title: Effectiveness of and tooth sensitivity with at-home bleaching in smokers: a multicenter clinical trial.
abstract: BACKGROUND
  The authors conducted a 2-center controlled clinical study to show the equivalence of at-home bleaching in smokers and nonsmokers at 1 week and 1 month and evaluate tooth sensitivity (TS).
  
  
  METHODS
  The authors selected 60 smokers and 60 nonsmokers with central incisors of shade A2 or darker. The participants performed bleaching with 10% carbamide peroxide for 3 hours daily for 3 weeks. The authors evaluated the color by using a shade guide and a spectrophotometer before, during, and after bleaching (1 week and 1 month). Patients recorded TS by using a 0-4 scale and a visual analog scale. The authors used multivariable regression analysis to test factors associated with color change and TS (α = .05).
  
  
  RESULTS
  Smokers and nonsmokers showed significant color change statistically equivalent to within ± 2.0 units at 1 week after bleaching. Overall, color shade improved by 4.1 shade guide units (95% confidence interval [CI], 3.7-4.5) and 7.8 units of color change measured with the spectrophotometer (95% CI, 7.1-8.5) at 1 month. None of the factors affected the TS risk. TS absolute risk and intensity were similar between groups (P > .05), with an overall estimate of 47% (95% CI, 38-56%).
  
  
  CONCLUSIONS
  The immediate effectiveness of whitening- and bleaching-related TS were not affected by smoking.
  
  
  CONCLUSIONS
  Smoking did not affect the immediate color change (1 week). Effective whitening was achieved regardless of whether the patient was a smoker. However, this equivalence was not apparent 1 month after bleaching, with smokers having slightly darker teeth.
authors.forename: Juliana Larocca
authors.initials: JL
authors.lastname: de Geus
authors.forename: Cristian
authors.initials: C
authors.lastname: Bersezio
authors.forename: Javiera
authors.initials: J
authors.lastname: Urrutia
authors.forename: Toshiro
authors.initials: T
authors.lastname: Yamada
authors.forename: Eduardo
authors.initials: E
authors.lastname: Fernández
authors.forename: Alessandro Dourado
authors.initials: AD
authors.lastname: Loguercio
authors.forename: Alessandra
authors.initials: A
authors.lastname: Reis
authors.forename: Stella
authors.initials: S
authors.lastname: Kossatz
mesh_terms: D000328:Adult; D003807:Dentin Sensitivity / Q000139:chemically induced*; D005260:Female; D006801:Humans; D008297:Male; D012648:Self Care / Q000379:methods; D012907:Smoking / Q000009:adverse effects*; D014073:Tooth Bleaching / Q000009:adverse effects / Q000379:methods*; D058205:Tooth Bleaching Agents / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058205:Tooth Bleaching Agents
keywords: Tooth bleaching; dentin sensitivity; smoking