At Home Whitening vs In Office

1. AT HOME WHITENING VS IN-
OFFICE PROFESSIONAL WHITENING
Tabasum Bukhari, Sharon John & Nancy Sahayarajah
EVBP 5500
Carrie Maynard RDH
July 29, 2016

2. PICO Question
◦Is In-Office Professional whitening more effective
compared to at-home whitening?

3. Types of whitening options Include:
◦ In-Office Professional Whitening
◦ At-Home Tray whitening
◦ Crest White Strips
◦ DIY Whitening
◦ Banana Peel
◦ Baking Soda
◦ Coconut Oil
◦ Whitening Tooth Paste
◦ Colgate Total Whitening Gel, Optic White Tooth paste
◦ Crest 3D White
◦ Arm & Hammer Advance White
◦ GLO Brilliant Personal Teeth Whitening Device
◦ Claims to whiten teeth in 5 days, No sensitivity

5. Problem
◦ Many individuals choose to whiten their teeth due to esthetics and
dissatisfaction with the colour of their teeth as seen in clinic
◦ With a multitude of products on the market and in dental offices, an individual
who may consider whitening their teeth will first wonder which product is better
◦ Many different products claim to be the best whitening product

6. Intervention
◦ Through many studies and research, it is proven that having your
teeth professionally whitened, whether it would be at home
whitening or office whitening is more effective than an over the
counter product (Carey, C. M., 2014)
◦ More people choose In-office whitening or At-home whitening
products compared to over the counter products that may
sometimes have a false claim

7. Comparison
◦ But the real question is: Which Whitening Treatment is more
effective ?

8. Outcome
◦ In-office bleaching materials contain high hydrogen peroxide
concentrations ranging from 15-38%, while the hydrogen
peroxide content in at-home bleaching products usually ranges
from 3% to 16% (De Geus, D., Wambier, L., Kossatz, S., Loguercio,
A., and Reis, S., 2016).
◦ it is assumed that due to the high concentration of bleaching
agents in the in-office whitening products and more patient
compliance to in-office treatment for any treatment, in-office
whitening would be more effective in whitening teeth as
opposed to at-home treatment (Giachetti, L., Bertini, F., Bambi,
C., Nieri, M., & Russo, D. S., 2010).

9. Products Contained in Whitening Products
◦ Two most common bleaching agents are hydrogen peroxide
and carbamide peroxide (Bernardon, J., et al., 2010).
◦ Carbamide peroxide, used in many bleaching products, breaks
down into hydrogen peroxide and urea, with hydrogen peroxide
being the active bleaching agent (Bernardon, K., Ferrari, P.,
Baratieri, N., & Rauber, B., 2015).
◦ A bleaching product containing 10% carbamide peroxide yields
approximately 3.5% hydrogen peroxide (Bernardon, K., et al.,
2015).

10. Considerations of Whitening
◦ Whitening should be a client specific Treatment
◦ Considerations for Whitening are
◦ Sensitivity
◦ Dental restorations
◦ Dark stains
◦ Single dark teeth
◦ Some staining present on teeth may be due to a specific problem that
either will not be affected by whitening agents or may be a sign of disease
or condition that requires further attention (Giachetti, L., et al., 2010).
◦ Patients should consult with their dentist to determine the best treatment
method for them,

11. Our Argument
◦ In-office whitening is more effective in tooth
whitening compared to tray whitening
◦ Client Compliance is better and the client
would carry through with treatment much
better than skipping a day with tray
whitening
◦ Costs more, therefore client compliance is
better
◦ Immediate Results as it whitens up to several
shades in a one hour appointment
◦ Work is done for you
◦ Time it takes for appointments are shorter
than the two week period of at home
whitening every night

12. ◦ Works better on stubborn stains
◦ viscosity of in office whitening agents
are less runny, therefore, better
adhesion to the surface of the tooth
◦ Less damage to tissues
◦ Less treatments would need to be done
(time convenient)
◦ Control of solution by dental team at an
office could prevent tissue damage and
damage to restorations
Our Argument

13. Cons of In-Office Whitening
◦ Cost ($600 & up)
◦ Need to go in for whitening appointments
◦ May cause severe sensitivity as the peroxide content is higher
◦ Pulpal irritation and sensitivity may occur with treatments that use
halogen light
◦ Risk of side effects

14. Counter Argument
◦ Tray whitening is more effective than in-office treatment due to:
◦ More clients prefer at home whitening
◦ Can be done in the comfort of your own home
◦ Can be done whenever the client wants to (during the
day/night)
◦ Concentration of hydrogen peroxide is less and may cause
less sensitivity in clients
◦ Costs less

15. Results
◦ Studies have shown that at home whitening products produce
the same results as office whitening and with office whitening you
still have to perform home whitening to maintain the color
(Bernardon, K., et al. 2015).
◦ Studies found that although in office whitening has higher
concentrations of whitening agents, at the end of the day studies
show that there is no significant difference in how white teeth
become when comparing it to at home whitening (Bernardon, J.,
et al. 2010).

16. References
◦ Bernardon, K., Ferrari, P., Baratieri, N., & Rauber, B. (2015). Comparison of treatment time versus
patient satisfaction in at-home and in-office tooth bleaching therapy. The Journal of
Prosthetic Dentistry, 114(6), 826-830.
◦ Bernardon, J., Sartori, N., Ballarin, A., Perdigao, J., Lopes, G., and Baratieri, L. (2010). Clinical
Performance of Vital Bleaching Techniques. Operative Dentistry. 35(1), 3-10.
◦ Carey, C. M. (2014). Tooth Whitening: What We Now Know. The Journal of Evidence-Based Dental
Practice, 14 Suppl, 70–76. http://doi.org/10.1016/j.jebdp.2014.02.006
◦ Dawson, P., Sharif, M., Smith, A., and Brunton, P. (2011). A Clinical Study Comparing the
Efficacy and Sensitivity of Home vs Combined Whitening. Operative Dentistry. 36(5),
460-466.
◦ De Geus, D., Wambier, L., Kossatz, S., Loguercio, A., and Reis, S. (2016). At-home vs In-office
Bleaching: A Systematic Review and Meta-analysis. Operative Dentistry. 37(4), 290-
2964.
◦ El-Murr, J., Ruel,D., and St-Georges, A. (2011). Effects of External Bleaching on Restorative
Materials: A Review. Canadian Dental Association. 71:b59, 1-6.
◦ Giachetti, L., Bertini, F., Bambi, C., Nieri, M., & Russo, D. S. (2010). A Randomized Clinical Trial
Comparing At-Home and In-Office Tooth Whitening Techniques. The Journal of the American
Dental Association, 141(11), 1357-1364.
◦ J. B. da Costa, R. McPharlin, R. D. Paravina, and J. L. Ferracane (2010) Comparison of At-home
and In-office Tooth Whitening Using a Novel Shade Guide. Operative Dentistry. 35(4), 381-388.
◦ Meireles, S., Fontes, T., Coimbra, A., Bona, D., & Demarco, F. (2012). Effectiveness of different
carbamide peroxide concentrations used for tooth bleaching: An in vitro study. J. Appl. Oral Sci.
Journal of Applied Oral Science. 20(2), 186-191.