title: Evaluation of side effects and patients' perceptions during tooth bleaching.
abstract: OBJECTIVE
  The objective of this nightguard vital bleaching (NGVB) study was to compare tooth sensitivity (TS), gingival irritation (GIr), and other side effects, as well as patients' perceptions during tooth bleaching, from treatment with experimental 5 and 7% hydrogen peroxide (HP) bleaching solutions with those of a commercially available 10% carbamide peroxide (CP) product.
  
  
  METHODS
  Sixty-one participants completed the study wearing a scalloped maxillary treatment tray without reservoirs with the different concentrations of bleaching gels for 30 minutes twice a day for 7 days. Parameters evaluated were changes in gingival index (GI), nonmarginal gingival index, nongingival oral mucosal index, and tooth vitality. Participants were seen pretreatment, after 7 treatment days, and 1 week post-treatment. A daily log form to record TS and GIr was completed by each participant as well as a sensitivity questionnaire at each appointment. Additionally, at 10 months post-treatment, a questionnaire was sent to the participants concerning TS and GIr relative to the treatment process.
  
  
  RESULTS
  Data from end-of-treatment questionnaires, daily log forms, and clinical examination revealed a statistical difference (p < or = 0.05) in the patients' ranking of and days of TS and GIr between group S (7% HP) and group T (10% CP, control group) at the end of active treatment. There also existed a statistical clinical change in the GI levels for groups R and S compared with the control group T. There was no statistical difference (p > 0.05) in any of the parameters evaluated among the three products at 7 days or 10 months post-treatment.
  
  
  CONCLUSIONS
  Participants in group S reported significantly more TS, GIr, and days of each compared with the control. There also existed a significant clinical change in the GI levels for groups R and S compared with the control group T. There was no significant difference among the three products at 7 days post-treatment. After ending treatment, TS/GIr was resolved in 2 to 3 days and did not recur during the 10 months post-treatment.
  
  
  CONCLUSIONS
  The experimental HP bleaching solutions, as described in this study, can be used in NGVB with no long-term side effects as evaluated in this study for up to 10 months post-treatment.
authors.affiliation: Department of Diagnostic Sciences and General Dentistry, UNC School of Dentistry, Chapel Hill, NC 27599-7450, USA. ralph_leonard@dentistry.unc.edu
authors.forename: Ralph H
authors.initials: RH
authors.lastname: Leonard
authors.forename: Lynn R
authors.initials: LR
authors.lastname: Smith
authors.forename: Glenn E
authors.initials: GE
authors.lastname: Garland
authors.forename: Karen K
authors.initials: KK
authors.lastname: Tiwana
authors.forename: Lynette A
authors.initials: LA
authors.lastname: Zaidel
authors.forename: George
authors.initials: G
authors.lastname: Pugh
authors.forename: Nora C
authors.initials: NC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000077463:Carbamide Peroxide; D016009:Chi-Square Distribution; 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 / Q000009:adverse effects; D008297:Male; D016877:Oxidants / Q000009:adverse effects; D010545:Peroxides / Q000009:adverse effects; D011795:Surveys and Questionnaires; D014073:Tooth Bleaching / Q000009:adverse effects* / Q000379:methods*; D014508:Urea / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide