Evaluation of side effects and patients' perceptions during tooth bleaching.
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.
Leonard
Ralph H
RH
Department of Diagnostic Sciences and General Dentistry, UNC School of Dentistry, Chapel Hill, NC 27599-7450, USA. ralph_leonard@dentistry.unc.edu
Smith
Lynn R
LR
Garland
Glenn E
GE
Tiwana
Karen K
KK
Zaidel
Lynette A
LA
Pugh
George
G
Lin
Nora C
NC
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
D004338:Drug Combinations; D016877:Oxidants; D010545:Peroxides; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide