Effectiveness of remineralization agents on the prevention of dental bleaching induced sensitivity: A randomized clinical trial

Objectives: This study aims to compare the use of different remineralization agents before in-office bleaching for decreasing bleaching induced sensitivity.

Methods: A total of 64 volunteers were randomly divided into four groups. Before undergoing in-office bleaching with 38% hydrogen peroxide gel (three applications of 15 min each, one session), clinicians applied a placebo gel (control group), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), neutral sodium fluoride gel (NSF) or nano-hydroxyapatite solution (n-HAP) on all buccal surfaces of teeth. The gel was left undisturbed for 4 min. The efficacy of tooth whitening was assessed by determining the colour change using SGU. Patients recorded their tooth sensitivities on the VAS scale. Kruskal-Wallis test followed by Mann-Whitney U test was used to compare changes in tooth colour and intensity of tooth sensitivity between groups.

Results: Overall, there was no significant difference in shade change between the groups. Control and CPP-ACP groups showed significantly higher rates of hypersensitivity than NSF and the n-HAP group (p < 0.05).

Conclusions: The use of a remineralization agent (n-HAP/NSF) before in-office bleaching did not affect the bleaching efficacy but did reduce tooth sensitivity. The before bleaching treatment use of an n-HAP solution can be suitable for reducing bleaching born sensitivity as well as commonly used NSF remineralizing gel before in-office tooth bleaching can reduce tooth sensitivity, the most common side effect associated with this procedure.