Abstract
Objective To assess the efficacy and safety of dentist-prescribed, home-applied tooth whitening agents
Data sources Medline 1989–1999 inclusive
Study selection Placebo controlled clinical trials of 10% carbamide peroxide using a custom-fitted tray, which reported efficacy using a change in shade guide units were included.
Data extraction and synthesis Shade guide unit change was evaluated to reflect efficacy, and both gingival and plaque indices to reflect safety. All 3 were analysed for the significance of 4 variables: treatment group, daily application time, the duration of treatment, and brand of bleach were examined . Number needed to treat was calculated.
Results 28 trials evaluated tooth bleaching, 20 of which were dentists-prescribed, and patient applied agents. 7 met all the criteria. The data indicated that home-applied agents using a 10% carbamide peroxide gel delivered in a custom-fitted tray whitened teeth significantly, when compared to a placebo control.
Conclusions Within the caveats discussed in the paper, the results indicate that, on average, dentist-prescribed, home-applied tooth whitening will whiten teeth 2 shade guide steps for six months, and neither adversely nor beneficially affect the gingiva or plaque.
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Sackett, DL, Scott Richardson, W, Rosenberg, W and Haynes, RD Evidence-based Medicine; How to Practice and Teach EBM 1997) Churchill Livingstone, New York. 91–99.
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Address for reprints: Dr R Neiderman, Director, Centre for Evidence-Based Dentistry, The Forsyth Institute, 140 The Fenway, Boston, MA 02115-3799, USA. E-mail: rniederman@forsyth.org
Niederman R, Tantraphol MC, Conway S, Ferguson M, Redmon P, Hayes C. Effectiveness of Dentist-Prescribed, Home-Applied Tooth Whitening. A Meta-analysis. J.Contemporary Dental Practice Fall 2000, Volume 1, Number 4 (http://www.thejcdp.com/issue004/niedermn/01nied.htm)
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Bruce, M. Tooth whitening is effective, with neither adverse nor beneficial effects to gingiva or plaque. Evid Based Dent 3, 76 (2002). https://doi.org/10.1038/sj.ebd.6400125
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DOI: https://doi.org/10.1038/sj.ebd.6400125