- Continuing Education
A second delivery system common for oxidative whitening includes office prescribed/fabricated (but at home applied) tray/mouthguard-based systems. Newer forms of these tray-based options are available over-the-counter today as well. These bleaching systems historically have often used carbamide peroxide as the oxidation source, though hydrogen peroxide is used in some recent forms. In the original nightguard system the dentist would prepare fabricated trays to hold the bleaching agent and the patient would apply the bleach at home.1 Today, form fitting trays and boil and bite are marketed which enable the dentist to skip fabrication.
The levels of efficacy and tolerability are dependent on the concentration of applied peroxide, although good levels of tooth whitening can be obtained with these systems when used for the appropriate time periods.
Like other forms of treatments, these often invoke significant levels of transient dentinal hypersensitivity. The quantity of gel used in mouth guards is dictated by the fit of the mouthguard – often there is oozing around the edges of the guard while bleaching, which can create localized inflammation of gingival in some cases.100-106