Satisfaction with home-whitening lasts

By Sarah Guy

Patient satisfaction with the shade of their teeth after nightguard vital bleaching (NGVB) could last up to 12 years on average, report US researchers.

Their findings also show no adverse effects of the treatment; patients' gingival index and external cervical resorption (ECR) findings aligned with normal expectations at follow up.

"NGVB with 10% CP [carbamide peroxide] was found to be effective with minimal side effects up to 17 years posttreatment," say Lee Boushell (University of North Carolina [UNC], Chapel Hill, USA) and co-investigators.

Thirty-one participants of the 1989‑1996 UNC School of Dentistry NGVB trials completed Boushell at al's questionnaire a mean 12 years post-NGVB treatment. The research team assessed levels of patient satisfaction (very, partially, or not), whether they had any further whitening treatment, and if they perceived there to be any complications relating to the original treatment.

Participants' teeth (numbers 6‑11) were also clinically evaluated.

In all, 35% of respondents said they were satisfied (very or partially) with the shade of their teeth, indicating that "approximately one-third of the patients who utilize NGVB will likely experience lasting satisfactory results," write the authors in the Journal of Esthetic and Restorative Dentistry.

A total of 61% of participants had not retreated their teeth since the initial NGVB, after which all said they were very or partially satisfied with the result. Of the 24 patients who reported current satisfaction levels, 92% indicated they were satisfied.

Almost half of respondents (48%) said that they experienced tooth and/or gingival sensitivity during treatment, while just one individual reported such problems immediately after treatment, and one participant reported experiencing staining they believed was treatment-related.

The researchers explain that tooth sensitivity could result from the penetration of CP through the tooth structure and into the pulp, therefore, to reduce this side effect, "the recommended daily exposure time to CP should be decreased as concentration is increased."

Indeed, in light of current marketing and societal trends that encourage at-home teeth bleaching at regular intervals, new formulations with high concentrations of CP need to be evaluated in clinical trials, suggest Boushell and colleagues.

No caries (decay), periodontal problems, or other concerns relating to the NGVB were reported by any of the study participants, and 91% of examined teeth had a normal gum index, 7% had mild inflammation, and 2% had moderate inflammation.

Finally, radiographic observation revealed no evidence of ECR or apical lesions in the cohort, reports the research team.

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