Tooth color reduction and consequent patient satisfaction after office and home bleaching: a 6-month follow-up study

Hyo-Jin Goo; Hyeon-Sook Kwun; Jeong-Hee Park; Min-Jeong Cho; Eun-Kyong Kim; Youn-Hee Choi; Keun-Bae Song

doi:10.11149/jkaoh.2015.39.1.3

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Goo, Kwun, Park, Cho, Kim, Choi, and Song: Tooth color reduction and consequent patient satisfaction after office and home bleaching: a 6-month follow-up study

Original Article

J Korean Acad Oral Health 2015;39(1):3-8.

Published online: 12 March 2015

DOI: https://doi.org/10.11149/jkaoh.2015.39.1.3

Tooth color reduction and consequent patient satisfaction after office and home bleaching: a 6-month follow-up study

Hyo-Jin Goo¹, Hyeon-Sook Kwun¹, Jeong-Hee Park¹, Min-Jeong Cho², Eun-Kyong Kim³, Youn-Hee Choi², Keun-Bae Song²

¹Department of Dental Hygiene, Masan University, Changwon, Korea

²Department of Preventive Dentistry, Kyungpook National University School of Dentistry, Daegu, Korea

³Department of Dental Hygiene, College of Science &Technology, Kyungpook National University, Sangju, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu 700-412, Korea Tel: +82-53-660-6870 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 2 June 2014 Revised 10 January 2015 Accepted 13 February 2015

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The quest for a happy life is accompanied by an increase in social activities, living standards, and socioeconomic development, with individuals showing increased interest in health and esthetics. In the field of dentistry, not only prevention and treatment but also esthetics is gaining popularity. The aim of this study was to identify tooth color reduction and consequent patient satisfaction over a period of 6 months after office and home bleaching.

Methods

Thirty subjects were divided using the convenience sampling method into two groups based on the bleaching agent used: 10% carbamide peroxide (CP10; home bleach) and 15% hydrogen peroxide (office bleach). CP10 was used at home in a tray for 2 h/day over 14 days, while 15% hydrogen peroxide was light-activated for 15 min, three times/session (total, 45 min). A control set of teeth without any bleaching treatment was used as reference. Shade evaluation was conducted using the Shade Eye NCC at baseline, 1 week, and 1 and 6 months after bleaching. Data were analyzed using the Mann-Whitney U test and the nonparametric Friedman test.

Results

There were significant differences in tooth color before and after bleaching in both the home and office bleach groups, although intergroup differences were not observed. Although b* values after bleaching were lower than the original values, only slight tooth color reduction was observed at 6 months. ΔE*, which represents the overall change in color, at 1 and 6 months after bleaching was significantly different from that at baseline in the home bleach group, while it showed no significant differences in the office bleach group. According to a patient satisfaction survey, patient satisfaction significantly increased over time in the home bleach group, although it did not differ significantly between groups.

Conclusions

Tooth whitening was observed after bleaching in both groups. However, slight color reduction was observed at 6 months after bleaching, and complete restoration to the color before bleaching did not occur; therefore, long-term observation of color reduction is required.

Keywords: Color reduction, Patient satisfaction, Tooth bleaching

References

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Fig. 1.

Changes of b* with periods.

Table 1.

The subject's inclusion and exclusion criteria


Inclusion criteria	• Good general health and adequate oral hygiene
	• Have all nature anterior teeth of which shade are between A3~A2 shade guide
	• Willing to return for post-whitening evaluation
	• Agree to sign a consent form
Exclusion criteria	• Subjects with one of the six anterior teeth which more than 1/6 of their buccal surface was restored
	• Subjects with orthodontic treatment or tetracycline stained teeth
	• Presence of gross pathology on the soft or hard tissues in the oral cavity
	• Subjects with gingivitis, moderate or advanced periodontal disease
	• Subjects who had more than two caries lesions requiring immediate treatment
	• Subjects who have used tooth whiteners within the lastt 6 months
	• Smokers

Table 2.

Evaluation of color changes (b*, △E*) before and after tooth bleaching

		10% CP	15% HP	P-value*
		Mean±SD	Mean±SD	P-value*
b*	Before	15.37±2.25	16.03±1.48	0.493
	After 1 week	11.01±1.88	12.29±1.22	0.074
	P-value**	0.001	0.001
△E*	After 1 week	5.65±1.56	4.48±0.97	0.029

10% Carbamide peroxide (10% CP), 15% Hydrogen peroxide (15% HP). *Mann-Whitney test. **Willcoxon Signed Ranked test.

Table 3.

Evaluation of color changes (b*) according to period and group

		10% CP	15% HP	P-value*
		Mean±SD	Mean±SD	P-value*
b*	Before	15.37±2.25	16.03±1.48	0.493
	After 1 week	11.01±1.88^a	12.29±1.22^a	0.074
	After 1 month	11.91±2.10^b	12.76±1.40^b	0.290
	After 6 months	12.03±2.31^b	13.16±1.79^b	0.152
	P-value**	0.006	0.004

10% Carbamide peroxide (10% CP), 15% Hydrogen peroxide (15% HP). *Mann-Whitney test. **Friedman test.

^a ,bDifferent letters denote there are significant difference between groups by Willcoxon test.

Table 4.

Change of color (△E*) according to period and group

		10% CP	15% HP	P-value*
		Mean±SD	Mean±SD	P-value*
△E*	1 month-1 week	1.44±0.80	1.27±0.65	0.647
	6 months-1 week	2.47±0.94	1.25±1.22	<0.001
	P-value**	0.001	0.344

10% Carbamide peroxide (10% CP), 15% Hydrogen peroxide (15% HP). *Mann-Whitney test. **Willcoxon Signed Ranked test.

Table 5.

Changes of satisfaction measure after tooth bleaching

	10% CP	15% HP	P-value*
	Mean±SD	Mean±SD	P-value*
After 1 week	3.50±0.31^a	3.57±0.45	0.786
After 1 month	3.26±0.31^b	3.44±0.42	0.241
After 6 months	3.33±0.41^a,b	3.41±0.22	0.149
P-value**	0.030	0.062

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