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

Abstract

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.

Comparative clinical efficacy of four different desensitising agents in relieving post-bleaching sensitivity

“…The reason for this finding may be attributed to the fast that the main mechanism of action of this dentifrice involves the obliteration of exposed root dentin tubules which is not applicable to the cohort studied. This is in accordance with the research of Thiesen et al (1) Group 3 containing Novamin or CSSP represents a method of tubule occlusion consisting of oxides of calcium, sodium, phosphorus ions and help in the formation of hydroxycarbonate apatite (HCA), which is similar in composition to minerals of teeth and bone. (21) This was found to be significantly effective in reducing post-bleaching sensitivity on the first day of both sessions using the subjective scale.…”

“…The main intrinsic causes of discoloration are aging and necrosis of pulp, while those of extrinsic discoloration are pigments from common beverages and tobacco. (1)(2)(3)(4) One of the commonest measures adopted to manage discoloured teeth is In-office vital tooth bleaching, because of its conservative approach and high success rate. (1,2) Hydrogen peroxide, at varying concentrations, is usually the chief ingredient in bleaching materials used for this purpose.…”

“…(1)(2)(3)(4) One of the commonest measures adopted to manage discoloured teeth is In-office vital tooth bleaching, because of its conservative approach and high success rate. (1,2) Hydrogen peroxide, at varying concentrations, is usually the chief ingredient in bleaching materials used for this purpose. Like most treatments, this method too comes with its share of side effects including sensitivity, changes to the tooth structure and effects on bonding.…”

A clinical, randomized, controlled study on the use of desensitizing agents during tooth bleaching

“…2 Most clinical studies have shown that both approaches effectively reduce TS. 4,[8][9][10][11] However, because neurogenic inflammation may play a role in TS resulting from tooth bleaching, 2,10 we hypothesize that desensitizing products should prevent the bleaching product from reaching the pulp by obliterating the dentin tubules more quickly and consequently preventing the inflammation rather than by simply inhibiting the painful neural stimulus.…”

The effect of gum chewing on sensitivity associated with in‐office whitening procedures

“…Another study found that a 5% potassium nitrate and 2% sodium fluoride gel used before in-office bleaching decreased the incidence of sensitivity (6). Additionally, the use of potassium nitrate toothpaste before whitening has been shown to reduce sensitivity during and after tooth-whitening procedures (18)(19)(20).…”