Dental Whitening: synonym of sensitiveness?

Dental Whitening: synonym of sensitiveness?

By Luiz Narciso Baratieri

Undoubtedly, the most conservative option to improve teeth coloring is the dental whitening. However, with the pass of the years it seems that dental has become a synonym of of dental sensitiveness phenomena. Still, it has always been associated to the use of trays at night (home whitening) or gingival barriers (office whitening). For office whitening, there seem to exist, or at least it was wanted that us, dentists, thought so, one only technique, complicated and long (with the mix of two products and that needed the gingival barrier) and one only product (hydrogen peroxide), that sometimes involved expensive equipment (lamps, laser, etc…)

For these reasons it seems important questioning some of these dogmas and propose a simple alternative, safe, and above all without sensitiveness, to whiter teeth. Home whitening related, from two decades research has been proven the maximum oxygen release rate occurs in one hour (Matis et al, 1999) and that longer use time rise the chances of gingival irritation and dental sensitiveness. Still the myth that higher concentrations produce better results was torn down when it was found that lower concentrations produce more lasting results with a smaller color return. Todays is possible to obtain success in more than 90% of the cases with higher duration and minimum side effects (Christenses, 1997; Lutz et al., 2000).

Till today, the solution to the sensitiveness problem, proposed by many manufacturers, was to use a desensitizer, sold by the manufacturer itself. Recently, the only available systematic revision on the matter showed that the only efficient substance is potassium oxalate (Cunha-Cruz et al, 2011). Present in green vegetables, black tea and coffee is a salt that inhibits the neurons depolarization and obliterates the dentary tubes. Thinking of this, a Brazilian company (BM4, Palhoça, SC) added 3% potassium oxalate to the whitening gel (one syringe contains 60 times a smaller amount than one cup of black tea).

Power Bleaching whitening gels (10% and 16% for home whitening and 37% for office) are made of carbamide peroxide, which makes them much safer, especially on office. Beside, a last generation Carbopol® that makes the product extremely stable (manufacturer’s information). Because of that the products doesn’t need much mixing, can be used for its validity after opened (fridge storage) possess high consistency, is of easy appliance, can be applied several times a day, several days in a whole and can be used without a gingival barrier (1). Power bleaching 37% must be applied in a thick layer (2).