Absolute Risk Of Tooth Sensitivity Research Articles

Effect of the type of application tip for 35% hydrogen peroxide on bleaching efficacy and tooth sensitivity: A randomized clinical trial.

Evaluate the bleaching efficacy (BE) and tooth sensitivity (TS) of in-office bleaching using different application tips. Forty-eight participants were selected (split-mouth), one to receive bleaching with an attached brush tip and one with a conventional tip. The procedure was performed with Whiteness Automixx Plus 35%. The BE was evaluated at the beginning, weekly, one and 12 months post-bleaching with a Vita Easyshade spectrophotometer (ΔE*ab , ΔE00 , and WID ) and with Vita classical A1-D4 and Vita Bleachedguide shade guides units (ΔSGU). Absolute risk and intensity of TS were recorded using the Visual Analogue Scale. The equivalence of BE was analyzed using the two one-sided t-tests for paired samples. The absolute risk of TS was evaluated using the McNemar test, and the TS intensity was measured with the paired t test (α = 0.05). The equivalence of BE was observed for both groups in all color evaluations (p > 0.05). A lower absolute risk and intensity of TS were observed for the attached brush tip when compared with the conventional tip (p < 0.003 and p < 0.0001). Using an attached brush tip showed the same BE as a conventional tip. However, for the attached brush tip, there was a reduction in TS. The applicator-attached brush tip is recommended for in-office dental bleaching, because of the possible reduction in risk and intensity of TS.

Topical application of Otosporin® before in-office bleaching: a split mouth, triple-blind, multicenter randomized clinical trial.

To evaluate if the topical application of Otosporin® before in-office bleaching with a 35% hydrogen peroxide (HP) gel reduces the risk and intensity of tooth sensitivity (TS), as well as the bleaching effectiveness. Twenty participants were selected for this split mouth, triple-blind, multicenter randomized clinical trial. Before each bleaching session, the placebo was applied in the patient's hemi-arch and the other half received the Otosporin®, according to the randomization procedure. Both products were applied topically for 10min. The 35% HP was applied in two sessions with a 1-week interval. The risk and intensity of TS were assessed using the Numerical Scale (NRS) and the Visual Analog Scale (VAS). The bleaching effectiveness were evaluated with the visual scales and with a digital spectrophotometer. The absolute risk of TS was compared by McNemar's test. To compare the intensity of TS, the Wilcoxon signed-rank test was used to evaluate the NRS, while the paired t test was used to evaluate VAS. Bleaching effectiveness (ΔSGUs and ΔEab, ΔE00, and ΔWID) was compared between groups using the paired t-test (α = 0.05). No significant difference at risk (p = 1.0) and intensity of TS (p > 0.59; VAS and p = 1.00 for NRS) was detected between groups. For both groups, a significant bleaching was observed after 30days of evaluation (p < 0.39). The previous application of Otosporin® in the in-office bleaching did not reduce the risk and intensity of TS and did not affect the effectiveness of the bleaching. The application of Otosporin® before in-office bleaching with 35% HP was not able to reduce the risk and intensity of TS.

The influence of the renewal or the single application of the peroxide gel on the efficacy and tooth sensitivity outcomes of in-office bleaching-A systematic review and meta-analysis.

To answer the question: "Does the peroxide gel application regimen (single application vs. renewal) influence the efficacy and the tooth sensitivity outcomes of in-office tooth bleaching?" The search was done in Pubmed, Cochrane, LILACS, Scopus, Web of Science, and EMBASE in February 2021 (updated in July 2021). Randomized clinical trials (RCT) comparing the single application vs. the renewal protocols of HP were included. The meta-analyses were performed for the objective (ΔEab ), subjective (ΔSGU) color changes, and absolute risk of tooth sensitivity (TS). Heterogeneity was evaluated using Q test (I2 ). Cochrane Collaboration tool assessed the risk of bias (RoB). The GRADE evaluated the certainty of evidence. Five RCT studies remained. Two studies showed high RoB, and three presented some concerns. No significant differences were observed between the protocols in terms of the ΔEab , ΔSGU, and TS. ΔEab exhibited substantial heterogeneity (I2 =87%), while ΔSGU (I2 =60%) and the TS (I2 =62%) presented a moderate one. The certainty of evidence was considered low or very low, depending on the variable response and the evaluation time. The application regimen (single vs. renewal of HP) did not impact color change or the absolute risk of TS. The renewal of bleaching gel during the in-office appointment may not be necessary. However, there is at least a low certainty of evidence. Because of this, further randomized clinical trials with appropriate methodology on this topic are encouraged.

Sonic Activation of a Desensitizing Gel Prior to In-Office Bleaching.

This double-blind, randomized, and controlled clinical trial evaluated the effect of sonic activation during the application of a desensitizing agent (DA) containing 5% potassium nitrate and 2% sodium fluoride on the occurrence of tooth sensitivity (TS) associated with in-office dental bleaching. Treatment with or without sonic activation of the DA was randomly assigned to one-half of the maxillary teeth of 34 patients in a split-mouth design. On the side without sonic activation (noSA), the DA was applied and maintained in contact with the teeth for 10 minutes. On the sonic activation side (SA), the DA was activated 30 seconds per tooth. The DA application was followed by application of 35% hydrogen peroxide in two bleaching sessions separated by a one-week interval. The primary outcome was the absolute risk of TS, recorded using a numeric rating scale and a visual analog scale. Color was evaluated with a digital spectrophotometer and a value-oriented shade guide. No significant difference between treatments was observed in the absolute risk of TS, which occurred in 93% (p=1.00) of both noSA and SA groups. The TS intensity was higher in the 24-hour interval after sessions, for both treatments, without differences between them. There was no difference in the color change for the treatments, with the average change in number of shade guide units of the Vita Classical scale of 6.35 for both (p=0.87). Sonic activation of DA containing 5% potassium nitrate and 2% sodium fluoride did not reduce the absolute risk and intensity of TS associated with in-office bleaching.

Comparison of the Effect of Agitation on Whitening and Tooth Sensitivity of In-Office Bleaching: A Randomized Clinical Trial.

This single-blind, split-mouth, randomized trial was aimed at evaluating the bleaching efficacy (BE) and tooth sensitivity (TS) of a 20% hydrogen peroxide (HP) bleaching agent used under active or passive application. Twenty-two patients with canines darker than C2 were selected. Teeth were bleached in two sessions, with a one-week interval between treatments. The bleaching agent was applied using active (HPactive) or passive (HPpassive) application. Each tooth in the HPactive-allocated hemiarch received bleaching gel with sonic activation after 10 and 30 minutes from the start of treatment, with rounded movements all over the buccal surface. The color changes were evaluated by subjective (Vita Classical and Vita Bleachedguide) and objective (VITA Easyshade Spectrophotometer) methods at baseline and 30 days after the second session. TS was recorded up to 48 hours after treatment using a 0-10 visual analog scale. Color change in shade guide units (SGUs) and ΔE was analyzed using a Wilcoxon test (α=0.05). The absolute risk and intensity of TS were evaluated using McNemar test and a Wilcoxon test, respectively (α=0.05). Significant whitening was observed in both groups after 30 days of clinical evaluation. The activation did not significantly influence BE (ΔSGU HPpassive=5.6 and HPActive=5.8; p=0.98; and ΔE HPpassive=10.6 and HPactive=10.3; p=0.83). Absolute risk of TS (HPactive=36.4% and HPpassive=31.8%; p=0.94) was similar for both groups (Fisher exact test). TS intensity (visual analogue scale) was higher during the bleaching sessions and up to 24 hours thereafter for both groups, with no differences between groups (two-way analysis of variance and Tukey). The active application of a 20% HP gel did not improve BE and TS.

&lt;p&gt;Effects of Exposure to Cola-Based Soft Drink on Bleaching Effectiveness and Tooth Sensitivity of In-Office Bleaching: A Blind Clinical Trial&lt;/p&gt;

ObjectiveThe purpose of this single-blind (evaluators) and parallel design study was to evaluate whether exposure to a cola-based soft drink during bleaching treatment with 35% hydrogen peroxide (HP) affects color change and bleaching-induced tooth sensitivity.Material and methodsForty-four patients with central incisors darker than A2 were selected. Participants who did not drink cola-based soft drinks were assigned to the control group (CG), while participants who drank a cola-based soft drink at least twice a day were assigned to the experimental group (EG). For the CG, foods with staining dyes were restricted. For the EG, there was no restriction on food and patients were asked to rinse their mouths with a cola-based soft drink for 30 s, 4 times daily. For both groups, 2 sessions with three 15 min applications of 35% HP were performed. Shade evaluation was assessed via subjective (VITA classical and VITA bleacheguide shade guides) and objective methods (Easyshade spectrophotometer) at baseline, during bleaching (first, second, and third weeks), and post bleaching (1 week and 1 month). Patients recorded their sensitivity perceptions using a numerical rating scale and 0–10 visual analog scales. Variation in shade guide units and the 2 colors (DE) were evaluated with a Student’s t-test (α = 0.05) and Mann–Whitney test (α = 0.05). Absolute risk of tooth sensitivity and intensity of tooth sensitivity were evaluated by a Chi-square test (α=0.05).ResultsEffective bleaching was observed for both groups after 30 days, without statistical difference (p > 0.08). There was no significant difference in absolute risk of bleaching-induced tooth sensitivity between the 2 groups (p = 0.74). Higher and significant scores in pain scales were detected for the EG in comparison to the CG (p < 0.05).ConclusionEven that the cola-based soft drink exposure during in-office bleaching treatments did not affect the bleaching’s effectiveness; patients reported a higher intensity in bleaching-induced tooth sensitivity.

Clinical Study of Bleaching Gel Storage Temperature on Tooth Color and Sensitivity.

The objective of this triple-blind, split-mouth, randomized clinical trial was to evaluate the bleaching efficacy and tooth sensitivity of an in-office bleaching agent submitted to different storage temperatures (room temperature at 21.04°C±3.13°C or refrigeration at 5°C). Thirty volunteers were selected who had central incisors with color A2 or higher. The volunteers' maxillary hemi-arches received either the bleaching treatment with room temperature or refrigerated storage temperatures (two sessions of 3×15 minutes, one-week interval). Color variation was evaluated by subjective (Vita Classic and Vita Bleachedguide) and objective methods (Vita Easyshade spectrophotometer). Tooth sensitivity was evaluated with the visual analog scale (0-10) and the numerical rating scale (five points). The consistency of bleaching gels was evaluated by flow test, and pH was measured, both in triplicate. Color variation (SGU) and ΔE were analyzed by paired t-test (α=0.05). The absolute risk of pain was assessed by McNemar test (α=0.05), data from the numerical rating scale by the Wilcoxon signed-rank test (α=0.05), and visual analog scale by paired t-test. Comparison between the times within each group was analyzed by Friedman test. Gel consistency and pH were analyzed by one-way analysis of variance and Tukey post-test. Regarding the absolute risk of tooth sensitivity, no significant difference was observed between the groups. The relative risk for tooth sensitivity was 1.13 (95%, confidence interval 0.70-1.82). Both tooth sensitivity scales were statistically similar. The results of the subjective evaluation (Vita Classic: p=0.73, Vita Bleachedguide: p=1.00) and the objective evaluation (p=1.00) of bleaching efficacy corresponded to the hypothesis of equality between groups after bleaching. Both pH values were around 7, and for the consistency test, there were significant differences between the groups (p=0.002). Storage temperature of the analyzed in-office bleaching agent had no influence on tooth color effectiveness and tooth sensitivity.

Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial.

This study evaluated the effect of the administration of pre-operative dexamethasone on tooth sensitivity stemming from in-office bleaching. A triple-blind, parallel-design, randomized clinical trial was conducted on 70 volunteers who received dexamethasone or placebo capsules. The drugs were administered in a protocol of three daily 8-mg doses of the drug, starting 48h before the in-office bleaching treatment. Two bleaching sessions with 37.5% hydrogen peroxide gel were performed with a 1-week interval. Tooth sensitivity (TS) was recorded on visual analog scales (VAS) and numeric rating scales (NRS) in different periods up to 48h after bleaching. The color evaluations were also performed. The absolute risk of TS and its intensity were evaluated by using Fisher's exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney U test and a two-way repeated measures ANOVA and Tukey's test, respectively. In both groups, a high risk of TS (Dexa 80% x Placebo 94%) was detected. No significant difference was observed in terms of TS intensity. A whitening of approximately 3 shade guide units of the VITA Classical was detected in both groups, which were statistically similar. It was concluded that the administration pre-operatively of dexamethasone, in the proposed protocol, does not reduce the incidence or intensity of bleaching-induced tooth sensitivity. The use of dexamethasone drug before in-office bleaching treatment does not reduce incidence or intensity of tooth sensitivity. NCT02956070.

Effect of topical application of dipyrone on dental sensitivity reduction after in-office dental bleaching: A randomized, triple-blind multicenter clinical trial

BackgroundTooth sensitivity commonly occurs during and immediately after dental bleaching. The authors conducted a trial to compare tooth sensitivity after in-office bleaching after the use of either a topical dipyrone or placebo gel. MethodsA split-mouth, triple-blind, randomized, multicenter clinical trial was conducted among 120 healthy adults having teeth that were shade A2 or darker. The facial tooth surfaces of the right or left sides of the maxillary arch of each patient were randomly assigned to receive either topical dipyrone or placebo gel before 2 in-office bleaching sessions (35% hydrogen peroxide) separated by 2 weeks. Visual analog and numerical rating scales were used to record tooth sensitivity during and up to 48 hours after bleaching. Tooth color change from baseline to 1 month after bleaching was measured with shade guide and spectrophotometer measures. The primary outcome variable was absolute risk of tooth sensitivity. An intention-to-treat analysis was used to analyze data from all patients who were randomly assigned to receive the dipyrone and placebo gels. ResultsNo statically significant difference was found in the absolute risk of tooth sensitivity between the dipyrone and placebo gels (83% and 90%, respectively, P = .09; relative risk, 0.92; 95% confidence interval, 0.8 to 1.0). A whitening effect was observed in both groups with no statistically significant difference (P > .05) between them. No adverse effects were observed. ConclusionTopical use of dipyrone gel before tooth bleaching, at the levels used in this study, did not reduce the risk or intensity of bleaching-induced tooth sensitivity. Practical ImplicationsTopical application of dipyrone gel does not reduce bleaching-induced tooth sensitivity.

Combination of Acetaminophen/Codeine Analgesics Does Not Avoid Bleaching-Induced Tooth Sensitivity: A Randomized, Triple-Blind Two-Center Clinical Trial.

This study aimed to determine if the combination of opioids and nonopioids analgesics (Tylex) may provide a better analgesic effect. A triple-blind, parallel, randomized two-center clinical trial was conducted with 105 healthy patients who received either a placebo or a combination of acetaminophen/codeine. The first dose of Tylex 30 mg (acetaminophen 500 mg/codeine 30 mg) or placebo was administered one hour before the in-office bleaching (35% hydrogen peroxide), and extra doses were administered every six hours for 48 hours. The TS was recorded using a visual analog scale of 0 to 10 and a numeric rating scale of 0 to 4 in different periods: during bleaching, one hour up to 24 hours, and 24 hours up to 48 hours postbleaching. The color was measured before and one month after dental bleaching with a visual shade guide (Vita Classical), Vita Bleachedguide 3D-MASTER, and the spectrophotometer Vita Easyshade. The absolute risk of TS was evaluated using the Fisher exact test. Data of TS intensity with numeric rating scale of the two groups were compared with the Mann-Whitney U-test and the Friedman test, while data from the visual analog scale were evaluated by two-way repeated measures analysis of variance and the Tukey test for pairwise comparison. The color changes between groups were compared using the Student t-test (α=0.05). No significant differences between the groups were observed in the risk and intensity of TS. The overall absolute risk of TS was approximately 96%. No significant differences between groups were observed in terms of color change ( p>0.05) for any scale. The use of an acetaminophen/codeine combination prior to in-office bleaching does not reduce the risk and intensity of bleaching-induced TS.

Clinical Evaluation of 10% Hydrogen Peroxide on Tooth Sensitivity and Effectiveness in at Home Dental Bleaching

The purpose of this study was to evaluate the dental effect and sensitivity of at-home dental bleaching with 10% hydrogen peroxide (H2O2). Twenty volunteers with A2 or darker central incisors were selected for this study. Was used 10% H2O2 for thirty minutes twice a day, for two weeks. Shade evaluation was assessed visually by the value-oriented shade guide Vita Classical shade guide, Vita Bleachedguide 3D-MASTER and by the Easyshade spectrophotometer at baseline, during bleaching (first and second weeks), and post-bleaching (one month). The perceptions of sensitivity were recorded by the patients through the numerical rating scale (0 to 4) and 0 to 10 visual analog scales daily. Data from the shade guide units was subjected to a one way repeated measures (RM) analysis of variance (ANOVA) test (a = 5%). The overall AE, absolute risk and intensity of tooth sensitivity were calculated as well as the 95% confidence interval. The absolute risk of tooth sensitivity was 65% and the intensity was mild. Data from ASGU and AE after 1 month of bleaching for H2O2 10% showed significant whitening, 4 units for Vita Classical, 5 units for Vita Bleachedguide and 9.7 units for spectrophotometer. At-home bleaching using 10% hydrogen peroxide is effective in 14 days of bleaching. The most common adverse events were mild tooth sensitivity, and no subjects discontinued use early because of a treatment-related adverse event. At-home dental bleaching with 10% hydrogen peroxide gel reduces the time of use of the tray, maintaining the effectiveness with low intensity of dental sensitivity. Brazilian clinical trials registry (REBEC) RBR-45xmzj.

A Single-Blind Randomized Trial About the Effect of Hydrogen Peroxide Concentration on Light-Activated Bleaching.

To compare the bleaching efficacy and tooth sensitivity (TS) of two hydrogen peroxide (HP) concentrations (20% and 35%) used for in-office bleaching associated or not with a light-emitting diode (LED)/laser light activation. Seventy-seven patients with a right maxillary canine darker than A3 were selected for this single-blind randomized trial. The participants were distributed in four groups: bleaching with 35% HP, 35% HP + LED/laser, 20% HP, and 20% HP + LED/laser. The anterior teeth were bleached in two sessions, using a 35% or 20% HP gel with a one-week interval. Each session had three applications of 15 minutes. For the light-activated groups, the LED/laser energy (Whitening Laser Light Plus, DMC) was employed according to the manufacturer's instructions. The color change was evaluated by subjective and objective methods. Participants recorded TS with five-point verbal and visual analog scales. Color change in ΔE was evaluated by analysis of variance and Tukey tests (α=0.05) and in ΔSGU with Kruskall-Wallis and Dunn test. The absolute risk of TS and TS intensity were evaluated by Fisher exact test and Kruskall-Wallis test, respectively (α=0.05). All groups achieved the same level of whitening, except for the 20% HP group, which showed the lowest degree of whitening in the subjective analysis. The use of light did not increase the absolute risk or intensity of TS. No significant difference among groups was observed when color changes were assessed with the spectrophotometer. According to the value-oriented shade guide, the use of LED/laser light activation was able to increase the degree of whitening of the 20% HP group, but this association was not useful for the 35% HP gel. The spectrophotometer, however, did not detect significant differences among groups.

Comparison of the Effects of In-office Bleaching Times on Whitening and Tooth Sensitivity: A Single Blind, Randomized Clinical Trial

The objective of the present study was to compare the bleaching efficacy (BE) and tooth sensitivity (TS) of in-office bleaching applied under different time protocols. Fifty-three patients were randomly distributed into three groups: the bleaching agent was applied in one (1×15), two (2×15), or three (3×15) 15-minute applications. The labial surfaces of the anterior teeth were bleached using a 35% hydrogen peroxide gel. Two bleaching sessions with a one-week interval between were performed. The shade evaluation was performed with a visual shade guide and spectrophotometer before and 30 days after bleaching. Participants recorded TS with a five-point verbal scale. Color change was analyzed by one-way analysis of variance and Tukey tests. The absolute risk of TS and TS intensity were evaluated by the Fisher exact and Friedman/Kruskal-Wallis tests, respectively (α= 0.05). Significant whitening was observed in all groups, with statistically lower BE for the 1×15 group (p<0.05). The absolute risk of TS (95% confidence interval) was lower for the 1×15 group than for the other groups (p<0.05). The TS intensity of the 3×15 group was statistically higher than that associated with the other protocols (p<0.05). A single 15-minute application produced less TS but reduced BE. The protocol with 2×15 produced a degree of BE similar to that of the 3×15 group, but with reduced overall TS intensity.

Effectiveness of nano-calcium phosphate paste on sensitivity during and after bleaching: a randomized clinical trial.

The study aimed to evaluate the effectiveness of in-office bleaching and associated tooth sensitivity on application of nano-calcium phosphate paste as desensitizing agent. Bleaching was performed with 35% hydrogen peroxide gel in 40 patients who were randomly divided into placebo and nano-calcium phosphate paste groups. Bleaching efficacy (BE) was evaluated using a value-oriented Vita shade guide. Tooth sensitivity was recorded using a numeric rating scale (0-4) during bleaching and up to 48 h after each session. The primary outcome of absolute risk of tooth sensitivity was compared using the Fisher's exact test (α = 0.05). The intensity of tooth sensitivity and the efficacy of in-office bleaching were also statistically evaluated. No significant differences in absolute risk and intensity of tooth sensitivity were detected between the groups (p = 1.0 and p = 0.53, respectively). BE was also found to be similar between the groups (p = 0.67). Although the use of a nano-calcium phosphate paste associated with fluoride and potassium nitrate did not influence the whitening outcome, but it also did not reduce bleaching-induced tooth sensitivity.

In-office bleaching with a two- and seven-day intervals between clinical sessions: A randomized clinical trial on tooth sensitivity

ObjectivesIn-office bleaching is usually performed in 2–3 sessions with one-week interval. The impact of shorter interval times on tooth sensitivity has not been evaluated. This study aimed to compare the absolute risk of tooth sensitivity (TS) and colour change after in-office bleaching with a two- and seven-day intervals between sessions. MethodsWe selected for this randomized, single-blind study, 40 patients with colour C2 or darker. We performed two bleaching sessions with a 35% hydrogen peroxide gel with either a 1-week or 2-day interval. We recorded the TS up to 48h with a VAS scale and the colour at baseline and 30 days after bleaching with a value-oriented shade guide and a spectrophotometer. The risk and intensity of TS were compared with the Fisher's exact test and two-way repeated measures ANOVA. Colour change (ΔSGU and ΔE) were evaluated by Student's t-test (alpha=5%). ResultsApproximately 60% of the participants reported TS (65% and 55% for the 7 and 2-day groups). A significant whitening of approximately 6 shade guide units was detected for both groups. No difference was detected between groups. ConclusionsThe reduction of the interval between bleaching sessions from seven to two days reduced the treatment time without increasing the bleaching-induced TS (clinicaltrials.gov identifier: NCT1959789). Clinical significanceIn-office bleaching with a 2-day interval did not increase the risk and intensity of bleaching-induced tooth sensitivity.

Randomized controlled trial of sealed in-office bleaching effectiveness.

Regardless of the high success rate, patients commonly report the occurrence of tooth sensitivity during the in-office bleaching procedures. Recently, it has been demonstrated that using a customized tray (called sealed in-office bleaching technique) reduces peroxide penetration. The aim of this randomized clinical study was to evaluate tooth sensitivity and bleaching efficacy of sealed bleaching, in comparison with a conventional in-office technique. Twenty patients were randomized allocated in two groups in which 35% hydrogen peroxide gel was used in a single 45-min application. For the sealed technique, a customized bleaching tray was fabricated and carefully positioned over the bleaching agent during the session. The color was recorded at a baseline, 7 and 28 days after the bleaching session, using Vita Easy Shade spectrophotometer. Tooth sensitivity was recorded during (20 and 40 min) and immediately after the treatment using a visual analogue scale. The bleaching efficacy was evaluated by repeated-measures ANOVA, while the absolute risk of tooth sensitivity and its intensity were evaluated by Fisher's exact and Mann-Whitney tests, respectively (α=0.05). No significant difference on bleaching efficacy was observed between the conventional (7.4 and 8.1 ΔE) and sealed techniques (7.8 and 8.3 ΔE) at both evaluation periods. No significant difference was observed regarding the absolute risk of tooth sensitivity (p=0.15). Sealed technique showed a significant decrease of sensitivity intensity after 40 min (p=0.03). Sealed bleaching technique was able to reduce the sensitivity intensity during the bleaching procedure, without jeopardizing the bleaching efficacy.

The Effect of Perioperative Ibuprofen Use on Tooth Sensitivity Caused by In-Office Bleaching

This study determined the effect of the administration of perioperative ibuprofen 400 mg on tooth sensitivity caused by in-office bleaching. A triple-blind, parallel-design, randomized clinical trial was conducted on 30 adults who received placebo or ibuprofen before and after bleaching. The drugs were administered three times per day for 48 hours; the first dose was given one hour prior to the bleaching treatment. Two bleaching sessions with 35% hydrogen peroxide gel were performed with a one-week interval. Tooth sensitivity was recorded on two scales: visual analogue and five-point verbal rating scale up to 48 hours after bleaching. The shade evaluation was performed with a visual shade guide and spectrophotometer, before and 30 days after bleaching. The absolute risk of tooth sensitivity and its intensity were evaluated by Fisher exact and Mann-Whitney tests, respectively. The shade changes were evaluated by Student's t-test. Both groups showed similar absolute risk of tooth sensitivity (p>0.05). Lower tooth sensitivity was observed in the experimental group only up to one hour postbleaching (p=0.04). Similar tooth sensitivity was observed in the other periods of time. The perioperative use of the anti-inflammatory ibuprofen was not able to avoid tooth sensitivity but reduced its intensity up to one hour after bleaching.

Clinical Effects of Exposure to Coffee During At-home Vital Bleaching

The purpose of the present study was to evaluate whether exposure to coffee during bleaching treatment with 16% carbamide peroxide (CP) affects the degree of whitening and tooth sensitivity. Forty patients with central incisors darker than A2 were selected. Participants who did not drink coffee were assigned to the control group (CG), while participants who drink coffee at least twice a day were assigned to the experimental group (EG). For CG, foods with dyes were restricted. For EG there was no restriction on food and patients were asked to make coffee rinses for 30 seconds, four times daily. For both groups 16% CP was used for a period of three hours daily for three weeks. Shade evaluation was assessed visually by Vita classical shade guide and by the Easyshade spectrophotometer at baseline, during bleaching (first, second, and third weeks), and postbleaching (one week and one month). Patients recorded their sensitivity perceptions by means of the numerical rating scale and 0-10 visual analog scales. Variation in shade guide units and the two colors (ΔE) were evaluated by two-way analysis of variance and Tukey tests (α=0.05). Absolute risk of tooth sensitivity and intensity of tooth sensitivity was evaluated by Fisher exact and Mann-Whitney tests (α=0.05). Effective bleaching was observed for both groups after three weeks, without statistical difference. No difference in terms of risk of tooth sensitivity and intensity of tooth sensitivity was detected between groups. Approximately 57% of the participants experienced tooth sensitivity, which was recorded mainly as "mild." Exposure to coffee during bleaching treatment does not seem to affect the degree of bleaching and tooth sensitivity.

Efficacy of and Effect on Tooth Sensitivity of In-office Bleaching Gel Concentrations: A Randomized Clinical Trial

With the aim of reducing the side effects of in-office bleaching agents, less-concentrated hydrogen peroxide (HP) gels have been released by manufacturers. We evaluated the tooth sensitivity (TS) and bleaching efficacy (BE) of two HP concentrations in this study. Gels containing 35% and 20% HP (HP35 and HP20, respectively) were applied on teeth of 60 caries-free patients. Color was recorded at baseline and one week after the first and second bleaching sessions using the Vita Classical shade guide. TS was recorded on a 0-4 scale. BE at each weekly recall was evaluated by Kruskall-Wallis and Mann-Whitney tests (α=0.05). Absolute risk of TS and its intensity was evaluated by Fisher exact and Mann-Whitney tests, respectively (α=0.05). After two bleaching sessions, color change of approximately eight tabs was obtained with HP35; whereas, with HP20 it was six tabs (p<0.05). Only 26.7% (HP35) and 16.7% (HP20) of the participants reported TS, and no statistical differences were detected among them. Both in-office bleaching gels showed similar TS intensity, but the 35% HP agent produced faster bleaching.