title: Subjective intensities of pain and contentment with treatment outcomes during tray bleaching of vital teeth employing different carbamide peroxide concentrations.
abstract: OBJECTIVE
  It has been suggested that tooth whitening might cause considerable pain. The aim of this study was to evaluate subjective intensities of pain during bleaching of vital teeth and to assess the patients' contentment with the treatment outcome.
  
  
  METHODS
  Thirty patients were treated for 1 week in a double-blind study design. Employing gels containing 17%, 10%, or 0% (control group) carbamide peroxide, patients wore bleaching trays for 2 hours per day and described subjective intensities of pain while wearing the trays by means of a visual analog scale. The patients' subjective contentment with the bleaching outcome was measured with an intermodal intensity comparison.
  
  
  RESULTS
  For the 17% gel, a median value of 3.5 U (max: 10; min: 1) for pain intensity was observed; this was statistically different from the value seen with the 10% group (2.0 U; max: 7; min: 0) (P < .05). Both test groups differed significantly from the control group, which had a median value of 0.0 U (max: 3; min: 0) (P < .05). Patients' contentment with the treatment outcome did not differ between the test groups (P > .05), although statistical differences were observed between the control and the test groups (P < .05) after bleaching for 1 week.
  
  
  CONCLUSIONS
  Application of carbamide peroxide-containing bleaching agents to vital teeth causes pain correlated with the agent's concentration. Since both highly and less concentrated gels might result in a similar contentment with the treatment outcome, the use of highly concentrated agents appears not to be justified to improve vital tooth color.
authors.affiliation: Department of Operative and Preventive Dentistry, University of Bonne, Germany. fkrause@uni-bonne.de
authors.forename: Felix
authors.initials: F
authors.lastname: Krause
authors.forename: Søren
authors.initials: S
authors.lastname: Jepsen
authors.forename: Andreas
authors.initials: A
authors.lastname: Braun
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000077463:Carbamide Peroxide; D003807:Dentin Sensitivity / Q000139:chemically induced*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D016877:Oxidants / Q000008:administration & dosage* / Q000009:adverse effects; D010147:Pain Measurement; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010545:Peroxides / Q000008:administration & dosage* / Q000009:adverse effects; D018709:Statistics, Nonparametric; D014073:Tooth Bleaching / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods* / Q000523:psychology; 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