title: Changes in oral health related quality of life after dental bleaching in a double-blind randomized clinical trial.
abstract: OBJECTIVE
  This study aimed to assess changes in oral health-related quality of life (OHRQoL) in individuals enroled in a double-blind randomized clinical trial conducted to evaluate the efficacy and safety of two carbamide peroxide concentrations used in at-home vital bleaching in the city of Pelotas, Southern Brazil.
  
  
  METHODS
  Ninety-two volunteers with a shade mean of C1 or darker for the six maxillary anterior teeth were randomized into two balanced groups (n=46) according to bleaching agent concentration: 10% or 16% carbamide peroxide. The patients were instructed to use the whitening agent in a tray for 2h once a day for three weeks. To assess changes in OHRQoL, participants completed the oral impact on daily performance (OIDP) at the start and one week after the completion of treatment. Because there was no difference with regard to whitening effect or tooth sensitivity during or after treatment the two groups were merged for the analyses of the current article. Before-and-after changes in OIDP scores were assessed by chi-square and McNemar tests (p<0.05).
  
  
  RESULTS
  Mean pre- and post-treatment OIDP scores varied from 0.42 to 0.60. When the frequency of impacts for different activities were compared, there was an increase in difficulty in cleaning teeth (p=0.02) and a significant reduction in smiling and showing teeth with embarrassment (p=0.03). Regarding the symptoms and main oral conditions that generated impact, there was higher number of participants reporting pain (p=0.05) after treatment. In opposite, significant decrease was observed in individuals reporting being unhappy with their appearance (p=0.03). On the contrary, it was showed a decrease in impacts resulting from dental colour was observed after bleaching (p=0.03).
  
  
  CONCLUSIONS
  Quality of life is complex and encompasses different domains. Although positive impact of the dental bleaching was detected, with patients showing more their teeth without embarrassment, difficult in dental hygiene and pain resulting from the treatment were also reported, and this can negatively impact daily performances. Dentists must consider these aspects when performing aesthetics procedures.
authors: Department of Operative Dentistry, Federal University of Paraíba, Brazil. Electronic address: soniasaeger@hotmail.com.
authors: Sônia Saeger
authors: SS
authors: Meireles
authors: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. Electronic address: mariliagoettems@hotmail.com.
authors: Marília Leão
authors: ML
authors: Goettems
authors: Post-Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil. Electronic address: raquelvenancio@hotmail.com.
authors: Raquel Venâncio Fernandes
authors: RV
authors: Dantas
authors: Post-Graduate Program in Dentistry, University of Passo Fundo, RS, Brazil. Electronic address: dbona@upf.br.
authors: Álvaro Della
authors: ÁD
authors: Bona
authors: Post-Graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil. Electronic address: inasantos@uol.com.br.
authors: Iná S
authors: IS
authors: Santos
authors: Post-Graduate Programs in Dentistry and Epidemiology, Federal University of Pelotas, Pelotas, RS, Brazil. Electronic address: ffdemarco@gmail.com.
authors: Flávio Fernando
authors: FF
authors: Demarco
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D000077463:Carbamide Peroxide; D003807:Dentin Sensitivity / Q000209:etiology / Q000523:psychology; D004311:Double-Blind Method; D004522:Educational Status; D004955:Esthetics, Dental; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007182:Income; D008297:Male; D009909:Oral Health; D009910:Oral Hygiene / Q000523:psychology; D010545:Peroxides / Q000008:administration & dosage; D011788:Quality of Life; D012449:Safety; D012904:Smiling / Q000523:psychology; D014073:Tooth Bleaching / Q000523:psychology*; D058205:Tooth Bleaching Agents / Q000008:administration & dosage; D014075:Tooth Discoloration / Q000188:drug therapy / Q000523:psychology; D016896:Treatment Outcome; D014508:Urea / Q000008:administration & dosage / Q000031:analogs & derivatives; D055815:Young Adult
chemical_list: D010545:Peroxides; D058205:Tooth Bleaching Agents; D000077463:Carbamide Peroxide; D014508:Urea
keywords: Oral health; Quality of life; Randomized controlled trial; Tooth bleaching