Effect of an experimental desensitizing gel on bleaching-induced tooth sensitivity after in-office bleaching—a double-blind, randomized controlled trial

Abstract

Objectives To evaluate the risk and intensity of tooth sensitivity (TS), and the efficacy of in-office bleaching after applying an experimental desensitizing gel composed of 10% calcium gluconate, 0.1% dexamethasone acetate, 10% potassium nitrate, and 5% glutaraldehyde. Material and methods In a split-mouth, double-blind, placebo-controlled study, 50 participants had their upper hemiarches randomized into experimental and placebo groups. Desensitizing and placebo gels were applied for 10 min before in-office bleaching (35% hydrogen peroxide, 1 × 50 min; two bleaching sessions; 1-week interval). TS was recorded immediately after bleaching, 1, 24, and 48 h after each session, with a 0–10 visual analogue scale (VAS) and a five-point numerical rating scale (NRS). The color was recorded in all groups at baseline, 1 week after each session, and 1 month after the end of bleaching using shade guide units (ΔSGUs) and a spectrophotometer (Δ E ab , Δ E 00 , and ΔWI D ). Results Most participants (96%) felt some discomfort during treatment regardless of the study group. The odds ratio for pain was 0.65 (95% CI 0.1 to 4.1; p = 1.0). The intensity of TS did not differ between groups ( p > 0.31), and it was only 0.34 VAS units lower in the experimental group. A significant color change occurred in both groups regardless of the group. Conclusions The desensitizing experimental gel applied before in-office bleaching did not reduce the risk and the intensity of TS and did not affect color change. Clinical relevance Although the experimental desensitizing agent with varying mechanisms of action did not jeopardize the color change, it did not reduce the risk or intensity of in-office bleaching. Clinical trial registration number RBR-7T7D4D.

Effect of the type of application tip for 35% hydrogen peroxide on bleaching efficacy and tooth sensitivity: A randomized clinical trial

“…In the present study, a lower risk of TS was observed (81%) compared with the clinical studies that evaluated the first version of the current in-office bleaching gel (95%-100%). 35,[41][42][43] This occurred because in the previous study, the gel was a slightly acidic with an unstable pH during the 50-min application time (starting at pH 6.5 and ending at pH 5.5). 19,28 More acidic gels tend to penetrate deeper into the pulp 29 and cause greater risk and intensity of TS.…”

“…The absolute risk and the intensity of TS were evaluated, using the Visual Analogue Scale (VAS; 0-10), being "0" = no pain and "10" = severe pain. 29,[39][40][41][42][43] The participants received a TS diary that corresponded to each dental bleaching session. In each session, the participants were instructed to record the worst result in the following times: immediately after the session of bleaching, up to 1 h after, up to 24 h after, and up to 48 h after the procedure.…”

Can different agents reduce the damage caused by bleaching gel to pulp tissue? A systematic review of basic research

“…It is well-established that dental bleaching releases a significant amount of SP, a neurotransmitter that modulates pain [ 3 65 ]. In a clinical setting, this inflammatory process often manifests as intense tooth sensitivity following a bleaching procedure [ 8 9 66 ]. Initially, the pulp responds to mild stimuli by depositing reactionary dentin through the odontoblast cell layer [ 7 35 ].…”

“…However, prior research has highlighted potential harmful effects associated with these procedures. These include an increase in pulp inflammation in both humans and animals, a decrease in the mineralization potential of pulp cells, and severe postoperative dental sensitivity [ 1 4 5 6 7 8 9 ]. Furthermore, patients who undergo in-office bleaching have reported a higher incidence and intensity of tooth sensitivity compared to those who opt for at-home bleaching.…”

The Use of Diode Low-Power Laser Therapy before In-Office Bleaching to Prevent Bleaching-Induced Tooth Sensitivity: A Clinical Double-Blind Randomized Study

“…Recently, Vochikovski L et al ( 2022) [15], in a split-mouth, double-blind, placebocontrolled study consisting of 50 participants, proved that a desensitizing gel composed of 10% calcium gluconate, 0.1% dexamethasone acetate, 10% potassium nitrate, and 5% glutaraldehyde applied on the teeth for 10 min before in-office bleaching does not reduce the risk and the intensity of tooth sensitivity. Ortega-Moncayo MG et al (2021) [16] evaluated the effectiveness of applying a dentifrice containing 5% potassium nitrate before and during in-office dental bleaching in reducing bleaching-induced tooth sensitivity using a test and control group.…”