UTCAT2237, Found CAT view, CRITICALLY APPRAISED TOPICs

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Title

6.5% Hydrogen Peroxide and 10% Carbamide Peroxide Effectively Treat Tetracycline-Stained teeth

Clinical Question

In a patient with tetracylcine staining, does the at-home bleaching system successfully whiten teeth as compared to no treatment at all?

Clinical Bottom Line

6.5% hydrogen peroxide and 10% carbamide peroxide effectively treat tetracycline-stained teeth. This is supported by a clinical trial that successfully showed patients improved their tooth shade over a 6 month period of time of using a take-home tray-less kit of 6.5% hydrogen peroxide gel. Carbamide peroxide is also an effective treatment that has shown to have lasting effects for at least 90 months after a 6 month treatment course. These treatments are effective options that many patients will likely accept rather than no treatment at all.

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) 22073810	Kugel/2011	N= 30 participants	RCT
Key results	“The 6.5% hydrogen peroxide strip provided significant improvement in subjects with tetracycline stains.” After the 6 month trial was completed, 65% of the subjects reached a B1 color using the expanded VITA shade guide.
#2) 12859112	Leonard/2003	N= 15	Case Study Survey
Key results	10% Carbamide Peroxide for 6 months has shown to have long lasting effects for at least 90 months with minimal shade reduction over that time frame. Also showed that the patients were very positive about the lack of post-treatment side effects.

Evidence Search

Tetracycline staining AND peroxide OR Haywood

Comments on
The Evidence

The first article is an RCT that was not a double-blind study, and included a group of subjects that all had symptoms of tetracycline staining on their teeth. The results were followed monthly for a 6-month period and compliance seemed to be adequate stating that the treatment was “generally well-tolerated.” The downside to this evidence was the lack of information regarding the degree of staining the subjects had prior to treatment. The 2nd article was a post treatment survey for patients who received a 6 month treatment of 10 % carbamide peroxide, which was useful to determine long-term results and side effects.

Applicability

This study shows that offering this treatment is very applicable for general dentists encountering these types of patients. The general dentist should warn the patient of the possibility of tooth sensitivity while using the 6.5% hydrogen peroxide strips or the 10% carbamide peroxide tray system.

Specialty/Discipline

(General Dentistry)

Keywords

Tetracycline Bleaching, hydrogen peroxide,

ID#

2237

Date of submission:

04/12/2012

E-mail

davenportm@livemail.uthscsa.edu

Author

Matthew Davenport

Co-author(s)

Co-author(s) e-mail

Faculty mentor/Co-author

Robert A. Kaminski, DDS, MS

Faculty mentor/Co-author e-mail

KaminskiR@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
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

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