Incorporating ibuprofen/arginine gel in bleaching protocols reduces risk and intensity of tooth sensitivity: Study

"Clinicians may consider incorporation of desensitizing agents, such as the ibuprofen/arginine gel, into their bleaching protocols to enhance patient comfort and satisfaction," the researchers suggest.

Tooth bleaching is one of the most common cosmetic procedures patients seek due to dissatisfaction with colour and tooth appearance. Despite the success of dental bleaching procedures, adverse effects such as bleaching-induced tooth sensitivity (TS) and gingival irritation are commonly observed. Among these, bleaching-induced TS is the most prevalent.

The application of anti-inflammatories as topical desensitizers before dental bleaching is an approach to lower bleaching-induced tooth sensitivity. Giovana Mongruel Gomes, University of Ponta Grossa Ponta Grossa, Paraná, Brazil, and colleagues compared the intensity and risk of TS and the colour change resulting from in-office dental bleaching after using an experimental desensitizing gel containing arginine and ibuprofen.

The trial included sixty-two participants with upper canine shades A2 or darker. They 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).

The researchers used visual (0–10) and numeric rating (0–5) scales to assess the absolute risk and intensity of TSt, and group comparisons were made using the Wilcoxon test, McNemar test, and paired Student t-test. The colour change was assessed using Vita Bleachedguide (ΔSGU), Vita Classical, and Vita EasyShade (ΔEab, ΔE00, and ΔWID) before and one month after the bleaching procedure. A paired t-test was used to perform group comparisons for colour change.

The study led to the following findings:

• The odds ratio for TS was 0.14, meaning lower odds of TS for the desensitizing gel.
• A lower intensity of TS was also observed for the experimental group up to 48 h after bleaching.
• All colour evaluation tools demonstrated effective and similar whitening for both groups.

The findings showed that the topical application of ibuprofen in combination with arginine has demonstrated the ability to reduce the intensity and risk of tooth sensitivity while preserving the efficacy of the bleaching process.

"The topical application of ibuprofen/arginine on the in-office bleaching reduced risk and intensity of bleaching-induced tooth sensitivity," the researchers wrote.

Reference:

Hortkoff, D., Da Silva, K. L., Farago, P. V., Gomes, J. C., Reis, A., & Gomes, G. M. (2024). Effect of topical application of ibuprofen/arginine on the in-office bleaching-induced tooth sensitivity: A randomized, triple-blind controlled trial. Journal of Dentistry, 142, 104875. https://doi.org/10.1016/j.jdent.2024.104875