title: Effect of peroxide concentration and brushing on whitening clinical response.
abstract: This clinical trial compared the effects of hydrogen peroxide concentration and toothbrushing on clinical response to vital bleaching. Tooth bleaching was accomplished with a flexible, polyethylene strip coated with a hydrogen peroxide bleaching gel worn for 30 minutes twice daily over a 14-day period. A total of 36 subjects were randomized to 1 of 3 treatment groups: 5.3% hydrogen peroxide strip plus prebrushing, 6.5% hydrogen peroxide strip plus prebrushing, or 6.5% hydrogen peroxide strip without prebrushing. Two groups brushed with regular anticavity toothpaste immediately before bleaching, while the other group performed ad libitum brushing only. Tooth color was measured over a 14-day period using digital images of the anterior dentition. Over the 14-day treatment period, all 3 strip groups experienced highly significant (P < 0.001) whitening as evidenced by decreased yellowness (delta b*) and increased brightness (delta L*), as well as composite color change (delta E*) relative to baseline. Keeping brushing constant, the 6.5% hydrogen peroxide strip plus prebrushing group experienced a 31% to 60% improvement in whitening relative to the 5.3% hydrogen peroxide standard. Keeping concentration constant at 6.5% hydrogen peroxide, the prebrushing group experienced a directional 5% to 33% improvement in whitening relative to no prebrushing. All treatments were generally well tolerated. This study demonstrates that for strip-based delivery, increasing hydrogen peroxide concentration to 6.5% results in a significant improvement in efficacy with few tolerability trade-offs.
authors.affiliation: Procter & Gamble Company, Mason, Ohio, USA.
authors.forename: Robert W
authors.initials: RW
authors.lastname: Gerlach
authors.forename: Paul A
authors.initials: PA
authors.lastname: Sagel
authors.forename: Melissa E
authors.initials: ME
authors.lastname: Jeffers
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000077463:Carbamide Peroxide; D003807:Dentin Sensitivity / Q000139:chemically induced; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D005882:Gingival Diseases / Q000139:chemically induced; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016877:Oxidants / Q000008:administration & dosage* / Q000009:adverse effects; D010545:Peroxides / Q000008:administration & dosage / Q000009:adverse effects; D014073:Tooth Bleaching / Q000379:methods*; D014075:Tooth Discoloration / Q000628:therapy; D014099:Toothbrushing; D014508:Urea / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide