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Teeth Whitening Research

Although there are several case reports of vital tooth bleaching in children, there is limited clinical trial evidence of the safety or efficacy of this practice. Accordingly, a new clinical trial was conducted to evaluate the effects of 2 different bleaching systems, a 6.5% hydrogen peroxide strip system and a 10% carbamide peroxide tray system, in a population of preteens and teens. A total of 106 volunteers, aged 11 to 18 years, took part in this 8-week study.

Patients were randomized by a ratio of 2:1 to the strip or tray groups, with each group treating the maxillary arch first and then the mandibular arch for 4 consecutive weeks each. Individuals assigned to the strip group used the system twice daily for 30 minutes (a total of 56 contact hours over the 8-week study). Those assigned to the tray group used that system overnight (approximately 448 contact hours).

Digital images were obtained at baseline and after every 2-week treatment period. Average tooth color was determined in L*, a*, b* color space, where L* indicated lightness, a* indicated red-green, and b* indicated yellow-blue. Both systems significantly whitened teeth (P < 0.0001). While there were no significant differences between groups with respect to the primary whitening response (delta b*) on the maxillary teeth, 4 weeks of overnight treatment with the 10% carbamide peroxide tray (approximately 224 contact hours) yielded statistically significant whitening (P < 0.05) on the mandibular teeth compared with the 6.5% hydrogen peroxide strip used for 28 hours.

Both tooth-whitening systems had similar sensitivity/irritation reported after instructed use. This research demonstrates that tooth whitening in teens may be safely accomplished using either the short-contact-time hydrogen peroxide bleaching strips or the overnight carbamide peroxide tray systems tested in this study.

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