Clinical evaluation of professional vs over-the-counter tooth whitening agents

Objective: Dental product manufacturers are now marketing tooth whitening products directly to patients. The purpose of this study was to compare an over-the-counter product (Crest Whitestrips™, Procter & Gamble) with a professional administered tooth whitening material (15% Opalescence, Ultradent). Methods: Using a simultaneous split-mouth protocol, 30 patients ranging from 18 to 45 years of age were selected to wear the over-the-counter whitening strips on the maxillary left quadrant and a professionally made custom tray on their maxillary right quadrant. Chromameter and Vita shade readings were taken at baseline, after two weeks of bleaching, and two weeks after treatment was completed (week 4). During the two weeks of bleaching, patients used both products for two 30-minute applications every day. Data were analyzed using a one-way analysis of variance (ANOVA) followed by the Student-Newman-Keuls method when significant differences were found (P<0.05). Results: Both test products produced a measurable amount of tooth whitening with no statistically significant differences in efficacy, color regression, or side effect (P>0.05). Although no cases of tooth sensitivity were reported, some patients experienced gingival sensitivity. Overall, patient satisfaction was higher with the professionally made custom tray technique than with the over-the-counter strips. Conclusions: Both products were found to be clinically effective in tooth whitening. In fact, there were no statistical differences in the amount of whitening achieved immediately after two weeks of bleaching and two-weeks after treatment. The patients found the strips less stable on the teeth and not as well adapted as the custom tray, especially to malposed teeth. The strips only extend from canine to canine, so some patients with a wide smile felt that they did not achieve complete esthetic results.