A comparison of four systems of tooth whitening

M. TAVARES, J.M. GOODSON, J. STULTZ, and M.B. NEWMAN, The Forsyth Institute, USA

Objective

The purpose of this study was to compare the efficacy of a combined peroxide and light in-office tooth whitening system (BriteSmile) with 3 other whitening products. These included an overnight tray system, an in-office hand held light and peroxide system, and a whitening toothpaste.

Methods

100 subjects with an initial tooth shade of D4 (Vita) or darker participated in a parallel four-cell randomized single blind clinical trial. The outcome measure was the assessment of tooth color change of the 6 anterior maxillary teeth, 4 incisors and 2 canines. Tooth color was evaluated subjectively using a Vita shade guide and objectively using a chromameter to measure 9 sites across each tooth surface (3 incisal, 3 mid-tooth and 3 gingival). Safety and patient acceptance were evaluated by examination and subject questionnaires. Tooth color was assessed before and after treatment, and at 3 and 6 months.

Results

There were no significant differences in the initial average shade guide values between the 4 groups. Post treatment, the group assigned to the BriteSmile treatment demonstrated a significantly larger change in tooth color than the other groups, with a mean change of 7.95 (+1.38) shade guide values. The hand held light and peroxide group had a mean change of 5.31 (+1.35), the tray group had a mean change of 5.97 (+1.62), and the toothpaste group had a mean change of 1.63 (+1.60).

Conclusions

The BriteSmile system produced the greatest change in tooth color; this difference was highly significant (p<0.0001). The tray system and hand held system whitened teeth to a lesser extent. Their results differed significantly from toothpaste, but not from each other, indicating that the 2 procedures produced a similar whitening outcome. Toothpaste had a minimal effect on tooth whitening.