Effectiveness of and Dental Sensitivity to At-home Bleaching With 4% and 10% Hydrogen Peroxide: A Randomized, Triple-blind Clinical Trial

Oper Dent. 2018 May/Jun;43(3):232-240. doi: 10.2341/16-260-C.


Objectives: To evaluate the risk for and intensity of tooth sensitivity and color change of at-home dental bleaching with 4% and 10% hydrogen peroxide (HP).

Methods: For this study, 78 patients were selected according to the inclusion and exclusion criteria and randomized into two groups: HP 4 (White Class 4%, FGM) and HP 10 (White Class 10%, FGM). In both groups, the at-home bleaching was performed for a period of 30 minutes twice a day for two weeks. The color was assessed by Vita Classical, Vita Bleachedguide 3D-MASTER and spectrophotometer Vita Easyshade (Vita Zahnfabrik) at baseline, during bleaching (first and second weeks) and after bleaching (one month). Patients recorded their tooth sensitivity using a numeric rating scale (0-4) and visual analog scale (0-10). Data from color change (DeltaE data) was submitted to two-way analysis of variance. The color change data in Delta SGU from the two shade guide units were compared with the Mann Whitney test. The risk of tooth sensitivity was evaluated by χ2 test and the intensity of tooth sensitivity from both scales was evaluated by a Mann-Whitney test (α=0.05).

Results: The absolute risk and intensity of tooth sensitivity was higher in the group that used HP 10 than the one that used HP 4. Data from change in the number of shade guide units and color variation after one month of bleaching for both groups showed significant whitening, with no difference between groups.

Conclusions: At-home bleaching is effective with 4% and 10% HP concentrations, but 10% HP increased the absolute risk and intensity of tooth sensitivity during at-home bleaching.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dentin Sensitivity / chemically induced*
  • Double-Blind Method
  • Female
  • Humans
  • Hydrogen Peroxide / adverse effects
  • Hydrogen Peroxide / therapeutic use*
  • Male
  • Self Care / adverse effects
  • Self Care / methods
  • Spectrophotometry
  • Tooth Bleaching / adverse effects
  • Tooth Bleaching / methods*
  • Tooth Bleaching Agents / adverse effects
  • Tooth Bleaching Agents / therapeutic use*
  • Tooth Discoloration / drug therapy
  • Treatment Outcome
  • Young Adult


  • Tooth Bleaching Agents
  • Hydrogen Peroxide