Preemptive Use of Piroxicam on Tooth Sensitivity Caused By In-Office Bleaching: A Randomized Clinical Trial

Abstract

This clinical trial evaluated the effect of preemptive use of the non-steroidal anti-inflammatory drug piroxicam in a single dose 30 min prior to in-office bleaching on the prevention of tooth sensitivity (TS) reported by patients. Fifty patients were submitted to two sessions of in-office tooth bleaching with 35% hydrogen peroxide used for 2 sessions, each consisting of a single 45-min application, with an interval of 7 days between session. Thirty minutes prior to the procedure, the patient randomly received a single dose of piroxicam (200 mg) or placebo in a double-blind, randomized, crossover design. The TS was evaluated using verbal rate (VRS) and visual analog (VAS) scales during the bleaching procedure and at 24 h after each session. The color changes were assessed by the Vita Bleachedguide scale 1 week after each bleaching session. Risk of TS was calculated from the VRS and analyzed by the McNemar test, while the level of TS was analyzed by the Mann-Whitney test. For the VAS, t-tests were used to compare data from the treatments at each assessment time. Data regarding color changes were subjected to Wilcoxon and Mann-Whitney tests (α=0.05). The preemptive administration of piroxicam did not affect the risk and level of TS compared to placebo, irrespective of the assessment time. The treatment sequence did not affect bleaching effectiveness. In conclusion, the administration of a single dose of piroxicam prior to in-office tooth bleaching was unable to significantly reduce the risk and level of TS.

Effect of topical application of nanoencapsulated eugenol on dental sensitivity reduction after in‐office dental bleaching: a randomized, triple‐blind clinical trial

“…Specifically, five patients took analgesics or anti‐inflammatory drugs for pain relief. This is a common report when in office bleaching gels are applied 11‐15 . However, this symptom disappeared immediately after analgesic administration for these patients, and after 1 week, no patient reported TS.…”

“…This is a common report when in office bleaching gels are applied. [11][12][13][14][15] However, this symptom disappeared immediately after analgesic administration for these patients, and after 1 week, no patient reported TS. Finally, regarding the limiting factors of the study, most of the participants were young adults, which could affect the generalization of the study results to the general population.…”

“…[7][8][9] Therefore, some alternatives have been tested to reduce or even eliminate this adverse effect. Among them, the administration of oral systemic drugs able to inhibit the release of inflammatory mediators, 8,[10][11][12][13][14] and topical application of desensitizing/remineralizing agents 9,[15][16][17] are the most frequently evaluated. However, despite the ease of administration and good patient acceptance, the use of systemic drugs has not shown satisfactory results in reducing the risk and intensity of TS.…”

Knowledge of Brazilian dentists and students in treating dentine hypersensitivity

“…A second issue highlighted by a Consensus Document (Canadian Advisory Board on Dentin Hypersensitivity, 2003) was that DH was not routinely conducted by clinicians except when prompted by patients with DH. Differential diagnosis from other kinds of dental sensitivity, such as that related with molar incisor hypomineralization (MIH) (Laureano, et al, 2020;Raposo, et al, 2019) or bleaching (Peixoto, et al, 2019) is also often overlooked. Finally, DH treatment should be driven considering not only the event itself but also the dentist's and mainly the patient's perceptions and expectations (Canadian Advisory Board on Dentin Hypersensitivity, 2003).…”