Effect of Daily Usage Time of 4% Hydrogen Peroxide on the Efficacy and Bleaching-induced Tooth Sensitivity: A Single-blind Randomized Clinical Trial

• DOI: 10.2341/20-058-c
• Publication Date: 2021-08-23T21:29:30Z
• Authors: RMO Terra; KL da Silva; L Vochikovski; E Sutil; M Rezende; AD Loguercio; A Reis
• Keywords: Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Tooth Bleaching; Humans; Single-Blind Method; Hydrogen Peroxide; Dentin Sensitivity; Tooth Bleaching Agents; 3. Good health

SUMMARY

Objective Compare the risk/intensity of tooth sensitivity (TS) and color change of a 30-minute vs. the recommended 120-minute application time of 4% hydrogen peroxide (HP) for at-home bleaching.

Methods A single-blind, parallel, randomized clinical trial was conducted with 92 adult patients with caries and restoration-free anterior teeth A2 or darker, randomly allocated to two groups. Bleaching trays containing 4% HP were used for three-weeks. A four-week regimen was also offered to the patients for the 30-min group after the end of the 3-week protocol. The color change was assessed with the Vita Classical (VITA Zahnfabrik, Bad Säckingen, Germany) and Vita Bleachedguide shade guides (VITA Zahnfabrik) and the Vita Easyshade spectrophotometer (VITA Zahnfabrik) at baseline, weekly, and 30 days after the bleaching. The absolute risk and the intensity of TS were assessed daily using the 0–10 visual analogue scale (VAS) and 5-point Numerical Rating Scale (NRS) scale, and patient satisfaction was recorded with a Likert 0–7 scale. Risk of TS (Fisher’s test), intensity of TS in NRS scale (Mann-Whitney test), VAS scale (t-test), and a color change (t-test) were compared.

Results The 30-minute group saw color change of around 1 SGU inferior to the 120-minute group in all-time assessments (p<0.05). After an extra week of bleaching, mean color change was similar (p>0.05). Patient satisfaction was high for both groups (p>0.05).

Conclusions A four-week protocol of at-home dental bleaching with 4% HP for 30 minutes/day whitened teeth similarly to the 120 minutes/day protocol, with low intensity of dental sensitivity and high patient satisfaction.