Conventional at-home whitening using 20% carbamide peroxide proved significantly more effective and longer-lasting than other OTC whitening systems, despite higher tooth sensitivity, according to the results of a recent randomized controlled trial.
Published in BDJ Open, the trial evaluated the efficacy and tooth sensitivity of two over-the-counter (OTC) tooth whitening systems compared to conventional at-home whitening using 20% carbamide peroxide (CP). The study involved 39 participants divided into three groups: conventional at-home whitening, OTC ready-to-use gel trays, and OTC paint-on gel.
Results indicated that conventional at-home whitening achieved significantly higher color change (∆E) values compared to the OTC systems. Participants using the 20% CP showed a notable improvement in tooth color, while those using OTC products experienced a significant color relapse after 2 weeks and 6 months. Additionally, the at-home whitening group reported higher levels of tooth sensitivity.
The study found that the OTC-paint on gel group had ΔE values that did not exceed 2.74 at any measurement point, indicating a barely detectable whitening effect. Human eye detection of color change below 3.3 ΔE values was considered clinically insignificant. Furthermore, participants in the OTC groups reported significantly lower tooth sensitivity than those in the at-home whitening group. This suggests that the concentration of active agents in OTC products might be sub-optimal, contributing to lower efficacy.
The research highlighted the acidic pH of OTC products increased enamel surface roughness, leading to faster stain accumulation and shade relapse. In contrast, conventional at-home whitening revealed stable color change and higher overall efficiency.
The study concluded that conventional at-home whitening with 20% CP is more effective and provides longer-lasting results than the tested OTC systems. The findings suggest OTC whitening products may not deliver the desired aesthetic outcomes and could lead to misuse due to their lower efficacy.
The authors declared having no competing interests.