Novel treatment of in-office tooth bleaching sensitivity: A randomized, placebo-controlled clinical study

Objectives: Aim of this clinical trial was to investigate the effect of a calcium phosphate based desensitizer paste applied prior to in-office tooth whitening on bleaching sensitivity (BS). Methods: This crossover study was designed as randomized double-blinded, placebo-controlled trial. The desensitizer paste Teethmate AP (TAP) contains tetracalcium phosphate and dicalcium phosphate anhydrous in glycerol and polyethylene glycol, whereas placebo (PLA) is a calcium phosphate free analog. Fifty patients with sound maxillary incisors and canines were enrolled. Tooth shades were determined with a Vitapan Classic Shade guide. Randomly, TAP and PLA were applied to the left or to the right anterior teeth. After rinsing and air-drying the bleaching gel (Opalescence Boost PF 40%) was applied and left on the labial surfaces for 15 minutes. Sensitivity was recorded using a 10 cm visual analog scale (VAS) before, at 5, 10, and 15 minutes during, and at 1 hour, 1, 2, and 7 days after bleaching. Tooth whitening was determined with the shade guide after 1 day and 1 week. Results: Prebleaching desensitization with TAP reduced BS significantly when compared with PLA. Between 1 and 7 days the average sensitivity scores were close to zero, whereas the average scores for PLA were significantly higher during this time interval. Independent from the desensitizing treatment after 1 and 7 days the medians of the shades were between 5 and 3.5 units brighter. Conclusions: Prebleaching desensitization with TAP was effective in reducing BS during and after tooth whitening treatment and had no adverse effect on the bleaching result. Clinical significance: Prebleaching topical application of a calcium phosphate containing compound reduced significantly bleaching sensitivity during a single 15 minutes treatment and up to one week with a 40% hydrogen peroxide containing gel without compromising tooth whitening.