Can a 3% Hydrogen Peroxide Dentifrice Promote Tooth Whitening? A Randomized Clinical Trial.

OBJECTIVE: This randomized clinical trial evaluated the bleaching efficacy, tooth sensitivity (TS), and gingival irritation (GI) associated with toothbrushing using a 3% hydrogen peroxide dentifrice. MATERIAL AND METHODS: Ninety participants were randomly allocated into two treatment groups (n = 45): experimental - toothbrushing with a 3% hydrogen peroxide (HP3) dentifrice for 3 minutes, 3x/day, for 4 weeks; and the control group - at-home bleaching with 10% carbamide peroxide (CP10) for 3 hours/day over a 2-week period. Tooth color change was assessed using subjective and objective methods at baseline, after 2 and 4-weeks of treatment, and one-month post-treatment. The absolute risk and intensity of TS and GI were evaluated using a Visual Analog Scale (VAS) . Data were analyzed using the Mann-Whitney test, Friedman's 2-way ANOVA by ranks for related samples, and Fisher's exact test. A significance level of 5% was adopted for all statistical tests. RESULTS: One-month post-treatment, the HP3 produced a color change significantly lower than CP10 for all color parameters evaluated (p < 0.001). No significant intragroup differences were observed between the 2 and 4-week evaluations for either HP3 or CP10 (p > 0.05). Both protocols were associated with TS and GI; however, the HP3 protocol showed a lower absolute risk (p < 0.006) and lower intensity (p = 0.01) of TS than CP10. CONCLUSIONS: Toothbrushing with a HP3 dentifrice did not promote effective tooth bleaching and was associated with tooth sensitivity and gingival irritation. CLINICAL SIGNIFICANCE: The use of a HP3 dentifrice as a bleaching treatment is not recommended, as it may cause adverse effects without providing effective tooth whitening.