Comparison of Daytime and Nighttime Brush-Applied Whitening Systems

Objective: Brush-applied whitening systems have gained in popularity recently. This comparative clinical trial evaluated clinical response of two of these peroxide-containing, paint-on whitening systems over a three week period. Methods: 47 adults were randomized to Colgate® Simply White^TM, a daytime carbamide peroxide paint-on in an applicator bottle, or Crest® Night Effects^TM, an overnight sodium percarbonate film in individual sachets. Efficacy was measured objectively as L*a*b* color change using digital images of the maxillary anterior teeth after 2 & 3 weeks treatment. Results: The study population ranged in age from 21-70 years. Relative to baseline, only the percarbonate film exhibited significant (p < 0.001) improvement in b* and L* with treatment. Week 2 adjusted means and standard errors for Db* (yellowness) were –0.23 (0.12) for the paint-on group compared to –0.69 (0.12) for the film group. Lightness/brightness (DL*) means (SE) were 0.05 (0.12) and 0.69 (0.13) in the paint-on and film groups, respectively. Outcomes were consistent after 3 weeks, when 67% of film users and 9% of paint-on users experienced at least a 1-unit improvement in overall color (DW*). Between-group comparisons showed highly significant (p < 0.02) greater color improvement in all color parameters favoring the percarbonate film. Although both treatments were well tolerated, tooth sensitivity and oral irritation were more common in the film group. Conclusion: Clinical testing of daytime and nighttime brush-applied systems showed significantly better whitening with the percarbonate film compared to the carbamide peroxide paint-on gel.