In vivo Evaluation of an ADA-accepted In-office and At-home Bleaching Agent

Objectives: To evaluate an ADA accepted in-office and at-home bleaching product. We evaluated the degree of color change of teeth, any rebound effect, and sensitivity associated with their use. Methods: Two bleaching agents: Opalescence Tooth Whitening Gel with 10% carbamide peroxide (Ultradent Products, Inc., South Jordan, UT) and StarBrite (Interdent, Inc., Los Angeles, CA) with 35% hydrogen peroxide were used on 19 subjects in a half-mouth designed study. Manufacturer’s instructions were followed. Bleaching treatments were applied to the right or left maxillary anterior teeth randomly. Subjects were shown how to perform at-home bleaching treatment overnight for two weeks on one side. Two in-office treatments were accomplished on the other side. Each in-office treatment consisted of using the agent three separate times in a single setting. Subjects returned in 1, 2, 3, 6 and 12 weeks for evaluation of color using a colorimeter (Chroma Meter 321) and shade guide (Trubyte Bioform Color Ordered Shade Guide), and for taking slide photographs. Subjects reported sensitivity evaluation. Results: At-home treatment caused significantly more lightness than the in-office treatment after the active treatment period and at each follow-up visit (p=0.0001) in DL*, Da*, Db*, DE, D shade guide rank order and slide comparisons of sides. There was no statistically significant difference in tooth sensitivity overall (p=0.06) but at-home had significantly more soft tissue sensitivity (p=0.04). Subject survey indicated that they felt at-home treatment produced significantly different color of teeth than in-office treatment (p=0.0001). Conclusions: An ADA accepted at-home bleaching product is more effective than an ADA accepted in-office bleaching product in lightening teeth. At-home product caused more tissue sensitivity than in-office product. There was no difference in tooth sensitivity.