Pretty painful: Why does tooth bleaching hurt?

Markowitz, Kenneth

doi:10.1016/j.mehy.2009.11.044

Cited by 196 publications

(149 citation statements)

References 68 publications

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“…Since the afferent fibers of primary dental pulp contain TRPA1, it is possible that direct TRPA1 activation of nerve fibers is involved in the pain caused by tooth bleaching. 14 The mechanisms responsible for tooth sensitivity after bleaching have not been fully elucidated; however, some inflammatory mediators may play an important role. 1,15 These effects have commonly been reported in association with bleaching techniques and different peroxide concentrations, although inoffice whitening products cause greater sensitivity than at-home bleaching gels.…”

Section: Introductionmentioning

confidence: 99%

The influence of desensitizing dentifrices on pain induced by in-office bleaching

et al. 2013

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The purpose of this study was to evaluate whether the use of desensitizing dentifrices used 15 days prior to and after in-office tooth bleaching could eliminate or reduce tooth sensitivity. After institutional review board approval and informed consent, 45 subjects were selected and divided into 3 groups according to the dentifrice selected: Colgate Total (CT), Colgate Sensitive Pro-Relief (CS) or Sensodyne ProNamel (SP). The subjects used toothpaste and a toothbrush provided to them for 15 days prior to bleaching. They were then submitted to two in-office bleaching sessions (Whiteness HP Blue Calcium). Their tooth sensitivity was assessed using the Visual Analog Scale (VAS) for a week after each session. Their tooth shade alteration was measured with a Vitapan Classical shade guide to determine if the dentifrices could influence the effectiveness of the bleaching agent. The data were submitted to Wilcoxon, Kruskal-Wallis and Mann-Whitney tests (α = 0.05). The use of desensitizing dentifrices did not affect the bleaching efficacy. In regard to tooth sensitivity, there was a statistically significant difference between the results of the Control Group and Group T2 after the first session (p = 0.048). There was no statistically significant difference in the results for the other groups after the first session. In regard to the second session, there was no statistically significant difference in the results for all the groups. The use of a desensitizing dentifrice containing nitrate potassium reduced tooth sensitivity during the bleaching regimen. Dentifrices containing arginine and calcium carbonate did not reduce tooth sensitivity. Color change was not influenced by the dentifrices used.

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Section: Introductionmentioning

confidence: 99%

The influence of desensitizing dentifrices on pain induced by in-office bleaching

et al. 2013

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“…Although the etiology of this side effect has not yet been fully established, it seems that it results from the peroxide penetrating through enamel and dentin and into the pulp during tooth whitening. 24,25 Within five to 15 minutes after application of a bleaching gel, peroxide penetrates to the pulp, where it irritates nerves and essentially produces a reversible pulpitis. [26][27][28] Further proof of this passage of peroxide is found in the research that showed color changes in dentin next to the pulp as fast as it occurs next to the dentin-enamel junction.…”

Section: Discussionmentioning

confidence: 99%

Clinical Effects of Prolonged Application Time of an In-office Bleaching Gel

Reis¹,

Tay²,

Herrera³

et al. 2011

Operative Dentistry

104

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By refreshing the in-office bleaching gel at each clinical appointment, clinicians can improve the bleaching speed and reduce tooth sensitivity rates. SUMMARYObjective: The aim of this study was to evaluate whether the use of a gel applied for 1 3 45 minutes would have the same bleaching rate and tooth sensitivity levels when compared with 3 3 15-minute applications.Methods: In-office bleaching was performed in 30 participants with 35% hydrogen peroxide gel. In one group (n=15; 3315 minutes), the bleaching agent was refreshed every 15 minutes, three times at each bleaching appointment. In the other group (n=15; 1345 minutes) the gel was left undisturbed on the buccal surfaces of all teeth for 45 minutes at each bleaching appointment. This protocol was repeated after one week. The bleaching evaluation was completed by two blinded, calibrated evaluators who compared the baseline color of the maxillary anterior teeth with a valueoriented shade guide after each period. The patients recorded the tooth sensitivity on a 0-4 scale. The color changes were evaluated by appropriate tests (a=0.05). The percentage of patients with tooth sensitivity and its intensity were also statistically analyzed (a=0.05), respectively.Results: The use of gel for a single 45-minute period (1345 minutes) decreased the bleaching efficacy (p,0.05) 86.7%, and 100% of patients from the 3 3 15-minute and 1 3 45-minute groups, respectively, experienced tooth sensi-

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“…27 On the other hand, the study of Browning and others 26 reported that cold stimulus was the most painful stimulus, followed by gingival sensitivity and then sensitivity due to hot stimuli in patients using 10% carbamide peroxide with potassium nitrate and sodium fluoride as desensitizing agents.…”

Section: Tooth Sensitivity Evaluationmentioning

confidence: 99%

Assessment of the Effect of Casein Phosphopeptide–amorphous Calcium Phosphate on Postoperative Sensitivity Associated With In-office Vital Tooth Whitening

Maghaireh

Alzraikat

Guidoum

2014

Operative Dentistry

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Tooth sensitivity is the most frequent adverse effect of in-office vital tooth whitening. The use of a desensitizing gel after tooth whitening may reduce the incidence and severity of inoffice vital tooth-whitening sensitivity. SUMMARYThe aim of this study was to evaluate the efficacy of tooth mousse containing 10% casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) in reducing tooth sensitivity associated with in-office vital tooth whitening. In-office tooth whitening was performed for 51 participants using 35% hydrogen peroxide gel in a single visit. After the procedure, each participant was randomly assigned to one of three groups: gel without desensitizing agent (n=17), gel with 2% sodium fluoride (n=17), gel with 10% CPP-ACP (n=17). A small amount of the desensitizing gel assigned for each participant was applied directly on the labial surfaces of teeth and left undisturbed for three minutes. The participants were asked to apply the gel assigned to them for three minutes twice daily after brushing their teeth, and to continue this for 14 days. The participants were asked to return for follow-up visits after 24 hours and on days 3, 7, and 14, at which time teeth shade changes were assessed by one evaluator using a value-oriented Vita classic shade guide. The incidence, duration, and intensity of tooth sensitivity experienced was

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Pretty painful: Why does tooth bleaching hurt?

Cited by 196 publications

References 68 publications

The influence of desensitizing dentifrices on pain induced by in-office bleaching

The influence of desensitizing dentifrices on pain induced by in-office bleaching

Clinical Effects of Prolonged Application Time of an In-office Bleaching Gel

Assessment of the Effect of Casein Phosphopeptide–amorphous Calcium Phosphate on Postoperative Sensitivity Associated With In-office Vital Tooth Whitening

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