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Title Comparing The Application Method Of Different Peroxide-Containing Tooth Whitening Systems
Clinical Question In patients with discolored teeth, does undergoing at-home tooth whitening with bleaching trays, compared to using over-the-counter bleaching systems, experience a more esthetic result?
Clinical Bottom Line The findings in these short term studies are significant as the custom tray group experienced on average greater color improvement compared to either the paint-on gel or activated peroxide whitening dentifrice, differing significantly (p< 0.01) from either of the barrier-free systems. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 15794456Gerlach/200443 adultsRandomized Controlled Trial
Key resultsThe custom tray group experienced a significantly better color improvement (p< 0.01)compared to either the paint-on gel or activated peroxide whitening dentifrice that did not experience a significantly different color change (p< 0.10). Tooth sensitivity and oral irritation were the most common side effects in the tray and dentifrice groups, but there were no side effects in the paint-on group.
#2) 17054282Hasson/200625 articlesSystematic Review
Key results“Strips (5.5% to 6.5% hydrogen peroxide(HP)) are more effective than gel in tray at 10% carbamide peroxide (CP) mean difference 1.82 (95% confidence interval (CI) 0.26 to 3.38)” quoted from Weyant Results.
Evidence Search PubMed: "Tooth Bleaching"[Mesh] AND "Tooth Discoloration"[Mesh] AND "Dentifrices"[Mesh] AND "Esthetics, Dental"[Mesh]
Comments on
The Evidence
Studies used in the systematic review used short term follow-up periods and were supported by manufacturers of the products tested. Independent long term studies are needed to clarify the long term effectiveness of these procedures.
Applicability Using a barrier-based tray system for tooth whitening provides superior tooth color enhancement compared to other barrier-free over-the-counter whitening systems.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords whitening, bleaching, sensitivity, esthetic, time
ID# 474
Date of submission: 01/13/2010spacer Revised: 09/23/2011
E-mail cooperrb@uthscsa.edu
Author Amber Todora
Co-author(s) R. Bryn Cooper
Co-author(s) e-mail
Faculty mentor/Co-author Kevin M. Gureckis, DMD
Faculty mentor/Co-author e-mail gureckis@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Emily Moers (San Antonio, TX) on 04/24/2012
After a similar evidence search, a more recent article in the American Journal of Dentistry, 2007, reiterated the above key findings. PMID: 17993029 randomized control trial or 87 adults found 6% hydrogen peroxide whitening strips significantly whitened teeth compared to whitening gel and placebo.

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