title: Placebo-controlled clinical trial of use of 10% hydrogen peroxide whitening strips for medication-induced xerostomia.
abstract: OBJECTIVE
  A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the effectiveness and safety of peroxide-containing strip-based tooth whitening among subjects with medication-induced hyposalivation.
  
  
  METHODS
  Eligibility for this tooth whitening study was limited to dentate adults taking xerogenic medications with an unstimulated salivary flow < or = 0.2 ml/min. After giving informed consent, 42 subjects were randomized using a 2:1 ratio to 10% hydrogen peroxide whitening strips (Crest Whitestrips Premium) or placebo strips without peroxide. Strips were used for 30 min twice daily for a 14-day period. Usage was unsupervised, and only the maxillary arch was treated. On days 8 and 15, efficacy was assessed from standard digital images of the anterior dentition and quantified using the Cielab color system, while safety was assessed from interviews and clinical examinations.
  
  
  RESULTS
  At day 8, the peroxide group experienced significant (p < 0.001) color improvement relative to baseline and placebo. Adjusted means +/- standard errors for yellowness reduction were -1.65 +/- 0.115 units for the peroxide group and -0.32 +/- 0.170 units for the placebo group. For the increase in lightness, adjusted means +/- standard errors on day 8 were 1.53 +/- 0.130 units for the peroxide group and 0.37 +/- 0.191 units for the controls. Continued strip use through day 15 yielded incremental color improvement for the peroxide group. Mild and transient tooth sensitivity represented the most common adverse events. No subject discontinued treatment due to a product-related adverse event.
  
  
  CONCLUSIONS
  Twice daily use of 10% hydrogen peroxide whitening strips by adults with medication-induced xerostomia was well tolerated, with significant tooth color improvement evident within 7 days.
authors.affiliation: Tufts University School of Dental Medicine, Boston, MA 02111, USA. athena.papas@tufts.edu
authors.forename: Athena S
authors.initials: AS
authors.lastname: Papas
authors.forename: Gerard
authors.initials: G
authors.lastname: Kugel
authors.forename: Mabi
authors.initials: M
authors.lastname: Singh
authors.forename: Matthew L
authors.initials: ML
authors.lastname: Barker
authors.forename: Robert W
authors.initials: RW
authors.lastname: Gerlach
mesh_terms: D000328:Adult; D000368:Aged; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D014073:Tooth Bleaching / Q000009:adverse effects / Q000379:methods*; D014075:Tooth Discoloration / Q000150:complications / Q000628:therapy; D014987:Xerostomia / Q000139:chemically induced* / Q000150:complications; D055815:Young Adult
chemical_list: D006861:Hydrogen Peroxide