Placebo-Controlled Clinical Trial with Combined Whitening Strips and Dentifrice
October 1, 2008
Volume 4
,
Issue 9
,
October 2008
Howard E. Strassler, DMD
Gerlach RW, Barker ML, Booker DL, et al. J Dent Res. 2008;87(Spec Iss B): 1769.
Abstract
Objectives: A clinical study was conducted to evaluate the combined use of hydrogen peroxide whitening strips and a sodium hexametaphosphate whitening dentifrice on tooth color.
Methods: A randomized, placebo-controlled clinical study was conducted to evaluate tooth color with a whitening strip–paste combination versus control. The combination group (Crest® Healthy Radiance™) was assigned 10% hydrogen peroxide whitening strips and sodium hexametaphosphate dentifrice, while the control group was assigned a placebo strip (0% hydrogen peroxide) and pyrophosphate whitening dentifrice. Subjects received a manual toothbrush; strip use was 30 minutes once weekly on the maxillary arch, and brushing was twice daily beginning at baseline. Standard digital images were collected over a 3-week period to assess L*a*b* color change.
Results: A total of 57 subjects were randomized, attended all visits, and completed the study. Mean (SD) baseline tooth color was 17.9 (1.1) for b*, and 71.4 (1.4) for L*. Relative to baseline, the combination peroxide strip–dentifrice group exhibited significant (P < .05) b*L* color improvement beginning at Week 1 and continuing through Week 3. Most (89%) subjects in the peroxide strip–dentifrice group experienced two-parameter (Δb* & ΔL*) color improvement of 1+ unit, with groups differing (P < .001) on Δb*, ΔL* and Δa* at end-of-treatment, favoring the peroxide combination group. Oral irritation (4%) and tooth sensitivity (2%) were uncommon overall.
Conclusion: A placebo-controlled clinical trial demonstrated that a combination weekly 10% hydrogen peroxide whitening strip with a daily anticavity sodium hexametaphosphate dentifrice provided significant tooth whitening without meaningful or unexpected adverse events.
Commentary
People are delaying their regular check-ups and are not as quick to accept costly esthetic treatment plans, but they still want a beautiful white smile. Tooth whitening has made a resurgence and our patients are pursuing less expensive over-the-counter (OTC) options. For some people, the idea of only 1 or 2 weeks with an OTC product is cost-effective.
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Patients are going to ask about OTC products for tooth whitening and oral health. As clinicians, we need to make recommendations based on the evidence of oral health. Recently, a combined toothpaste–whitening strip product, Crest Healthy Radiance, was introduced. I have had several patients ask me if this product would not only improve their oral health but also whiten their teeth. This well-done clinical research study demonstrated that a combined toothpaste–whitening strip product with the strip used only once a week, in fact, can provide a patient with color improvement and whitening with minimal adverse effects. There should be little concern for adverse intraoral effects with long-term use of this family of products. For overall gingival health, use of a carbamide or hydrogen peroxide whitening agent can provide improvements in gingival health.1,2 When a patient asks about OTC products, we can feel comfortable making a cost-effective recommendation to fulfill his or her oral health and whitening needs.
About the Author
Howard E. Strassler, DMD
Professor and Director of Operative Dentistry
Department of Endodontics, Prosthodontics and Operative Dentistry
University of Maryland Dental School
Baltimore, Maryland
