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Title Dentist-Prescribed Overnight Bleaching is More Effective than Over-the-counter Methods for Vital Tooth Bleaching
Clinical Question In a healthy adult patient with good oral hygiene, how do over-the-counter bleaching products compare with dentist prescribed bleaching procedures or products?
Clinical Bottom Line Both methods effectively lighten the shade of teeth. However, when used according to manufacturers’ recommendations, dentist-prescribed bleaching trays have a greater whitening effect. (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) 19363980Matis/2009Healthy patientsSystematicReview-Meta-analysis
Key resultsThe 2009 Matis paper compared the whitening effect of 25 products using 4 bleaching systems. Treatments were performed according to the manufacturers’ recommendations. Overnight dentist-prescribed bleaching trays worked best, followed by daytime dentist-prescribed bleaching trays, then in-office treatment and over-the-counter strips. Whitening is time and concentration dependent. Potential risks of bleaching was not addressed in this study.
Evidence Search Search (("Tooth Bleaching"[Mesh] AND "Crest whitestrips "[Substance Name]) AND "Esthetics, Dental"[Mesh]) AND "Tooth Discoloration"[Mesh] Search Home based chemically-induced whitening Search "carbamide peroxide "[Substance Name] Search ((carbamide peroxide) Search ("Crest whitestrips "[Substance Name] AND ("Tooth Bleaching"[Mesh] OR "Tooth Discoloration"[Mesh])) AND "Tooth Bleaching/methods"[Mesh]
Comments on
The Evidence
Matis and colleagues performed a meta-analysis of nine published studies conducted at the Indiana University School of Dentistry. Six of the studies were split mouth studies. All nine studies used the Trubyte Bioform Color Ordered Shade Guide and a Chroma Meter to increase comparability. Another strength was that the same inclusion and exclusion criteria were used in all but one on the studies. It is known that the amount of whitening is time and concentration dependent. This study did not address the potential risks of bleaching.
Applicability The results are applicable to any patient seeking tooth-whitening treatment.
Specialty/Discipline (General Dentistry) (Restorative Dentistry)
Keywords Tooth bleaching, tooth discoloration, esthetic dentistry, hydrogen peroxide, carbamide peroxide, whitestrips
ID# 557
Date of submission: 03/31/2010spacer Revised: 08/29/2013
E-mail forney@livemail.uthscsa.edu
Author Alexandra M. Forney
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 Spencer Rowan (San Antonio, TX) on 04/20/2012
A PubMed search on this topic was completed April of 2012. The publications listed in the CAT still answer the clinical question most directly.

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