Title

Whitening at Home: Strips vs Gels

Clinical Question

Are strips or gel varnishes more effective home whitening treatment for adults?

Clinical Bottom Line

Strips bleached faster and more effectively than gel; both were surpassed by tray based overnight treatments. Of the whitening products on the market none show significant side effects but there is a need for more independent clinical trials due to current biases in research.

Best Evidence

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
12167948	Niederman/2000	7 systematic clinical trials	Meta-Analysis
Key results	Whitening products produced significant color change (p < 0.01), when compared to placebo control group (0.7 0.6, p > 0.05). However the brand of bleaching agent had a significant effect on tooth whitening, but the daily application time and duration of treatment did not.
19838560	Demarco/2009	30 articles	Systematic Review
Key results	This article offers the best support and overall review of the current at home bleaching products available. Furthermore the bias of the paper appears to be minimal. The study was funded by the Brazilian Oral Research foundation and was also presented at an international symposium in 2008. Pertinent results: Gels produce a non-clinically significant whitening effect. Whitening strips whiten similar to that of 10% CP in a tray. Independent, long-term clinical trials are needed to evaluate the effectiveness, side effects and corrections to existing bias in current research.
17054282	Hasson/2006	416 articles were identified, 25 used	Systematic Review
Key results	While strips appear to whiten teeth more effectively than gels it is difficult to ascertain if the differences in efficacy is due to application method or concentration of active ingredients. There is need for long-term pragmatic studies for evaluation of side effects.

Evidence Search

Over-the-counter tooth whitening. At Home Whitening strips gels. Tooth Whitening, meta-analysis.

Comments on
The Evidence

The three large and independent reviews appear to have come to similar conclusions on the efficacy of gels vs whitening strips although the statistical differences very. Article 19838560 provides the most comprehensive, complete and unbiased review of the majority of bleaching procedures available.

Applicability

Over the years esthetics have become a larger and larger concern from dental patients. These results are relevant to those seeking to whiten the shade of their teeth at home. The data suggests that while both strips and gels appear to whiten teeth, strips have more visible results.

Specialty

(General Dentistry) (Orthodontics) (Restorative Dentistry) (Dental Hygiene)

Keywords

Home bleaching, Over the counter bleaching, whitening, bleaching, strips, gels

ID#

2510

Date of submission

07/22/2013

E-mail

mcelhine@ohsu.edu

Author

Elizabeth Ann McElhinney

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Ronald Sakaguchi, DDS, MS, PhD, MBA & Eli Schwarz, DDS, MPH, PhD

Faculty mentor e-mail

sakaguch@ohsu.edu; schwarz@ohsu.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?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

None available