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What to Know About Whitening

Course Number: 491

Consumer Purchased Over-the-counter (OTC)

Description: OTC bleaching products are readily available and continue to gain popularity.7 They consist of lower concentrations of HP and are applied by the patient through prefabricated trays, brushing a paint-on gel, or placing whitening strips.1,5 Daily wear times may vary, yet most require their application over a 2-week period to see a change in color by 1 to 2 shades.1 Whitening mouthrinses, chewing gums and toothpastes also can be purchased OTC.4,5 OTC whitening products have been used for years demonstrating safety.

When compared to a placebo, several studies found that all OTC whitening products had superior whitening efficacy.5 Of the 71 studies included in a recent Cochrane review, 26 compared a whitening technique to a placebo (vs. another whitening technique) and found similar results over a short period of time, although the evidence was low to very low.5 For the remaining studies that did compare one bleaching agent to another bleaching agent, the variation in study designs did not make it possible to draw any conclusions regarding which application method, percent concentration, or duration time was superior. Consequently, the review recommended standardizing study protocols so that future research results could be compared.

Pros: Least expensive option, easy access to products, high degree of safety.

Cons: Lack professional supervision (which can result in adverse effects or mismanaged expectations); individuals must be compliant; OTC trays are not custom fit and may be uncomfortable; people with crowded or overlapped teeth may see poor results.5