ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Home Tooth Whitening May Cause Short Term Tooth Sensitivity
Clinical Question Do patients who use home tooth whitening agents experience more tooth sensitivity compared to patients who do not whiten their teeth?
Clinical Bottom Line There is increased tooth sensitivity following and during use of at home tooth whitening agents, but no long term effects. (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) 19233534Gerlach/2009Patients recieving 6% hydrogen peroxide whitening stripsMeta- Analysis
Key resultsOf 148 patients treated with 6% hydrogen peroxide, 20% experienced tooth sensitivity, but it was not great enough to adversely affect whitening.
#2) 18005286Leonard/2007Patients using 5%, 7% hydrogen peroxide and 10% carbamide peroxide bleaching agents.Randomized Control Trial
Key resultsThere was an increase in the tooth sensitivity experienced by patients using 7% hydrogen peroxide at the end of active treatment, but there was no difference in sensitivity among the 3 products at 7 days post treatment. Once treatment was complete, tooth sensitivity resolved in 2 to 3 days and did not recur during the 10 months recall.
#3) 17054282Hasson/2006Patients recieving home-based tooth bleaching agents.Systematic Review
Key resultsMild to moderate tooth sensitivity was the most common side effect after evaluting various trials. The whitening strips with high concentrations of hydrogen peroxide caused more users to experience tooth sensitivity. The author did report a need to evaluate long-terms harms.
Evidence Search Search "adverse effects "[Subheading], Search "Tooth Bleaching"[Mesh], Search "Dentin Sensitivity"[Mesh]
Comments on
The Evidence
The evidence did not focus exclusively on tooth sensitivity, but more on the overall effectiveness and safety of tooth whitening agents. It would be more beneficial to find evidence that directly measures the occurrence and degree of tooth sensitivity experienced by patients at various time intervals following bleaching treatments.
Applicability Overall I think this search is very applicable to patients who are considering tooth whitening at home because it looks at various hydrogen peroxide products and techniques.
Specialty/Discipline (General Dentistry)
Keywords tooth bleaching, dentin sensitivity, adverse effects
ID# 605
Date of submission: 05/11/2010spacer
E-mail Kennedyb@livemail.uthscsa.edu
Author Brooke Kennedy
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author William Francis Rose, Jr., DDS
Faculty mentor/Co-author e-mail ROSEW@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
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Comments on the CAT
(FOR PRACTICING DENTISTS' and/or FACULTY COMMENTS ON PUBLISHED CATs)
post a comment
by Roberto Benavides, Kuntal Patel & Puja Bhakta (San Antonio, TX) on 01/17/2013
The evidence ( PMID: 22433035) points out that the degree of post-whitening hypersensitivity varies according to the type of product being used. In this study, carbamide peroxide was used as the whitening agent with no reported hypersensitivity at the post-whitening appointment.
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