Six-month Continuous Use of Two At-home Professional Bleaching Systems on Tetracycline Stain

Objective: This research evaluated the safety and efficacy of two professionally-adminstered, at-home bleaching systems used continuously over 6-months to bleach intrinsic tetracycline stain. Methods: 40 adults with tetracycline stain were randomized in a ratio of 3:1 to a 6.5% hydrogen peroxide whitening strip or a 10% carbamide peroxide gel system delivered in a custom tray. Treatment was daily for 6 months following manufacturers instructions. Clinical response was assessed monthly, with effectiveness measured using a value-oriented, 16-step shade guide, and subjects were withdrawn from treatment when they reached minimum shade levels (B1). Results: The study population ranged from 22-70 years of age, and averaged moderate levels of tetracycline stain. Both groups experienced highly significant (p < 0.0001) shade improvement after 6-months continuous daily treatment. Mean shade changes from baseline were 10.7 and 10.5 units for the 6.5% hydrogen peroxide strip group and 10% carbamide peroxide tray group, respectively. Whitening onset was faster in the strip versus the tray systems, with these groups differing statistically (p < 0.05) at months 1-3. By Month 6, 45% of the total population reached the minimal shade level (B1). Mild and transient tooth sensitivity and oral irritation represented the most common findings, and no subject discontinued daily treatment early due to an adverse event. Conclusion: This comparative research establishes the effectiveness of daily use of 6.5% hydrogen peroxide whitening strips on tetracycline stain relative to an accepted tray system, and further reinforces the safety profile associated with these two professionally-administered bleaching systems. (This research was supported by The Procter & Gamble Co.)