Whitening strips are safe and effective in patients with dry mouth

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NEW YORK (Reuters Health), Sep 10 - Patients with medication-induced xerostomia can safely use 10% hydrogen peroxide whitening strips, researchers report in Gerontology, published online on August 25.

Hyposalivation is thought to make people poor candidates for tooth whitening, said Dr. Athena S. Papas in an e-mail message to Reuters Health, due to "the role of salivary enzymes in peroxide decomposition, certain formulation issues, the purported tenacity of the intrinsic tooth discoloration in that group, and the general lack of research" in these individuals.

Dr. Papas, from Tufts University in Boston, and her colleagues conducted a randomized trial in 42 adults on xerogenic medications who had unstimulated salivary flow < 0.2 mL/min. For two weeks, participants applied either 10% hydrogen peroxide whitening strips or placebo strips for 30 minutes, twice a day.

Overall, 31% of subjects were taking antihypertensives, 29% used antidepressants, and 40% used other anticholinergics. One placebo-treated patient voluntarily withdrew at the day 8 visit, and one peroxide-treated patient violated protocol and was deemed nonevaluable. All other subjects completed the study.

"In this study, 100% of the subjects in the peroxide strip group had objectively measured tooth whitening (reduction in yellowness and increased brightness), and the magnitude of the whitening increased with continued whitening strip use," Dr. Papas said. "As expected, the placebo strip response (no peroxide) was flat."

Both treatments were well tolerated. The most common adverse events were oral irritation and tooth sensitivity. No one withdrew due to a product-related adverse event.

"Tooth whitening is one of the most common cosmetic procedures, and for most individuals, the first step in aesthetic dentistry," Dr. Papas said.

"However," she continued, "professional and lay perception can contribute to older adults often forgoing this noninvasive treatment for more complex and costly care (such as restorative dentistry)."

"This new clinical trial demonstrates that peroxide-based strip whitening can be a viable first step in aesthetic treatment for older adults or individuals with diminished salivary function," she added.

The whitening strips used in the study were manufactured by the Procter & Gamble Company, which employs two of the paper's five authors.

By Michelle Rizzo

Gerontology 2009.

Last Updated: 2009-09-10 18:43:10 -0400 (Reuters Health)

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