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


International Journal of Dental Hygiene, vol.20, no.4, pp.650-657, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 20 Issue: 4
  • Publication Date: 2022
  • Doi Number: 10.1111/idh.12524
  • Journal Name: International Journal of Dental Hygiene
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Page Numbers: pp.650-657
  • Keywords: desensitizing agent, hydrogen peroxide, remineralization agent, tooth bleaching, tooth sensitivity
  • Istanbul Medipol University Affiliated: Yes


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.