Preemptive Use of Naproxen on Tooth Sensitivity Caused by In-Office Bleaching: A Triple-Blind, Crossover, Randomized Clinical Trial.

OBJECTIVES: A triple-blind, randomized, crossover clinical trial evaluated prior use of nonsteroidal anti-inflammatory naproxen on sensitivity reported by patients undergoing in-office tooth bleaching. METHODS AND MATERIALS: Fifty patients were subjected to two sessions of in-office tooth bleaching with 35% hydrogen peroxide in a single application of 40 minutes for two sessions, with an interval of seven days between applications. One hour prior to the procedure, each patient randomly received a single dose of naproxen (500 mg) or placebo. The patient's sensitivity level was evaluated during and immediately after the bleaching using two scales (verbal and visual analog); the verbal scale only was repeated after 24 hours. The effectiveness of the bleaching procedures was evaluated with the Bleachedguide scale. Relative risk to sensitivity was calculated and adjusted by session, while comparison of overall risk was performed by the McNemar test. Data on the sensitivity level for both scales and shade were subjected to the Friedman, Wilcoxon, and Mann-Whitney tests (α=0.05). RESULTS: The use of naproxen only decreased the absolute risk and intensity of tooth sensitivity reported immediately after the second session. On the other hand, no measurable effect was observed during or 24 hours after either session. The sequence of drug administration did not affect the bleaching effectiveness. CONCLUSIONS: Preemptive use of naproxen only reduced tooth sensitivity reported by patients immediately after the second session of bleaching.

The Impact of a Customized Tray on In-Office Bleaching Tooth Sensitivity: A Randomized Clinical Trial.

OBJECTIVE: It was recently demonstrated that using a tray over a bleaching agent reduces its pulpal chamber penetration, which can reduce tooth sensitivity. This study evaluated the effect of the sealed technique on the presence and level of sensitivity reported by patients during and after the bleaching procedure performed in office. METHODS: Forty-six patients underwent a bleaching procedure with 35% hydrogen peroxide used in a single application of 45 minutes for two sessions with an interval of seven days. A customized tray was maintained over the bleaching agent during the entire procedure in half of the patients. The sensitivity level was evaluated during and immediately after the bleaching using verbal and visual analogue scales. The shade alteration was evaluated with a bleach guide scale. The peak sensitivity after 24 hours and the presence/level at 24 hours were also evaluated using a verbal rating scale. Relative risks were calculated for all time assessments. Data on the sensitivity level for both scales were subjected to Friedman and Mann-Whitney tests (α=0.05). Data on the shades were analyzed by two-way repeated-measures analysis of variance and Tukey's test (α=0.05). RESULTS: The use of a customized tray increased the relative risks to the tooth measured 24 hours after each bleaching session. The sealed technique also increased the level of tooth sensitivity only at 24 hours after the first session. No difference was observed between the bleaching techniques regarding the shade evaluation. CONCLUSION: Using a tray over the bleaching agent can increase the level and risk of tooth sensitivity for the first 24 hours after in-office bleaching.