argin™ Technology – Mode of Action Dentine Occlusion

71. Fluorescence Overlay Reflection Dentine Tubules 100% Open – Top view Pro-Argin™ Technology – Mode of Action Confocal Dye Binding Fluorescein isothiocyanate as dye

72. Open tubules Overlay Reflection Fluorescence Dentine Tubules 100% Open – Side view Pro-Argin™ Technology – Mode of Action Confocal Dye Binding

73. Pro-Argin™ Technology – Mode of Action Confocal Dye Binding Dye concentrated In tubule Fluorescence Reflection Overlay Treated Dentine – Top view

74. Dye concentrated In tubule No open tubules Overlay Fluorescence Reflection Treated Dentine – Side view Pro-Argin™ Technology – Mode of Action Confocal Dye Binding

75. Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance Treatment of dentine surfaces with Colgate® Sensitive Pro-Relief™Desensitising Polishing Paste Subsequent treatment of occluded dentine samples with acidic soft drink Visualisation of dentine surface by 2 methods Confocal Laser Scanning Microscopy (CLSM) in reflectance mode CLSM using a fluorescent dye that adheres to surfaces, side view

76. Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance Before treatment Treated with Pro-Argin™ Technology 5xs 2nd Acid Challenge (24 hours later) 1 minute Acid Challenge

77. Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance Open tubules Open tubules Overlay Reflection Fluorescence

78. Pro-Argin™ Technology – Mode of Action Confocal Dye Binding – Acid resistance Treated with 8.0% Pro-Argin™ Technology 5x Untreated Open tubules Acid Challenge- treated with Acidic drink for 1 min Second Acid Challenge (24 hours later) - treated with Acidic drink for 1 min Tubule occlusion by the Pro-Argin™ technology is resistant to acid from common beverages

79. Pro-Argin™ Technology – Mode of Action Hydraulic Conductance Hydraulic conductance (Pashley et al) is used to measure inhibition of fluid flow in dentine tubules Effective occlusion agents reduce flow Hydraulic conductance experiments were conducted with Colgate Sensitive Pro-Relief™ Desensitising Polishing Paste (Pro-Argin™ formula)

80. Pro-Argin™ Technology – Mode of Action Hydraulic conductance Pro-Argin™ Technology significantly reduced fluid flow in dentine tublules

81. Pro-Argin™ Technology – Mode of Action Summary The arginine interacts with the calcium carbonate at physiological pH to form a positively charged agglomerate which is attracted by electrostatic forces to negative surfaces, including dentine This agglomerate promotes the formation of a calcium-rich mineral layer on the dentine surface to occlude the tubules. The occlusion protects dentinal fluid from exposure to external stimuli, thus stopping fluid movement in the tubules. This blocking of the fluid movement addresses the cause of pain and discomfort. The occluding layer resists acid attacks, such as provoked by certain acid beverages.

82. Pro-Argin™ Technology Documentation Mode of Action How the technology works In vitro tests Clinical Efficacy Hypersensitivity clinical studies Surface roughness study

83. Pro-Argin™ Technology Clinical Documentation Hypersensitivity Measurements Methodology In-Office desensitising (Prophylaxis) Paste containing 8% Arginine and Calcium Carbonate Colgate supported independent Clinical Documentation Ortek Clinical Documentation Toothpaste formula containing arginine and 1450 ppm fluoride as MFP in a calcium carbonate base

84. Hypersensitivity Measurements Methodology Dentine Hypersensitivity (DHS) improvements for a tested product are usually compared to negative &/or positive controls in order to establish product efficacy. Double-blind randomized parallel groups DHS is generally may be measured following the application of stimuli of known intensity: Tactile Air blast Thermal

85. Hypersensitivity Measurements Methodology Tactile stimulation Pressure stimulation based assessment Electronic Force Sensing Probe (Yeaple Probe) calibrated once daily Explorer tip stroked perpendicular to surface beginning at pre-set force of 10g and increasing by 10g increments until patient expresses discomfort. Scored as force (g) required to elicit discomfort Non-sensitive if no discomfort upon 50g of force.

86. Hypersensitivity Measurements Methodology Air blast stimulation Evaporative stimulus-based assessment One second of air delivered at 1cm distance from the surface From standard dental unit syringe at 60psi (±5) and 70°F(±3) Examiner scores subject response using Schiff Cold Air Sensitivity Scale, where: “0” No subject response to stimulus “1” responds but will continue “2” responds and moves or requests discontinuation “3” Painful response to stimulus, discontinuation requested

87. Pro-Argin™ Technology Clinical DocumentationHypersensitivity Clinical Research Methodology Fully compliant with American Dental Association Acceptance Guidelines for approval of desensitising products Reviewed by the US Food and Drug Administration (FDA) Also utilized in published research testing the effectiveness of desensitising products

88. Pro-Argin™ Technology Clinical DocumentationHypersensitivity Clinical Research Methodology Colgate Sensitive Pro-Relief™ Desensitising Polishing Paste with Pro-Argin™ Technology 8% arginine in a calcium carbonate/silica prophy base No fluoride Toothpaste formula containing arginine and 1450 ppm fluoride as MFP in a calcium carbonate base

89. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Study design for post-scaling application1 Objectives Compare the efficacy in reducing hypersensitivity after a single post scaling application, as the final polishing step in a dental prophylaxis Assess the duration of relief over 4 and 12 weeks. Methodology Study conducted in San Francisco, California 68 subjects (50% female) Test: Colgate Sensitive Pro-Relief™ Paste n=32 Negative Control: Nupro n=36 Mean age 36 years (24-56) Double blind, parallel group controlled study Tactile and air blast scores at baseline, immediate after product application, at 4 and 12 weeks. All used Crest anti cavity toothpaste and soft brush for duration of study. 1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A

90. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Post-scaling application - Tactile results1 p < 0.05 p < 0.05 Yeaple Probe Pressure Test product Control product 1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A

91. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Post-scaling application - Air Blast Results1 p < 0.05 p < 0.05 Schiff Scores Test product Control product 1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A

92. Post-scaling application1 Conclusions: Colgate® Sensitive Pro-Relief™ desensitising paste provides a statistically significant reduction in dentine hypersensitivity as compared to a control prophylaxis paste immediately after a single application following dental scaling. This relief lasts for 4 weeks. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product 1 Schiff T et al , (2009) Am.J of Dent, 22, Special Issue A, 8A-15A

93. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Study design for pre-scaling application2 Objective Compare the efficacy in reducing hypersensitivity when applied before professional prophylaxis Methodology Study conducted in Langhorn, Pennsylvania 45 subjects (33 female) Test: Colgate Sensitive Pro-Relief ™ Paste n=22 Negative Control: Nupro n=23 Mean age 45 years (23-66) Double blind, parallel group controlled study Tactile and air blast scores at baseline, Two 3 second applications of test or control product with prophy cup Reassess sensitivity after completion of scaling and polishing with Nupro prophy paste 2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A

94. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Pre-scaling application - Tactile Results2 p < 0.05 Yeaple Probe Pressure Test product Control product 2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A

95. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Pre-scaling application - Air Blast Results2 p < 0.05 Schiff Scores Test product Control product 2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A

96. Conclusions: When applied prior to a scaling, Colgate® Sensitive Pro-Relief™ desensitising paste with 8 % arginine and calcium carbonate provides a statistically significant reduction in dentine hypersensitivity measured after scaling compared to a control prophylaxis paste. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product Pre-scaling application2 2 Hamlin D et al, (2009) Am J of Dent, 22, Special Issue A, 16A-20A

97. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product ORTEK Sponsored Studies Immediate Relief Negative controlled Study Reductions in sensitivity after dental prophylaxis procedure Tactile: 53% improvement compared to 2% for the negative control Air blast: 37% improvement compared to 6% for the negative control Thermal: 37% improvement compared to 13% for the negative control 2. Immediate and Lasting (28 days) Relief Monadic-design Study Reductions in sensitivity immediately after dental prophylaxis procedure Tactile: 84% improvement from baseline Air blast: 72% improvement from baseline Reductions in sensitivity 28 days after dental prophylaxis procedure Tactile: 88% improvement from baseline Air blast: 68% improvement from baseline

98. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office product In vitro testing3 of surface roughness Composite Porcelain Amalgam Gold Enamel No significant alteration of surfaces 3 Garcia-Godoy F et al, (2009) Am J of Dent, 22, Special Issue A, 21A - 24A

99. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – In office productConclusions Significant immediate and lasting (28 days) tactile and air blast dentine hypersensitivity relief when applied as a single treatment after tooth scaling procedure, as the final polishing step in a dental prophylaxis. Significant tactile and air blast dentine hypersensitivity relief when applied as a single treatment before professional prophylaxis (scaling and polishing) procedure. No significant effect on surface roughness on the following substrates: resin composite, porcelain, amalgam, gold and human dental enamel.

100. Study design4 Objectives Compare the efficacy in reducing hypersensitivity after brushing application after 2, 4 and 8 weeks. Methodology Study conducted in private practice, Rome, Italy 80 patients (24 males, 56 females) 40 subjects in each group mean age of 42.2 y (± 10.6y) Test products: Test Formula: 8% Arginine/CaCO3/1450 ppm fluoride (as MFP) Positive Control: 3.75%KCl / 1450 NaF Double blind, parallel group controlled study Tactile and air blast scores at baseline, 2, 4 and 8 weeks Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula 4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22

101. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula Tactile Stimulation Results4 p < 0.05 p < 0.05 p < 0.05 Yeaple Probe Pressure Test formula Control product 4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22

102. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula Air Blast Stimulation Results4 p < 0.05 p < 0.05 Schiff Scores p < 0.05 Test formula Control product 4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22

103. Docimo R et al 4 Conclusions: Pro-Argin™ Technology was shown to effectively reduce tactile and air blast hypersensitivity compared to both the baseline values and to a positive control toothpaste* containing 3.75% KCl when used twice daily for two, four and eight weeks. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula * Sensodyne Total Care F toothpaste 4 Docimo R et al (2009) J Clin Dent 20 (Spec Iss): 17-22

104. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula Study Design5 Objectives Compare the efficacy in reducing hypersensitivity after brushing application after 3 days, 2, 4 and 8 weeks. Methodology Study conducted in clinical research centre, Mississauga, Canada. 77 patients (25 males, 52 females) 38 test and 39 control subjects mean age of 35.2 y ± 10.6) tested products Test formula: 8% Arginine /CaCO3/ 1450 ppm Fluoride (MFP) Positive Control: 3.75%KCl / 1450 NaF Double blind, parallel group controlled study Tactile and air blast scores at baseline, 3 days, 2, 4 and 8 weeks 5 Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.

105. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula Tactile Stimulation Results5 p < 0.05 p < 0.05 p < 0.05 Yeaple Probe Pressure Test formula Control product 5 Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.

106. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula Air Blast Stimulation Results5 p < 0.05 p < 0.05 p < 0.05 Schiff Scores Test formula Control product 5Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.

107. Ayad et al5 Conclusions: Pro-Argin™ Technology was shown to effectively reduce tactile and air blast hypersensitivity compared to both the baseline values and to a positive control toothpaste* containing 3.75% KCl when used twice daily for two, four and eight weeks. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula * Sensodyne Total Care F toothpaste 5 Ayad F et al (2009) J Clin Den (Spec Iss) 10-16.

108. Pro-Argin™ Technology Clinical Documentation Clinical Research Results – Test Formula : Summary Clinical data from two independent clinical trials showed show that the Pro-Argin™ Technology was shown to effectively deliver a sensitive benefit as compared to a leading desensitising toothpaste containing 2% potassium ion as the desensitising agent.

109. 100 Pro-Argin™ Technology Conclusions Pro-Argin™ Technology is an innovative and proprietary technology combining the key ingredients Arginine, an amino acid, and insoluble calcium carbonate. Occludes tubules rapidly and effectively to treat the cause of tooth sensitivity. Tubule occlusion is calcium rich and acid resistant. Provides fast relief and long lasting protection from hypersensitivity. Is compatible with fluoride and provides no secondary unpleasant effects. Provides clinically superior sensitivity relief compared to other leading desensitising technologies (3.75% potassium chloride equivalent to 2% potassium). Represents a reliable solution for treatment of dentine hypersensitivity of various aetiology.

113. Colgate Sensitive Pro-Relief Desensitizing In-Office Paste

114. Colgate Sensitive Pro-Relief Desensitizing In-Office Paste Clinically proven to deliver instant relief that lasts four weeks after a single application Fast and easy application using a rotary cup

115. With

116. With

117. Reduces sensitivity pain for a comfortable dental procedure With

118. Fast and easy to use Fill a rotary cup with paste.

119. Fill a rotary cup with paste. At low to moderate speed polish whole dentition. On sensitive areas apply product for 3 seconds and then repeat. Fast and easy to use

120. Proof of clinical efficacy

121. Post-procedure instant and lasting relief study Controlled study 68 male and female subjects (between 24 and 56 years of age) with established dentin hypersensitivity Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.

122. Post-procedure instant and lasting relief study Controlled study 68 male and female subjects (between 24 and 56 years of age) with established dentin hypersensitivity Products tested Pro-ArginTM technology desensitizing paste Negative control: pumice prophylaxis paste Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.

123. Post-procedure instant and lasting relief study Product A or B Scaling Day 28 Day 0 (Immediate) Baseline Controlled study 68 male and female subjects (between 24 and 56 years of age) with established dentin hypersensitivity Products tested Pro-ArginTM technology desensitizing paste Negative control: pumice prophylaxis paste Product applied after scaling procedure Evaluations at baseline, immediately after application, 28 days, 3 months Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.

124. Post-procedure instant and lasting relief study

125. Post-procedure instant and lasting relief study Effects on dentin hypersensitivity Tactile sensitivity scores Test paste Control paste Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.

126. Post-procedure instant and lasting relief study Effects on dentin hypersensitivity Tactile sensitivity scores Air blast sensitivity scores Test paste Control paste Test paste Control paste Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.

127. Post-procedure instant and lasting relief study Effects on dentin hypersensitivity Tactile sensitivity scores Air blast sensitivity scores 149.6% reduction Test paste Control paste Test paste Control paste 79% reduction 40.6% reduction 34.1% reduction Schiff T et al. Am J Dent. 2009;22(Spec Iss A):8A-15A.

131. Plugs and seals open tubules

132. Plugs and seals open tubules

133. Shown to be more effective than the control toothpaste with potassium salt

134. Air blast sensitivity score Shown to be more effective than the control toothpaste with potassium salt Brushing twice daily over a period of 8 weeks with Colgate® Sensitive Pro-Relief™ Toothpaste with Pro-Argin™ Technology is significantly (p<0.05) more effective in reducing sensitivity than using the control toothpaste (with potassium ions). Colgate Sensitive Pro-Relief™ Toothpaste Positive control: Toothpaste with 2% potassium ion Docimo R et al. J Clin Dent. 2009;20(Spec Iss):17-22.

135. Air blast sensitivity score Shown to be more effective than the control toothpaste with potassium salt Sensitivity relief Brushing twice daily over a period of 8 weeks with Colgate® Sensitive Pro-Relief™ Toothpaste with Pro-Argin™ Technology is significantly (p<0.05) more effective in reducing sensitivity than using the control toothpaste (with potassium ions). Colgate Sensitive Pro-Relief™ Toothpaste Positive control: Toothpaste with 2% potassium ion Docimo R et al. J Clin Dent. 2009;20(Spec Iss):17-22.

139. Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing

140. Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing 3 2 Air blast sensitivity scores 1 0 Baseline Immediate 3-day When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing. Colgate Sensitive Pro-Relief™ Toothpaste Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.

141. Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing 3 2 Air blast sensitivity scores 1 0 Baseline Immediate 3-day When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing. Colgate Sensitive Pro-Relief™ Toothpaste Positive control: Toothpaste with 2% potassium ion Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.

142. Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing 3 2 Air blast sensitivity scores 1 0 Baseline Immediate 3-day When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing. Colgate Sensitive Pro-Relief™ Toothpaste Positive control: Toothpaste with 2% potassium ion Negative control: Toothpaste with 1450 ppm fluoride only Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.

143. Shown to provide instant relief with direct application and continued relief with subsequent twice-daily brushing 3 2 Air blast sensitivity scores Sensitivity relief 1 0 Baseline Immediate 3-day When applied directly to the sensitive tooth with a fingertip and gently massaged for 1 minute, Colgate® Sensitive Pro-Relief™ Toothpaste provides instant sensitivity relief compared to the positive and the negative control. The relief was maintained after 3 days of twice-daily brushing. Colgate Sensitive Pro-Relief™ Toothpaste Positive control: Toothpaste with 2% potassium ion Negative control: Toothpaste with 1450 ppm fluoride only Nathoo S et al. J Clin Dent. 2009;20(Spec Iss):123-130.

144. Colgate Sensitive Pro-Relief™ Toothpaste

145. Colgate Sensitive Pro-Relief™ Toothpaste Colgate Sensitive Pro-Relief™ Toothpaste is the first toothpaste for at-home use and is clinically proven to provide instant and lasting sensitivity relief

146. Colgate Sensitive Pro-Relief™ Toothpaste Colgate Sensitive Pro-Relief™ Toothpaste is the first toothpaste for at-home use and is clinically proven to provide instant and lasting sensitivity relief Works instantly when applied directly to the sensitive tooth

147. Colgate Sensitive Pro-Relief™ Toothpaste Colgate Sensitive Pro-Relief™ Toothpaste is the first toothpaste for at-home use and is clinically proven to provide instant and lasting sensitivity relief Works instantly when applied directly to the sensitive tooth Contains fluoride for caries prevention

148. A breakthrough in dentin hypersensitivity relief

149. A breakthrough in dentin hypersensitivity relief An in-office treatment for instant sensitivity relief in one fast and easy step

150. A breakthrough in dentin hypersensitivity relief An in-office treatment for instant sensitivity relief in one fast and easy step A daily-use toothpaste as follow-up treatment for long-lasting relief

151. A breakthrough in dentin hypersensitivity relief An in-office treatment for instant sensitivity relief in one fast and easy step A daily-use toothpaste as follow-up treatment for long-lasting relief The first toothpaste to be clinically proven to offer instant relief when applied directly