Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial

J Dent. 2024 Mar:142:104875. doi: 10.1016/j.jdent.2024.104875. Epub 2024 Feb 1.


Objective: The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to reduce bleaching-induced tooth sensitivity (TS). This randomized controlled trial compared the risk and intensity of TS and the color change resulting from in-office dental bleaching after using an experimental desensitizing gel containing ibuprofen and arginine.

Methods: Sixty-two participants with upper canine shades A2 or darker were randomly assigned to either the ibuprofen-arginine desensitizing group or the placebo group. The desensitizing gel was applied for 15 min before in-office bleaching with 35 % hydrogen peroxide gel for 50 min (2 sessions). To assess the absolute risk and intensity of TS, visual (0-10) and numeric rating (0-5) scales were used, and group comparisons were made using the McNemar test, Wilcoxon test, and paired Student t-test (α = 0.05). Color change was evaluated using Vita Classical, Vita Bleachedguide (ΔSGU), and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. Group comparisons for color change were done using a paired t-test (α = 0.05).

Results: The odds ratio for TS was 0.14 [95 % CI 0.02 to 0.6], meaning lower odds of TS for the desensitizing gel. A lower intensity of TS was also observed for the experimental group (p < 0.005) up to 48 h after bleaching. All color evaluation tools demonstrated effective and similar whitening for both groups (p > 0.05).

Conclusions: Using the experimental desensitizing gel containing ibuprofen and arginine effectively reduced the risk and intensity of TS without compromising the bleaching efficacy.

Clinical relevance: The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity.

Keywords: Anti-inflammatory agents; Arginine; Dentin sensitivity; Ibuprofen; Tooth bleaching.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arginine / therapeutic use
  • Dentin Sensitivity* / chemically induced
  • Dentin Sensitivity* / prevention & control
  • Humans
  • Hydrogen Peroxide / adverse effects
  • Ibuprofen / therapeutic use
  • Sodium Compounds
  • Tooth Bleaching Agents* / adverse effects
  • Tooth Bleaching* / adverse effects
  • Tooth Bleaching* / methods
  • Treatment Outcome


  • Tooth Bleaching Agents
  • Ibuprofen
  • Hydrogen Peroxide
  • Sodium Compounds
  • Arginine