ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title No Conclusive Evidence That Light-Activated Bleaching Results In Greater Whitening Than Tray/Non-Light Activated Bleaching
Clinical Question In adult patients over the age of 18, does light activated or heat activated bleaching result in greater whitening or increased patient satisfaction compared to tray or strip delivered bleaching agents?
Clinical Bottom Line There is no conclusive evidence that light-activated bleaching results in greater whitening or patient satisfaction than tray/non-light activated bleaching. This is supported by two randomized controlled trials (40 and 90 patients).
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) 18335728Marson/200840 patients within age 18-28, caries free anterior teeth without restorations, good oral hygiene, periodontal disease and gingival irritation free, non smokers, and free of cervical lesions and any painful symptoms.Randomized Controlled Trial
Key results4 groups - Group 1–35% Hydrogen Peroxide (HP); Group 2–35% HP plus Halogen Curing Light XL 3000; Group 3–35% HP plus Demetron LED and Group 4–35% HP plus LED/LASER were tested to evaluate whiteness with a spectrophotometer, visually and patient satisfaction. Maxillary anterior teeth were tested. All 4 groups showed equality between the ΔE (differences in color before and after treatment) with p=0.999993. Similarly, all groups expressed equality in whitening during visual/shade evaluation with a p=1.00000. Patient satisfaction was about equal for all 4 groups (92.5% noted that the treatments whitened their teeth moderately – a lot. There was no statistically significant differences with or without the use of curing light after treatment and the use of light-activated sources for increased whitening was not conclusive clinically.
#2) 20166405Bernardon/201090 subjects with their anterior teeth (A2 or darker, Vita Classic shade guide)Randomized Controlled Trial
Key results3 treatment groups with split mouth study design - Group I: HB (at-home bleaching with 10% carbamide peroxide for two weeks) vs OBL (in-office bleaching with 35% hydrogen peroxide, two sessions, two-week intervals, with light irradiation); Group II: OB (in-office bleaching without light irradiation) vs OBL; Group III: HB vs combination (one session plus HB). With a p<0.05 after two weeks, at-home bleaching resulted in similar color changes as in-office bleaching with light irradiation. Light-activated bleaching did not improve the whiteness/bleaching efficacy.
Evidence Search "Tooth Bleaching"[Mesh] AND "spectrophotometry"[Mesh] AND Randomized Controlled Trial[ptyp]
Comments on
The Evidence
Marson 2008 is a randomized controlled trial with groups similar at the start, > 80% completion rate, groups treated same, adequate compliance and no competing interests. It is not known if there was a double-blind or recall bias. Bernardon 2010 is a randomized controlled trial with groups similar at the start, groups treated the same, adequate compliance and no competing interests. It is not known if there was a >80% completion or double blind or recall bias.
Applicability Subjects are representative of general dentistry/cosmetic dentistry patients including patients over the age of 18. Treatment is feasible in the clinic setting. Patients can benefit from lower costs (not spending more for light-activated whitening), less chair time, and more knowledge on teeth whitening. Patients may be harmed from realization that light-activated whitening isn’t as efficient as what many companies claim it to be.
Specialty/Discipline (Public Health) (General Dentistry) (Restorative Dentistry)
Keywords Light, light-activated, phototherapy, tooth bleaching, teeth bleaching, bleaching
ID# 2279
Date of submission: 04/11/2012spacer
E-mail nguyenad@livemail.uthscsa.edu
Author Alvin D. Nguyen
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author David Cox, DDS
Faculty mentor/Co-author e-mail CoxD@uthscsa.edu
Basic Science Rationale
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