title: Tray delivery of potassium nitrate-fluoride to reduce bleaching sensitivity.
abstract: OBJECTIVE
  Tooth sensitivity is a common side effect associated with tooth whitening. The purpose of this study was to determine if bleaching tray delivery of potassium nitrate-fluoride reduces bleaching sensitivity enough to allow continuation of whitening treatment.
  
  
  METHODS
  Thirty patients were enrolled in a university-approved clinical study and had their teeth bleached at night with 10% carbamide peroxide in a custom-fitted tray. The bleaching tray was a rigid experimental design for which sensitivity was expected. If tooth sensitivity was experienced, the patient applied a gel containing 5% potassium nitrate and 1,000 ppm sodium fluoride in the bleaching tray for various time periods. Log forms were collected upon completion of bleaching, and patient interviews were used to compare effects of the gel before and after sensitivity treatment.
  
  
  RESULTS
  Sixteen out of 30 patients experienced tooth sensitivity. Of those 16 patients, 12 used the gel, and 11 of the 12 reported a reduction in sensitivity. Treatment times ranged from 10 minutes before bleaching to 30 minutes before and after. The number of applications ranged from one to continuous use. Some patients were able to continue bleaching after one gel application with no subsequent sensitivity. Other patients were unable to continue bleaching unless they continued using the gel. The incidence of tooth sensitivity (53%) reported in this study is consistent with sensitivity reported in studies using semi-rigid custom-fitted trays made from stone casts with a nonscalloped, nonreservoir design.
  
  
  CONCLUSIONS
  The use of a 5% potassium nitrate-fluoride gel applied in the tray as needed for tooth sensitivity associated with nightguard vital bleaching can reduce sensitivity in a majority of patients and allow most patients to continue bleaching to completion.
authors.affiliation: Department of Oral Rehabilitation, Medical College of Georgia, School of Dentistry, Augusta, Georgia 30912-1260, USA. vhaywood@mail.mcg.edu
authors.forename: V B
authors.initials: VB
authors.lastname: Haywood
authors.forename: W F
authors.initials: WF
authors.lastname: Caughman
authors.forename: K B
authors.initials: KB
authors.lastname: Frazier
authors.forename: M L
authors.initials: ML
authors.lastname: Myers
mesh_terms: D000077463:Carbamide Peroxide; D003807:Dentin Sensitivity / Q000145:classification / Q000517:prevention & control*; D004338:Drug Combinations; D004867:Equipment Design; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D009566:Nitrates / Q000008:administration & dosage / Q000627:therapeutic use*; D016877:Oxidants / Q000009:adverse effects / Q000627:therapeutic use; D010545:Peroxides / Q000009:adverse effects / Q000627:therapeutic use; D017680:Potassium Compounds / Q000008:administration & dosage / Q000627:therapeutic use*; D012969:Sodium Fluoride / Q000008:administration & dosage / Q000627:therapeutic use*; D013499:Surface Properties; D013997:Time Factors; D014073:Tooth Bleaching / Q000009:adverse effects / Q000295:instrumentation*; D016896:Treatment Outcome; D014508:Urea / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use
chemical_list: D004338:Drug Combinations; D005782:Gels; D009566:Nitrates; D016877:Oxidants; D010545:Peroxides; D017680:Potassium Compounds; D000077463:Carbamide Peroxide; D014508:Urea; D012969:Sodium Fluoride; C023844:potassium nitrate