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Meta-Analysis
. 2018 Dec 18;12(12):CD006202.
doi: 10.1002/14651858.CD006202.pub2.

Home-based chemically-induced whitening (bleaching) of teeth in adults

Prashanti Eachempati  1 , Sumanth Kumbargere Nagraj, Salian Kiran Kumar Krishanappa, Puneet Gupta, Ibrahim Ethem Yaylali
Affiliations
Meta-Analysis

Home-based chemically-induced whitening (bleaching) of teeth in adults

Prashanti Eachempati et al. Cochrane Database Syst Rev. .

Abstract

Background: With the increased demand for whiter teeth, home-based bleaching products, either dentist-prescribed or over-the-counter products have been exponentially increasing in the past few decades. This is an update of a Cochrane Review first published in 2006.

Objectives: To evaluate the effects of home-based tooth whitening products with chemical bleaching action, dispensed by a dentist or over-the-counter.

Search methods: Cochrane Oral Health's Information Specialist searched the following databases: Cochrane Oral Health's Trials Register (to 12 June 2018), the Cochrane Central Register of Controlled Trials (CENTRAL; 2018, Issue 6) in the Cochrane Library (searched 12 June 2018), MEDLINE Ovid (1946 to 12 June 2018), and Embase Ovid (1980 to 12 June 2018). The US National Institutes of Health Ongoing Trials Register ClinicalTrials.gov (12 June 2018) and the World Health Organization International Clinical Trials Registry Platform (12 June 2018) were searched for ongoing trials. No restrictions were placed on the language or date of publication when searching the electronic databases.

Selection criteria: We included in our review randomised controlled trials (RCTs) which involved adults who were 18 years and above, and compared dentist-dispensed or over-the-counter tooth whitening (bleaching) products with placebo or other comparable products.Quasi-randomised trials, combination of in-office and home-based treatments, and home-based products having physical removal of stains were excluded.

Data collection and analysis: Two review authors independently selected trials. Two pairs of review authors independently extracted data and assessed risk of bias. We estimated risk ratios (RRs) for dichotomous data, and mean differences (MDs) or standardised mean difference (SMD) for continuous data, with 95% confidence intervals (CIs). We assessed the certainty of the evidence using the GRADE approach.

Main results: We included 71 trials in the review with 26 studies (1398 participants) comparing a bleaching agent to placebo and 51 studies (2382 participants) comparing a bleaching agent to another bleaching agent. Two studies were at low overall risk of bias; two at high overall risk of bias; and the remaining 67 at unclear overall risk of bias.The bleaching agents (carbamide peroxide (CP) gel in tray, hydrogen peroxide (HP) gel in tray, HP strips, CP paint-on gel, HP paint-on gel, sodium hexametaphosphate (SHMP) chewing gum, sodium tripolyphosphate (STPP) chewing gum, and HP mouthwash) at different concentrations with varying application times whitened teeth compared to placebo over a short time period (from 2 weeks to 6 months), however the certainty of the evidence is low to very low.In trials comparing one bleaching agent to another, concentrations, application method and application times, and duration of use varied widely. Most of the comparisons were reported in single trials with small sample sizes and event rates and certainty of the evidence was assessed as low to very low. Therefore the evidence currently available is insufficient to draw reliable conclusions regarding the superiority of home-based bleaching compositions or any particular method of application or concentration or application time or duration of use.Tooth sensitivity and oral irritation were the most common side effects which were more prevalent with higher concentrations of active agents though the effects were mild and transient. Tooth whitening did not have any effect on oral health-related quality of life.

Authors' conclusions: We found low to very low-certainty evidence over short time periods to support the effectiveness of home-based chemically-induced bleaching methods compared to placebo for all the outcomes tested.We were unable to draw any conclusions regarding the superiority of home-based bleaching compositions or any particular method of application or concentration or application time or duration of use, as the overall evidence generated was of very low certainty. Well-planned RCTs need to be conducted by standardising methods of application, concentrations, application times, and duration of treatment.

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Conflict of interest statement

Prashanti Eachempati: none known. Sumanth Kumbargere Nagraj: none known. Salian Kiran Kumar Krishanappa: none known. Puneet Gupta: none known. Ibrahim Ethem Yaylali: none known.

Figures

1
1
Study flow diagram.
2
2
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
3
3
Funnel plot of comparison: 4 HP strip versus placebo, outcome: 4.1 Tooth whitening ‐ assessed by the dentist.
4
4
Funnel plot of comparison: 11 CP tray versus CP tray, outcome: 11.1 Tooth whitening ‐ assessed by the dentist.
5
5
Forest plot of comparison: 13 CP tray versus HP tray, outcome: 13.1 Tooth whitening ‐ assessed by the dentist.
6
6
Forest plot of comparison: 14 HP strip versus CP tray, outcome: 14.1 Tooth whitening ‐ assessed by the dentist.
1.1
1.1. Analysis
Comparison 1 CP gel in tray versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
2.1
2.1. Analysis
Comparison 2 CP gel in tray versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
3.1
3.1. Analysis
Comparison 3 HP gel in tray versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
4.1
4.1. Analysis
Comparison 4 HP strip versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
5.1
5.1. Analysis
Comparison 5 CP paint‐on gel versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
6.1
6.1. Analysis
Comparison 6 HP paint‐on gel versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
7.1
7.1. Analysis
Comparison 7 Chewing gum SHMP versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
8.1
8.1. Analysis
Comparison 8 Chewing gum STPP versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
9.1
9.1. Analysis
Comparison 9 HP mouthwash versus placebo, Outcome 1 Tooth whitening ‐ assessed by the dentist.
10.1
10.1. Analysis
Comparison 10 CP tray versus CP tray, Outcome 1 Tooth whitening ‐ assessed by the dentist.
11.1
11.1. Analysis
Comparison 11 CP tray versus CP tray, Outcome 1 Tooth whitening ‐ assessed by the dentist.
11.2
11.2. Analysis
Comparison 11 CP tray versus CP tray, Outcome 2 Tooth whitening ‐ assessed by the dentist.
11.3
11.3. Analysis
Comparison 11 CP tray versus CP tray, Outcome 3 Tooth whitening ‐ reported by the patient.
12.1
12.1. Analysis
Comparison 12 CP tray versus CP tray, Outcome 1 Tooth whitening ‐ assessed by the dentist.
12.2
12.2. Analysis
Comparison 12 CP tray versus CP tray, Outcome 2 Tooth whitening ‐ assessed by the dentist.
12.3
12.3. Analysis
Comparison 12 CP tray versus CP tray, Outcome 3 Tooth whitening ‐ assessed by the dentist.
13.1
13.1. Analysis
Comparison 13 CP tray versus HP tray, Outcome 1 Tooth whitening ‐ assessed by the dentist.
13.2
13.2. Analysis
Comparison 13 CP tray versus HP tray, Outcome 2 Tooth whitening ‐ assessed by the dentist.
14.1
14.1. Analysis
Comparison 14 HP strip versus CP tray, Outcome 1 Tooth whitening ‐ assessed by the dentist.
14.2
14.2. Analysis
Comparison 14 HP strip versus CP tray, Outcome 2 Tooth whitening ‐ assessed by the dentist.
14.3
14.3. Analysis
Comparison 14 HP strip versus CP tray, Outcome 3 Tooth whitening ‐ reported by the patient.
15.1
15.1. Analysis
Comparison 15 HP strip versus HP tray, Outcome 1 Tooth whitening ‐ assessed by the dentist.
15.2
15.2. Analysis
Comparison 15 HP strip versus HP tray, Outcome 2 Patient comfort.
16.1
16.1. Analysis
Comparison 16 HP strip versus HP strip, Outcome 1 Tooth whitening ‐ assessed by the dentist.
17.1
17.1. Analysis
Comparison 17 HP strip versus HP mouthwash, Outcome 1 Tooth whitening ‐ assessed by the dentist.
18.1
18.1. Analysis
Comparison 18 CP paint‐on versus HP strip, Outcome 1 Tooth whitening ‐ assessed by the dentist.
19.1
19.1. Analysis
Comparison 19 HP paint‐on versus HP strip, Outcome 1 Tooth whitening ‐ assessed by the dentist.
19.2
19.2. Analysis
Comparison 19 HP paint‐on versus HP strip, Outcome 2 Tooth whitening ‐ assessed by the dentist.
19.3
19.3. Analysis
Comparison 19 HP paint‐on versus HP strip, Outcome 3 Tooth whitening ‐ reported by the patient.
20.1
20.1. Analysis
Comparison 20 SPC paint‐on versus HP strip, Outcome 1 Tooth whitening ‐ assessed by the dentist.
21.1
21.1. Analysis
Comparison 21 CP paint‐on versus CP paint‐on, Outcome 1 Tooth whitening ‐ assessed by the dentist.
22.1
22.1. Analysis
Comparison 22 CP paint‐on versus HP paint‐on, Outcome 1 Tooth whitening ‐ assessed by the dentist.
23.1
23.1. Analysis
Comparison 23 HP paint‐on versus HP paint‐on, Outcome 1 Tooth whitening ‐ assessed by the dentist.
24.1
24.1. Analysis
Comparison 24 SPC paint‐on versus CP paint‐on, Outcome 1 Tooth whitening ‐ assessed by the dentist.
25.1
25.1. Analysis
Comparison 25 SPC paint‐on versus HP paint‐on, Outcome 1 Tooth whitening ‐ assessed by the dentist.
See this image and copyright information in PMC

Update of

References

References to studies included in this review

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Delgado 2007 {published data only}
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Ferrari 2007 {published data only}
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Gerlach 2000 {published data only}
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Gerlach 2002 {published data only}
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Gerlach 2002b {published data only}
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Gerlach 2004 {published data only}
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Gerlach 2004e {published data only}
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Gerlach 2005 {published data only}
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Giniger 2005 {published data only}
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Hannig 2007 {published data only}
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Hasturk 2004 {published data only}
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Hyland 2015 {published data only}
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Karpinia 2002 {published data only}
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Kihn 2000 {published data only}
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Kose 2011 {published data only}
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Kowitz 1994 {published data only}
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Krause 2008 {published data only}
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Nathoo 2001 {published data only}
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    1. Russell CM, Dickinson GL, Johnson MH, Curtis JW Jr, Downey MC, Haywood VB, et al. Dentist‐supervised home bleaching with ten percent carbamide peroxide gel: a six‐month study. Journal of Esthetic Dentistry 1996;8(4):177‐82. [PUBMED: 9468838] - PubMed
Shahidi 2005 {published data only}
    1. Shahidi H, Barker ML, Sagel PA, Gerlach RW. Randomized controlled trial of 10% hydrogen peroxide whitening strips. Journal of Clinical Dentistry 2005;16(3):91‐5. [PUBMED: 16305009] - PubMed
Swift 2004 {published data only}
    1. Swift EJ Jr, Miguez PA, Barker ML, Gerlach RW. Three‐week clinical trial of a 14% hydrogen‐peroxide, strip‐based bleaching system. Compendium of Continuing Education in Dentistry 2004;25(8 Suppl 2):27‐32. [PUBMED: 15645892] - PubMed
Swift 2009 {published data only}
    1. Swift EJ Jr, Heymann HO, Wilder AD Jr, Barker ML, Gerlach RW. Effects of duration of whitening strip treatment on tooth color: a randomized, placebo‐controlled clinical trial. Journal of Dentistry 2009;37 Suppl 1:e51‐6. [PUBMED: 19523738] - PubMed
Tam 2001 {published data only}
    1. Tam L. Effect of potassium nitrate and fluoride on carbamide peroxide bleaching. Quintessence International 2001;32(10):766‐70. [PUBMED: 11820045] - PubMed
Tsubura 2005 {published data only}
    1. Tsubura S, Yamaguchi R. Clinical evaluation of a new bleaching product 'Polanight' in a Japanese population. Odontology 2005;93(1):52‐5. [PUBMED: 16170477] - PubMed
Turkun 2010 {published data only}
    1. Turkun M, Celik EU, Aladag A, Gokay N. One‐year clinical evaluation of the efficacy of a new daytime at‐home bleaching technique. Journal of Esthetic and Restorative Dentistry 2010;22(2):139‐48. [PUBMED: 20433566 ] - PubMed
Walters 2004 {published data only}
    1. Walters PA, Biesbrock AR, Bartizek RD. Benefits of sodium hexametaphosphate containing chewing gum for extrinsic stain inhibition. Journal of Dental Hygiene 2004;78(4):1‐7. [PUBMED: 16197748] - PubMed
Wong 2004 {published data only}
    1. Wong AHH. A Randomized Controlled Trial of Home Tooth‐Whitening Products [Dissertation]. The University of Hong Kong 2004.
Xu 2007 {published data only}
    1. Xu X, Zhu L, Tang Y, Wang Y, Zhang K, Li S, et al. Randomized clinical trial comparing whitening strips, paint‐on gel and negative control. American Journal of Dentistry 2007;20:28A‐31A. [PUBMED: 19681256] - PubMed
Ziebolz 2007 {published data only}
    1. Ziebolz D, Helms K, Hannig C, Attin T. Efficacy and oral side effects of two highly concentrated tray‐based bleaching systems. Clinical Oral Investigations 2007;11(3):267–75. [PUBMED: 17333304 ] - PubMed
Ziebolz 2008 {published data only}
    1. Ziebolz D, Hannig C, Attin T. Influence of a desensitizing agent on efficacy of a paint‐on bleaching agent. American Journal of Dentistry 2008;21(2):77‐82. [PUBMED: 18578172] - PubMed

References to studies excluded from this review

Alkmin 2005 {published data only}
    1. Alkmin YT, Sartorelli R, Florio FM, Basting RT. Comparative study of the effects of two bleaching agents on oral microbiota. Operative Dentistry 2005;30(4):417‐23. [PUBMED: 16130860] - PubMed
Amini 2009 {published data only}
    1. Amini P, Qaqish J, Anastasia MK, Hamilton AJ, Gerlach RW, Farrell S. Clinical response of experimental whitening strips with 6‐weeks daily use. IADR/AADR/CADR General Session; 2009 Apr 1‐4; Miami (Florida). 2009. [2277 ]
Amini 2011 {published data only}
    1. Amini P, Qaqish J, Conde E, Anastasia MK, Widmeyer V, Farrell S. Immediate effects and color degradation profile of 2‐hour whitening strip. IADR/AADR/CADR General Session; 2011 March 16‐19; San Diego (California). 2011. [2539]
Anastasia 2010 {published data only}
    1. Anastasia MK, Conde E, Widmeyer V, Fiedler S, Farrell S. Clinical efficacy and safety of two marketed whitening treatments. AADR/CADR Annual Meeting; 2010 March 3‐6; Washington (DC). 2010. [447]
Andreana 2000 {published data only}
    1. Andreana S, Ciancio SG, Mather ML. Clinical evaluation of bleaching gels on patients with sensitive teeth. Journal of Dental Research 2000;79(1 Suppl):216 (Abs No 583).
Archila 2010 {published data only}
    1. Archila L, Ibanez E, Conde E, Widmeyer V, Anastasia MK, Farrell S. Short‐term whitening efficacy of marketed high‐adhesion whitening strips. AADR/CADR Annual Meeting; 2010 March 3‐6; Washington (DC). 2010. [833]
Auschill 2009 {published data only}
    1. Auschill TM, Schneider‐del ST, Hellwig E, Arweiler NB. Clinical comparison of two different bleaching systems: tray versus strips. IADR/AADR/CADR General Session; 2009 Apr 1‐4; Miami (Florida). 2009. [2832]
Browning 2001 {published data only}
    1. Browning WD, Myers ML, Downey MC, Pohjola RM, Hackman ST, Cliett BA. Safety and efficacy of an experimental tooth whitening agent. Journal of Dental Research 2001;80(1 Suppl):182 (Abs No 1176).
Burgio 2001 {published data only}
    1. Burgio PA, Donovan TE, Kugel G, Matranga LF. Multi‐center clinical study to compare the effectiveness of dental bleaching. Journal of Dental Research 2001;80(1 Suppl):150 (Abs No 918).
Cardoso 2010 {published data only}
    1. Cardoso PC, Reis A, Loguercio A, Vieira LC, Baratieri LN. Clinical effectiveness and tooth sensitivity associated with different bleaching times for a 10 percent carbamide peroxide gel. Journal of the American Dental Association 2010;141(10):1213‐20. [PUBMED: 20884923] - PubMed
Collins 2004 {published data only}
    1. Collins LZ, Maggio B, Gallagher A, York M, Schafer F. Safety evaluation of a novel whitening gel, containing 6% hydrogen peroxide and a commercially available whitening gel containing 18% carbamide peroxide in an exaggerated use clinical study. Journal of Dentistry 2004;32(1):47‐50. [PUBMED: 14738835] - PubMed
Corby 2014 {published data only}
    1. Corby PM, Biesbrock A, Gerlach R, Corby AL, Moreira A, Schork NJ, et al. Treatment responses to tooth whitening in twins. Twin Research and Human Genetics 2014;17(1):23‐6. [PUBMED: 24429255] - PubMed
Curtis 1996 {published data only}
    1. Curtis JW, Dickinson GL, Downey MC, Russell CM, Haywood VB, Myers ML, et al. Assessing the effects of 10 percent carbamide peroxide on oral soft tissues. Journal of the American Dental Association 1996;127(8):1218‐23. [PUBMED: 8803398] - PubMed
de Geus 2015a {published data only}
    1. Geus JL, Rezende M, Margraf LS, Bortoluzzi MC, Fernandez E, Loguercio AD, et al. Evaluation of genotoxicity and efficacy of at‐home bleaching in smokers: a single‐blind controlled clinical trial. Operative Dentistry 2015;40(2):E47‐55. [PUBMED: 25535783] - PubMed
de Geus 2015b {published data only}
    1. Geus JL, Bersezio C, Urrutia J, Yamada T, Fernandez E, Loguercio AD, et al. Effectiveness of and tooth sensitivity with at‐home bleaching in smokers: a multicenter clinical trial. Journal of the American Dental Association 2015;146(4):233‐40. [PUBMED: 25819654] - PubMed
Dickinson 2000 {published data only}
    1. Dickinson GL, Browning WD, Hawkins IK, Downey MC, Myers ML, Hackman ST, et al. Clinical evaluation of ADS tooth whitening gel. Journal of Dental Research 2000;79(1 Suppl):438 (Abs No 2359).
Donly 2001 {published data only}
    1. Donly KJ, Gerlach R, Segura A, Walters P, Zhou X. Post‐orthodontic tooth whitening. Journal of Dental Research 2001;80(1 Suppl):151 (Abs No 924).
Donly 2002 {published data only}
    1. Donly KJ, Donly AS, Baharloo L, Rojas‐Candelas E, Garcia‐Godoy F, Zhou X, et al. Tooth whitening in children. Compendium of Continuing Education in Dentistry 2002;23(1A):22‐8. [PUBMED: 11913290] - PubMed
Donly 2002a {published data only}
    1. Donly KJ, Gerlach RW. Clinical trials on the use of whitening strips in children and adolescents. General Dentistry 2002;50(3):242‐5. [PUBMED: 12116511] - PubMed
Farrell 2006 {published data only}
    1. Farrell S, Barker ML, Sagel PA, Gerlach RW. Use of a physical barrier to improve efficacy of a paint‐on whitening gel: a seven‐day randomized clinical trial. Journal of Clinical Dentistry 2006;17(5):117‐21. [PUBMED: 17240929] - PubMed
Farrell 2008 {published data only}
    1. Farrell S, Barker ML, McMillan DA, Gerlach RW. Placebo‐controlled trial evaluating safety with 12‐months continuous use of 6% hydrogen peroxide whitening strips. Journal of Dentistry 2008;36(9):726‐30. [PUBMED: 18635304] - PubMed
Fugaro 2004 {published data only}
    1. Fugaro JO, Nordahl I, Fugaro OJ, Matis BA, Mjor IA. Pulp reaction to vital bleaching. Operative Dentistry 2004;29(4):363‐8. [PUBMED: 15279473] - PubMed
Fugaro 2005 {published data only}
    1. Fugaro OJ, Fugaro JO, Matis B, Gregory RL, Cochran MA, Mjor I. The dental pulp: inflammatory markers and vital bleaching. American Journal of Dentistry 2005;18(4):229‐32. [PUBMED: 16296427] - PubMed
Garcia‐Godoy 2012 {published data only}
    1. Garcia‐Godoy C, Truehart D, Rothrock JK, Farrell S, Anastasia MK, Conde E, et al. Whitening efficacy and color degradation profile of 2‐hour whitening strips. AADR/CADR Annual Meeting; 2012 March 21‐24; Tampa (Florida). 2012. [478]
Gerlach 2002c {published data only}
    1. Gerlach RW, Sagel PA, Jeffers ME, Zhou X. Effect of peroxide concentration and brushing on whitening clinical response. Compendium of Continuing Education in Dentistry 2002;23(1A):16‐21. [PUBMED: 11913289] - PubMed
Gerlach 2002d {published data only}
    1. Gerlach RW, Gibb RD, Zhou X. Clinical response of maxillary and mandibular teeth following use of 6.5% hydrogen peroxide whitening strips. Journal of Dental Research 2002;81(1 Suppl):A‐253 (Abs No 1954).
Gerlach 2002e {published data only}
    1. Gerlach RW, Campolongo KL, Zhou X. Use of a chroma meter to compare the shade change for two professional tooth whitening systems. Journal of Dental Research 2002;81(1 Suppl):A‐253 (Abs No 1957).
Gerlach 2003a {published data only}
    1. Gerlach RW, Barker ML. Clinical response of three direct‐to‐consumer whitening products: strips, paint‐on gel, and dentifrice. Compendium of Continuing Education in Dentistry 2003;24(6):458, 461‐4, 466. [PUBMED: 14515596] - PubMed
Gerlach 2004a {published data only}
    1. Gerlach RW, Barker ML, Tucker HL. Clinical response of three whitening products having different peroxide delivery: comparison of tray, paint‐on gel, and dentifrice. Journal of Clinical Dentistry 2004;15(4):112‐7. [PUBMED: 15794456] - PubMed
Gerlach 2004c {published data only}
    1. Gerlach RW, Barker ML, McMillan DA, Sagel PA, Walden GL. In‐use comparative kinetics of professional whitening strips: peroxide recovery from strips, teeth, gingiva, and saliva. Compendium of Continuing Education in Dentistry 2004;25(8 Suppl 2):14‐20. [PUBMED: 15645890] - PubMed
Gerlach 2004d {published data only}
    1. Gerlach RW, Barker ML. Professional vital bleaching using a thin and concentrated peroxide gel on whitening strips: an integrated clinical summary. Journal of Contemporary Dental Practice 2004;5(1):1‐17. [PUBMED: 14973556] - PubMed
Godson 2001 {published data only}
    1. Goodson JM, Taveres M, Stutz J, Liao SS, Kent R, Newman M. Colorimeter measurement of tooth whitening. Journal of Dental Research 2001;80(1 Suppl):182 (Abs No 1170). [1170]
Gursoy 2008 {published data only}
    1. Gursoy UK, Eren DI, Bektas OO, Hurmuzlu F, Bostanci V, Ozdemir H. Effect of external tooth bleaching on dental plaque accumulation and tooth discoloration. Medicina Oral, Patologia Oral y Cirugia Bucal 2008;13(4):E266‐9. [PUBMED: 18379454] - PubMed
Jadad 2011 {published data only}
    1. Jadad E, Montoya J, Arana G, Gordillo LA, Palo RM, Loguercio AD. Spectrophotometric evaluation of color alterations with a new dental bleaching product in patients wearing orthodontic appliances. American Journal of Orthodontics and Dentofacial Orthopedics 2011;140(1):e43‐7. [PUBMED: 21724070] - PubMed
Jorgensen 2002 {published data only}
    1. Jorgensen MG, Carroll WB. Incidence of tooth sensitivity after home whitening treatment. Journal of the American Dental Association 2002;133(8):1076‐82. [PUBMED: 12198987] - PubMed
Karpinia 2003 {published data only}
    1. Karpinia K, Magnusson I, Barker ML, Gerlach RW. Clinical comparison of two self‐directed bleaching systems. Journal of Prosthodontics 2003;12(4):242‐8. [PUBMED: 15061232] - PubMed
Lee 2003 {published data only}
    1. Lee BJ, Paik DI, Kim JB. Clinical evaluation of the tooth‐whitening effect of a 2.6% hydrogen peroxide tooth‐whitening strip. AADR/CADR Anual Meeting; 2003 March; San Antonio (Texas). 2003. [1876]
Leonard 2002 {published data only}
    1. Leonard RH Jr, Garland GE, Eagle JC, Caplan DJ. Safety issues when using a 16% carbamide peroxide whitening solution. Journal of Esthetic and Restorative Dentistry 2002;14(6):358‐67. [PUBMED: 12542101] - PubMed
Leonard 2004 {published data only}
    1. Leonard RH, Smith LR, Garland GE, Caplan DJ. Densensitizing Agent Efficacy during Whitening in an At Risk Population. Journal of Esthetic and Restorative Dentistry 2004;16(1):49‐56. [PUBMED: 15259543] - PubMed
Leonard 2007 {published data only}
    1. Leonard RH Jr, Smith LR, Garland GE, Tiwana KK, Zaidel LA, Pugh G Jr, et al. Evaluation of side effects and patients' perceptions during tooth bleaching. Journal of Esthetic and Restorative Dentistry 2007;19(6):355‐64; discussion 365‐6. [PUBMED: 18005286] - PubMed
Lisante 2009 {published data only}
    1. Lisante TA, Askinazi J, Simmons K, Charles C, Mcguire JT. Comparative whitening effectiveness of three hydrogen peroxide‐containing mouthrinses. IADR/AADR/CADR General Session; 2009 Apr 1‐4; Miami (Florida). 2009. [2597]
Loyola‐Rodriguez 2003 {published data only}
    1. Loyola‐Rodriguez JP, Pozos‐Guillen Ade J, Hernandez‐Hernandez F, Berumen‐Maldonado R, Patino‐Marin N. Effectiveness of treatment with carbamide peroxide and hydrogen peroxide in subjects affected by dental fluorosis: a clinical trial. Journal of Clinical Pediatric Dentistry 2003;28(1):63‐7. [PUBMED: 14604145] - PubMed
Majeed 2011 {published data only}
    1. Majeed A, Grobler SR, Moola MH. Clinical evaluation of two at‐home tooth‐whitening products using a spectrophotometer. 45th CED‐IADR/NOF Meeting; 2011 Aug 31; Budapest (Hungary). 2011. [231]
Marques 2012 {published data only}
    1. Marques DN, Mata AD, Silveira JM, Marques JR, Amaral JP, Guilherme NF. Hydrogen peroxide release kinetics into saliva from different whitening products: a double‐blind, randomized clinical trial. Clinical Oral Investigations 2012;16(1):155‐63. [PUBMED: 21221681] - PubMed
Martin 2015 {published data only}
    1. Martin J, Vildosola P, Bersezio C, Herrera A, Bortolatto J, Saad JR, et al. Effectiveness of 6% hydrogen peroxide concentration for tooth bleaching ‐ A double‐blind, randomized clinical trial. Journal of Dentistry 2015;43(8):965‐72. [PUBMED: 26057085] - PubMed
Matis 1999 {published data only}
    1. Matis BA, Gaiao U, Blackman D, Schultz FA, Eckert GJ. In vivo degradation of bleaching gel used in whitening teeth. Journal of the American Dental Association 1999;130(2):227‐35. [PUBMED: 10036846] - PubMed
Matis 2002 {published data only}
    1. Matis BA, Yousef M, Cochran MA, Eckert GJ. Degradation of bleaching gels in vivo as a function of tray design and carbamide peroxide concentration. Operative Dentistry 2002;27(1):12‐8. [PUBMED: 11817465] - PubMed
Matis 2002a {published data only}
    1. Matis BA, Hamdan YS, Cochran MA, Eckert GJ. A clinical evaluation of a bleaching agent used with and without reservoirs. Operative Dentistry 2002;27(1):5‐11. [PUBMED: 11817468] - PubMed
Matis 2005 {published data only}
    1. Matis BA, Cochran M, Wang G, Franco M, Eckert GJ, Carlotti RJ, et al. A clinical evaluation of bleaching using whitening wraps and strips. Operative Dentistry 2005;30(5):588‐92. [PUBMED: 16268392] - PubMed
Mazur 2013 {published data only}
    1. Mazur RF, Busato P, Souza EM, Vieira S, Marini A, Rached R. Effect of aloe vera on the adverse effects of bleaching. IADR/AADR/CADR General Session; 2013 March 20‐23; Seattle (Washington). 2013. [1144]
NCT02603354 {published data only}
    1. NCT02603354. Efectiveness of a brief protocol by a low (6%) concentration gel peroxide hydrogen of teeth bleaching (brief 6%). clinicaltrials.gov/ct2/show/NCT02603354 (first received 11 November 2015).
NCT02682329 {unpublished data only}
    1. NCT02682329. Combination of dental bleaching techniques, randomized clinical trial. clinicaltrials.gov/ct2/show/NCT02682329 (first received 15 February 2016).
Perdigao 2013 {published data only}
    1. Perdigao J, Dutra‐Correa M, Saraceni CHC, Delazari MA, Kodama RM, Bergamini MR. Clinical evaluation of 10% carbamide peroxide with different desensitizers. IADR/AADR/CADR General Session; 2013 March 20‐23; Seattle (Washington). 2013. [603]
Pinto 2014 {published data only}
    1. Pinto MM, Godoy CH, Bortoletto CC, Olivan SR, Motta LJ, Altavista OM, et al. Tooth whitening with hydrogen peroxide in adolescents: study protocol for a randomized controlled trial. Trials 2014;15:395. [PUBMED: 25315893] - PMC - PubMed
Pinto 2017 {published data only}
    1. Pinto MM, Goncalves ML, Mota AC, Deana AM, Olivan SR, Bortoletto C, et al. Controlled clinical trial addressing teeth whitening with hydrogen peroxide in adolescents: a 12‐month follow‐up. Clinics (Sao Paulo, Brazil) 2017;72(3):161‐70. [PUBMED: 28355362] - PMC - PubMed
Rezende 2013 {published data only}
    1. Rezende M, Loguercio AD, Reis A, Kossatz S. Clinical effects of exposure to coffee during at‐home vital bleaching. Operative Dentistry 2013;38(6):E229‐36. [PUBMED: 23570297] - PubMed
Sagel 2001 {published data only}
    1. Sagel PA, Walters PA, Gibb RD, Gerlach RW. Duration of tooth whitening following 14 days treatment with peroxide‐containing whitening strips. Journal of Dental Research 2001;80(1 Suppl):182 (Abs No 1173).
Schiff 1994 {published data only}
    1. Schiff T, Borden LC. The effect of a new experimental prebrushing dental rinse on plaque removal. Journal of Clinical Dentistry 1994;4(4):107‐10. [PUBMED: 8031477] - PubMed
Schulte 1993 {published data only}
    1. Schulte JR, Morrissette DB, Gasior EJ, Czajewski MV. Clinical changes in the gingiva as a result of at‐home bleaching. Compendium 1993;14(11):1362, 1364‐6. [PUBMED: 8620374] - PubMed
Schulte 1994 {published data only}
    1. Schulte JR, Morrissette DB, Gasior EJ, Czajewski MV. The effects of bleaching application time on the dental pulp. Journal of the Americal Dental Association 1994;125(10):1330‐5. [PUBMED: 7844297] - PubMed
Simon 2001 {published data only}
    1. Simon JF, McClanahan SF, Gerlach RW. Clinical trial comparing tooth whitening with peroxide‐containing strips to a marketed whitening dentifrice. Journal of Dental Research 2001;80(1 Suppl):237 (Abs No 1616).
Simon 2011 {published data only}
    1. Simon JF, Lewis M, Powell L, Wilson N, Conde E, Anastasia MK, et al. Efficacy of 2‐hour whitening strip under extended use conditions. IADR/AADR/CADR General Session; 2011 March 16‐19; San Diego (California). 2011. [2540]
Smith 2001 {published data only}
    1. Smith LR, Leonard RH, Eagle JC, Murdoch WC, Garland GE, Caplan DJ. Efficacy of desensitizing gel in reducing tooth sensitivity during whitening. Journal of Dental Research 2001;80(1 Suppl):246 (Abs No 1683).
Swift 2001 {published data only}
    1. Swift EJ Jr, Heymann HO, Ritter AV, Rosa BT, Wilder AD Jr. Clinical evaluation of a novel 'trayless' tooth whitening system. Journal of Dental Research 2001;80(1 Suppl):151 (Abs No 921).
Tam 1999 {published data only}
    1. Tam L. Clinical trial of three 10% carbamide peroxide bleaching products. Journal of the Canadian Dental Association 1999;65(4):201‐5. [PUBMED: 10224721] - PubMed
Walter 2011 {published data only}
    1. Walter R, Miguez PA, Oliveira GCB, Oliveira GMS, Farrell S, Anastasia MK, et al. Safety and efficacy of a 2‐hour whitening strip. IADR/AADR/CADR General Session; 2011 March 16‐19; San Diego (California). 2011. [555]
Yankell 1997 {published data only}
    1. Yankell SL. Efficacy of chewing gum in preventing extrinsic tooth staining. Journal of Clinical Dentistry 1997;8(6):169‐72. [PUBMED: 9586534] - PubMed
Zantner 2006 {published data only}
    1. Zantner C, Derdilopoulou F, Martus P, Kielbassa AM. Randomized clinical trial on the efficacy of 2 over‐the‐counter whitening systems. Quintessence International 2006;37:695‐706. [PUBMED: 17017631] - PubMed

References to studies awaiting assessment

Barnes 1998 {published data only}
    1. Barnes DM, Kihn PW, Romberg E, George D, DePaola L, Medina E. Clinical evaluation of a new 10% carbamide peroxide tooth‐whitening agent. Compendium of Continuing Education in Dentistry 1998;19(10):968‐72, 977‐8. [PUBMED: 10371880] - PubMed
Bizhang 2017 {published data only}
    1. Bizhang M, Domin J, Danesh G, Zimmer S. Effectiveness of a new non‐hydrogen peroxide bleaching agent after single use ‐ a double‐blind placebo‐controlled short‐term study. Journal of Applied Oral Science 2017;25(5):575‐84. [PUBMED: 29069156] - PMC - PubMed
Braun 2007 {published data only}
    1. Braun A, Jepsen S, Krause F. Spectrophotometric and visual evaluation of vital tooth bleaching employing different carbamide peroxide concentrations. Dental Materials 2007;23(2):165‐9. [PUBMED: 16504281] - PubMed
Browning 2004 {published data only}
    1. Browning WD, Chan DC, Frazier KB, Callan RS, Blalock JS. Safety and efficacy of a nightguard bleaching agent containing sodium fluoride and potassium nitrate. Quintessence International 2004;35(9):693‐8. [PUBMED: 15470992] - PubMed
Ferrari 2004 {published data only}
    1. Ferrari M, Kugel G, Cagidiaco MC, Barker ML, Gerlach RW. Clinical trial evaluating the peroxide concentration response of whitening strips over 28 days. American Journal of Dentistry 2004;17(4):291‐4. [PUBMED: 15478494] - PubMed
Gambarini 2004 {published data only}
    1. Gambarini G, Testarelli L, Luca M, Dolci G. Efficacy and safety assessment of a new liquid tooth whitening gel containing 5.9% hydrogen peroxide. American Journal of Dentistry 2004;17(2):75‐9. [PUBMED: 15151330] - PubMed
Gegauff 1993 {published data only}
    1. Gegauff AG, Rosenstiel SF, Langhout KJ, Johnston WM. Evaluating tooth color change from carbamide peroxide gel. Journal of the American Dental Association 1993;124(6):65‐72. [PUBMED: 8505452] - PubMed
Gerlach 2004b {published data only}
    1. Gerlach RW, Sagel PA. Vital bleaching with a thin peroxide gel: the safety and efficacy of a professional‐strength hydrogen peroxide whitening strip. Journal of the American Dental Association 2004;135(1):98‐100. [PUBMED: 14959882] - PubMed
Guerrero 2007 {published data only}
    1. Guerrero JC, Jimenez‐Farfan MD, Lopez‐Salgado A, Barker ML, Gerlach RW. Professional whitening strips in a university population. American Journal of Dentistry 2007;20 Spec No A:15A‐8A. [PUBMED: 19681253] - PubMed
Heymann 1998 {published data only}
    1. Heymann HO, Swift EJ Jr, Bayne SC, May KN Jr, Wilder AD Jr, Mann GB, et al. Clinical evaluation of two carbamide peroxide tooth‐whitening agents. Compendium of Continuing Education in Dentistry 1998;19(4):359‐62, 364‐6. [PUBMED: 9656849] - PubMed
Kim 2018 {published data only}
    1. Kim YM, Ha AN, Kim JW, Kim SJ. Double‐blind randomized study to evaluate the safety and efficacy of over‐the‐counter tooth‐whitening agents containing 2.9% hydrogen peroxide. Operative Dentistry 2018;43(3):272‐81. [PUBMED: 29513635] - PubMed
Maran 2018 {published data only}
    1. Maran BM, Vochikovski L, Andrade Hortkoff DR, Stanislawczuk R, Loguercio AD, Reis A. Tooth sensitivity with a desensitizing‐containing at‐home bleaching gel ‐ a randomized triple‐blind clinical trial. Journal of Dentistry 2018;72:64‐70. [PUBMED: 29551346] - PubMed
NCT02151058 {published data only}
    1. NCT02151058. A clinical trial to test the effect of a marketed mouth rinse on stain removal [Whitening action of a hydrogen peroxide/sodium fluoride containing mouth rinse: a 2 week randomized controlled trial]. clinicaltrials.gov/ct2/show/NCT02151058 (first received 30 May 2014).
NCT03217994 {published data only}
    1. NCT03217994. Efficacy of a 6% hydrogen peroxide tooth bleaching agent [Efficacy of a 6% hydrogen peroxide tooth bleaching agent without ligth]. clinicaltrials.gov/ct2/show/NCT03217994 (first received 14 July 2017).
Ozcan 2003 {published data only}
    1. Ozcan M, Kulak Y, Kazazoglu E. The efficacy of two prototype chewing gums for the removal of extrinsic tooth stain. International Dental Journal 2003;53(2):62‐6. [PUBMED: 12731691] - PubMed
Pohjola 2002 {published data only}
    1. Pohjola RM, Browning WD, Hackman ST, Myers ML, Downey MC. Sensitivity and tooth whitening agents. Journal of Esthetic and Restorative Dentistry 2002;14(2):85‐91. [PUBMED: 12008806] - PubMed
Reinhardt 1993 {published data only}
    1. Reinhardt JW, Eivins SE, Swift EJ Jr, Denehy GE. A clinical study of nightguard vital bleaching. Quintessence International 1993;24(6):379‐84. [PUBMED: 8234642] - PubMed
Rosenstiel 1996 {published data only}
    1. Rosenstiel SF, Gegauff AG, Johnston WM. Randomized clinical trial of the efficacy and safety of a home bleaching procedure. Quintessence International 1996;27(6):413‐24. [PUBMED: 8941836] - PubMed
Rossi 2018 {published data only}
    1. Rossi B, Freitas PM, Tedesco TK, Goncalves F, Ferreira LS. Tooth color changes and sensitivity in patients undergoing dental bleaching with 10% hydrogen peroxide using customized trays or strips: a randomized clinical trial. Minerva Stomatologica 2018;67(2):55‐61. [PUBMED: 29446268] - PubMed
Shin 2010 {published data only}
    1. Shin BG, Yang SE. The evaluation of clinical efficacy and longevity of home bleaching without combined application of in office bleaching. Journal of Korean Academy of Conservative Dentistry 2010;35(5):387‐94.
Sielski 2003 {published data only}
    1. Sielski C, Conforti N, Stewart B, Chaknis P, Petrone ME, DeVizio W, et al. A clinical investigation of the efficacy of a tooth‐whitening gel. Compendium of Continuing Education in Dentistry 2003;24(8):612‐4, 616‐8. [PUBMED: 14692166] - PubMed
Simon 2014 {published data only}
    1. Simon JF, Powell L, Hollis S, Anastasia MK, Gerlach RW, Farrell S. Placebo‐controlled clinical trial evaluating 9.5% hydrogen peroxide high‐adhesion whitening strips. Journal of Clinical Dentistry 2014;25(3):49‐52. [PUBMED: 26054177] - PubMed

References to ongoing studies

NCT03026725 {published data only}
    1. NCT03026725. Effect of tri calcium phosphate on efficacy and sensitivity with Vital tooth whitening using 20% carbamide peroxide [Effect of tri calcium phosphate paste on efficacy and postoperative sensitivity associated with at‐home Vital tooth whitening using 20% carbamide peroxide ‐ A randomized controlled study]. clinicaltrials.gov/ct2/show/NCT03026725 (first received 20 January 2017).

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References to other published versions of this review

Hasson 2006
    1. Hasson H, Ismail A, Neiva G. Home‐based chemically‐induced whitening of teeth in adults (Review). Cochrane Database of Systematic Reviews 2006, Issue 4. [DOI: 10.1002/14651858.CD006202] - DOI - PubMed

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