Effects of a whitening strip combined with a desensitizing primer on tooth color

Hae-Eun Shin; Sang-Uk Im; Eun-Kyung Kim; Jong-Hun Kim; Jae-Hyun Ahn; Youn-Hee Choi; Keun-Bae Song

doi:10.11149/jkaoh.2016.40.1.31

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Shin, Im, Kim, Kim, Ahn, Choi, and Song: Effects of a whitening strip combined with a desensitizing primer on tooth color

Original Article

J Korean Acad Oral Health 2016;40(1):31-37.

Published online: 12 March 2016

DOI: https://doi.org/10.11149/jkaoh.2016.40.1.31

Effects of a whitening strip combined with a desensitizing primer on tooth color

Hae-Eun Shin¹, Sang-Uk Im¹, Eun-Kyung Kim², Jong-Hun Kim³, Jae-Hyun Ahn³, Youn-Hee Choi¹, Keun-Bae Song¹

¹Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea

²Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea

³LG Household & Health Care LTD, Research Park, Daejeon, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, 2177, Dalgubeol-daero, Jung-gu, Daegu 41940, Korea Tel: +82-53-660-6870 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 8 January 2016 Revised 12 February 2016 Accepted 18 February 2016

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

The purpose of this study was to evaluate the efficacy of a 2.9% hydrogen peroxide (HP) whitening strip with a desensitizing agent as a primer.

Methods

This study was approved by the Institutional Review Board of Kyungpook National University Hospital. A total of 144 subjects (mean age: 21.7 years) were recruited after they provided informed consent for participation in the study. All participants used the whitening strip and primer for 1.5 h a day for 14 days. ShadeEye-NCC and Vita classical shade guide were used to determine the color changes, with respect to baseline, after 1, 3, 5, 7, and 14 days. A self-administered questionnaire was used to collect data on satisfaction after bleaching and irritating symptoms during the 14 days. All collected data were analyzed with repeated measures ANOVA and one-way ANOVA using SPSS 20.0 for windows.

Results

Brightness (ΔL*) was significantly higher in groups 2 and 3 than in the control group after 3 days of the experiment. Chroma (Δb*) started to decrease in groups 2 and 3, compared to control, after 1 day. Perceived symptoms of irritation were significantly lower in groups using the strip combined with the desensitizing primer than in the control group. Satisfaction after bleaching was higher in the experimental groups than in control.

Conclusions

The HP whitening strip with a desensitizing agent as a primer is clinically effective in bleaching human enamel after 3 days of use. It also reduces the prevalence of gingival irritation.

Keywords: Desensitizing agent, Primer, Whitening strip

References

1. Xiao J, Zhou XD, Zhu WC, Zhang B, Li JY, Xu X. The prevalence of tooth discolouration and the self-satisfaction with tooth colour in a Chinese urban population. J Oral Rehabil. 2007; 34:351–360.

2. Hong JH. Good teeth care is sufficient enough to change one’s impression. Seoul: Pampas;2007. p. 210–211.

3. Vallittu PK, Vallittu AS, Lassila VP. Dental aesthetics: A survey of attitudes in different groups of patients. J Dent. 1996; 24:335–338.

4. Lee HJ, Jeon ES. A research on the questionnaires about Busan citizens understanding of the tooth whitening. J Korean Soc Dent Hyg. 2006; 6(1):79–91.

5. Gu HJ, Lee YE, Baek HJ, Kim JS, Song KB. Effect of fluoride application after tooth bleaching using the diode laser. J Korean Acad Dent Health. 2008; 32(2):160–169.

6. Jung SH, Bae KH, Lee WJ, Moon HS, Paik DI, Kim JB. Clinical study on the effect of therapeutic toothpaste, vitamin E, and hydrogen peroxide on the tooth whitening. J Korean Acad Dent Health. 2001; 25(2):221–226.

7. Haywood VB, Heymann HO. Nightguard vital bleaching. Quintessence Int. 1989; 20(3):173–176.

8. Heymann H. Tooth whitening: Facts and fallacies. Br Dent J. 2005; 198(8):514.

9. Gerlach RW, Gibb RD, Sagel PA. A randomized clinical trial comparing a novel 5.3% hydrogen peroxide whitening strip to 10%, 15%, and 20 carbamide peroxide tray based bleaching systems. Compend Contin Educ Dent. 2000; 29(Suppl):S22–28.

10. Gerlach RW. Whitening paradigms 1 year later: Introduction of a novel professional tooth-bleaching system. Compend Contin Educ Dent. 2002; 23(1):4–8.

11. Cibirka RM, Myers M, Downey MC. Clinical study of tooth shade lightening from dentist-supervised patient-applied treatment with two 10% carbamide peroxide gels. J Esthet Dent. 1999; 11:325–331.

12. Hasson H, Ismail AI, Neiva G. Home-based chemically induced whitening of teeth in adults. The Cochrane library. 2006; 4:1–59.

13. Auschill TM, Hellwig E, Schmidale S, Sculean A, Arweiler NB. Efficacy, side-effects and patients’ acceptance of different bleaching techniques (OTC, in-office, at-home). Oper Dent. 2005; 30(2):156–163.

14. Charakorn P, Cabanilla LL, Wagner WC, Foong WC, Shaheen J, Pre-gitzer R, et al. The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching. Oper Dent. 2009; 34:131–135.

15. Kossatz S, Dalanhol AP, Cunha T, Loguercio A, Reis A. Effect of light activation on tooth sensitivity after in-office bleaching. Oper Dent. 2001; 36:251–257.

16. Reis A, Dalanhol AP, Cunha TS, Kossatz S, Loguercio AD. Assessment of tooth sensitivity using a desensitizer before light activated bleaching. Oper Dent. 2011; 36:12–17.

17. Costa J, Lubisich E, Ferracane J, Hilton T. Comparison of efficacy of an in office whitening system used with and without a whitening priming agent. J Esthet Restor Dent. 2011; 23(2):97–104.

18. Gustavo M, Patricia A, Greice B, Edward J, Swift Jr. Svetlana F, et al. Safety and efficacy of a high-adhesion whitening strip under extended wear regimen. J Dent. 2013; 41(Suppl 3):S46–52.

19. Meireles SS, Heckmann SS, Santos IS, Della Bona A, Demarco FF. A double blind randomized clinical trial of at home tooth bleaching using two carbamide peroxide concentration: 6 month follow up. J Dent. 2008; 36(11):878–884.

20. Bazzi JZ, Bindo MJ, Rached RN, Mazur RF, Vieira S, Souza EM. The effect of at-home bleaching and toothbrushing on removal of coffee and cigarette smoke stain and color stability of enamel. J Am Dent Assoc. 2012; 143(5):1–7.

21. Lenhard M. Assessing tooth color change after repeated bleaching in vitro with a 10 percent carbamide peroxide gel. J Am Dent Assoc. 1996; 127(11):1618–1624.

22. Reinhardt JW, Eivins SE, Swift EJ, Denehy GE. A clinical study of nightguard vital bleaching. Quintessence Int. 1993; 24(6):379–384.

23. Park ES, Seong SR, Hong ST, Kim JE, Lee SY. A clinical evaluation of a bleaching strip containing 2.9% hydrogen peroxide. J Korean Acad Conserv Dent. 2006; 31:269–280.

24. Jung SH, Park DY, Ma DS, Kim JY, Kim JH. Effect of 2.6% hydrogen peroxide containing tooth whitening strip on stained hydroxyapatite tablets. J Korean Acad Oral Health. 2002; 26:385–396.

25. Elize B, Alessandro DL, Alessandra R, Stella K. Effectiveness of a desensitizing agent before in-office tooth bleaching in restored teeth. Clin Oral Invest. 2014; 18:839–845.

26. Kose C, Reis A, Baratieri LN, Loguercio AD. Clinical effects of at-home bleaching along with desensitizing agent application. Am J Dent. 2011; 24(6):379–382.

27. Farrell S, Barker ML, McMillan DA, Gerlach RW. Placebo-controlled trial evaluating safety with 12-months continuous use of 6% hydrogen peroxide whitening strips. J Dent. 2008; 36:726–730.

Table 1.

Inclusion and exclusion criteria

Inclusion criteria	- Be in good general and oral health
	- Have all natural anterior teeth of which shade are
	between D3-A2 shade guide
	- Willing to return for post whitening evaluation
	- Agree to sign a consent form
Exclusion criteria	- Have anterior teeth with orthodontic braces or restoration
	- Have critical pathological lesion in oral tissue
	- Have gingival inflammation or multiple dental caries
	- Have more than two teeth need to be treated immediately
	- Have ever been involved in other study in 6 months
	- Have experience of high sensitivity during dental bleaching
	- Have ever used of whitening agent in 6 months

Table 2.

Study group and characteristic of treatment materials

Group	Patch	Primer
Group 1	Not contained HP	Contained desensitizing agents
Group 2	Contained 2.9% HP	Contained desensitizing agents
Group 3	Contained 2.9% HP	Contained 2.8% HP

HP: hydrogen peroxide.

Table 3.

Factor analysis for tooth bleaching satisfaction and reliability of each decisive factor

Factors	Items	Factor loading			Cronbach's 
Factors	Items	I	II	III	Cronbach's 
Satisfaction	My teeth became more white after bleaching.	0.88	―0.10	0.16	0.93
	Self-confidence of personal relations was increased after bleaching.	0.80	0.05	0.09
	My teeth became more bright after bleaching.	0.90	―0.17	0.15
	My teeth became more clear after bleaching.	0.88	―0.10	―0.01
	Self-confidence during smile was increased after bleaching.	0.84	0.04	0.06
	I really satisfied with tooth bleaching.	0.84	0.08	0.06
Side effects	I felt cold sensitivity during bleaching.	0.14	0.11	0.75	0.61
		My teeth became more rough after bleaching.	0.12	0.04	0.66
		My teeth was impaired after bleaching.	0.00	―0.04	0.82
Social life	I agree that tooth bleaching can affect my future life.	0.07	0.77	0.01	0.75
		White teeth have an effect on social life.	―0.13	0.82		0.07
		White teeth is a basal condition of the beauty.	―0.05	0.84		0.04

Table 4.

Color changes △L* of total tooth among the group at each time

	Group 1	Group 2	Group 3	P-value^†
Baseline	71.03±1.81	70.62±1.42	70.10±1.44	0.511
After 1 day	0.04±0.76	0.27±0.89	0.49±0.71	0.076
After 3 days	0.00±0.92^a	0.77±1.06^b	1.07±0.82^b	<0.001
After 5 days	―0.29±1.19^a	0.81±1.43^b	1.32±1.21^b	<0.001
After 7 days	―0.09±1.30^a	1.38±1.64^b	1.64±1.24^b	<0.001
After 14 days	―0.05±1.52^a	2.26±1.80^b	2.25±1.45^b	<0.001

^† P-value was determined by one- way ANOVA test for continuous variables.

^abc Same letters means there is no significant difference between groups by tukey’s multiple comparison.

Table 5.

Color changes △a* of total tooth among the group at each time

	Group1	Group2	Group3	P-value^†
Baseline	0.59±0.72	0.53±0.63	0.35±0.60	0.325
After 1 day	0.06±0.48	―0.05±0.34	―0.08±0.47	0.382
After 3 days	0.05±0.43^a	―0.39±0.43^b	―0.56±0.46^b	<0.001
After 5 days	0.16±0.52^a	―0.46±0.54^b	―0.53±0.47^b	<0.001
After 7 days	0.22±0.59^a	―0.66±0.53^b	―0.48±0.52^b	<0.001
After 14 days	0.15±0.59^a	―0.89±0.64^b	―0.92±0.70^b	<0.001

^† P-value was determined by one- way ANOVA test for continuous variables.

^abc Same letters means there is no significant difference between groups by tukey’s multiple comparison.

Table 6.

Color changes △b* of total tooth among the group at each time

	Group 1	Group 2	Group 3	P-value^†
Baseline	14.61±2.32	14.84±2.52	14.60±2.04	0.325
After 1 day	―0.27±0.89^a	―0.79±0.74^b	―1.26±0.96^c	<0.001
After 3 days	―0.48±1.14^a	―2.20±0.93^b	―2.90±1.34^c	<0.001
After 5 days	―0.41±1.01^a	―2.80±1.21^b	―2.89±2.79^b	<0.001
After 7 days	―0.51±0.94^a	―3.49±1.19^b	―4.42±1.45^c	<0.001
After 14 days	―0.17±0.97^a	―4.51±1.68^b	―5.70±1.49^c	<0.001

^† P-value was determined by one- way ANOVA test for continuous variables.

^abc Same letters means there is no significant difference between groups by tukey’s multiple comparison.

Table 7.

Color changes △E* of total tooth among the group

	Group 1	Group 2	Group 3	P-value^†
ΔE	1.71±0.78^a	5.38±1.91^b	6.34±1.72^c	<0.001

^† P-value was determined by one- way ANOVA test for continuous variables.

^abc Same letters means there is no significant difference between groups by tukey’s multiple comparison.

Table 8.

Vita classical shade guide

	Group 1	Group 2	Group 3	P-value^†
Baseline	6.20±2.07	6.64±2.06	7.14±1.61	0.145
After 1 day	5.86±1.53	6.29±2.10	6.37±1.44	0.448
After 3 days	5.84±1.61^a	5.05±1.98^ab	4.53±1.93^b	0.018
After 5 days	5.51±1.65^a	4.54±1.81^ab	3.89±1.60^b	0.001
After 7 days	5.21±1.37^a	3.47±1.50^b	3.29±1.42^b	<0.001
After 14 days	5.56±1.58^a	2.90±1.63^b	2.18±1.07^b	<0.001
P-value**	0.021	<0.001	<0.001

**P-value was determined by repeated measures ANOVA.

^† P-value was determined by one- way ANOVA test for continuous variables.

^abc Same letters means there is no significant difference between groups by tukey’s multiple comparison.

Table 9.

Gingiva irritation of each group (Unit: N (%))

	After 1 day	After 3 days	After 5 days	After 7 days	After 14 days
Group 1	0 (0.0)	0 (0.0)	0 (0.0)	2 (15.4)	0 (0.0)
Group 2	0 (0.0)	1 (11.1)	1 (7.7)	1 (7.7)	2 (6.1)
Group 3	0 (0.0)	8 (88.9)	12 (92.3)	10 (76.9)	8 (80.0)
P-value*		0.001	<0.001	0.002	0.003

Chi-square test.

Table 10.

Satisfaction score of each group (Unit: Mean±SD)

	Group 1	Group 2	Group 3	P-value^†
Satisfaction score	13.82±3.74^a	20.42±3.50^b	20.69±3.63^b	<0.001

^† P-value was determined by one- way ANOVA test for continuous variables.

^abc Same letters means there is no significant difference between groups by tukey’s multiple comparison.

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