Skip to main content

Advertisement

SpringerLink
Log in

Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial

  • Original Article
  • Published:
Clinical Oral Investigations Aims and scope Submit manuscript

Abstract

Objectives

This study evaluated the effect of the administration of pre-operative dexamethasone on tooth sensitivity stemming from in-office bleaching.

Materials and methods

A triple-blind, parallel-design, randomized clinical trial was conducted on 70 volunteers who received dexamethasone or placebo capsules. The drugs were administered in a protocol of three daily 8-mg doses of the drug, starting 48 h before the in-office bleaching treatment. Two bleaching sessions with 37.5% hydrogen peroxide gel were performed with a 1-week interval. Tooth sensitivity (TS) was recorded on visual analog scales (VAS) and numeric rating scales (NRS) in different periods up to 48 h after bleaching. The color evaluations were also performed. The absolute risk of TS and its intensity were evaluated by using Fisher’s exact test. Comparisons of the TS intensity (NRS and VAS data) were performed by using the Mann-Whitney U test and a two-way repeated measures ANOVA and Tukey’s test, respectively.

Results

In both groups, a high risk of TS (Dexa 80% x Placebo 94%) was detected. No significant difference was observed in terms of TS intensity. A whitening of approximately 3 shade guide units of the VITA Classical was detected in both groups, which were statistically similar.

Conclusions

It was concluded that the administration pre-operatively of dexamethasone, in the proposed protocol, does not reduce the incidence or intensity of bleaching-induced tooth sensitivity.

Clinical relevance

The use of dexamethasone drug before in-office bleaching treatment does not reduce incidence or intensity of tooth sensitivity.

Clinical trial registration number

NCT02956070

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Tin-Oo MM, Saddki N, Hassan N (2011) Factors influencing patient satisfaction with dental appearance and treatments they desire to improve aesthetics. BMC Oral Health 11:6. https://doi.org/10.1186/1472-6831-11-6

    Article  PubMed  PubMed Central  Google Scholar 

  2. Giniger M, Macdonald J, Ziemba S, Felix H (2005) The clinical performance of professionally dispensed bleaching gel with added amorphous calcium phosphate. J Am Dent Assoc 136:383–392

    Article  PubMed  Google Scholar 

  3. Samorodnitzky-Naveh GR, Grossmann Y, Bachner YG, Levin L (2010) Patients’ self-perception of tooth shade in relation to professionally objective evaluation. Quintessence Int 41:80–83

    Google Scholar 

  4. Haywood VB, Heymann HO (1989) Nightguard vital bleaching. Quintessence Int 20:173–176

    PubMed  Google Scholar 

  5. Leonard Jr RH, Bentley C, Eagle JC, Garland GE (2001) Nightguard vital bleaching: a long-term study on efficacy, shade retention, side effects, and patients’ perceptions. J Esthet Restor Dent 13:357–369

    Article  Google Scholar 

  6. Bernardon JK, Sartori N, Ballarin A, Perdigão J, Lopes G, Baratieri LN (2010) Clinical performance of vital bleaching techniques. Oper Dent 35:3–10. https://doi.org/10.2341/09-008CR

    Article  PubMed  Google Scholar 

  7. Rezende M, Loguercio AD, Reis A, Kossatz S (2013) Clinical effects of exposure to coffee during at-home vital bleaching. Oper Dent 38:E229–E236. https://doi.org/10.2341/12-188-C

    Article  PubMed  Google Scholar 

  8. Carey CM (2014) Tooth whitening: what we now know. J Evid Based Dent Pract 14(Suppl):70–76. https://doi.org/10.1016/j.jebdp.2014.02.006

    Article  PubMed  Google Scholar 

  9. Dahl JE, Pallesen U (2003) Tooth bleaching—a critical review of the biological aspects. Crit Rev Oral Biol Med 14:292–304

    Article  PubMed  Google Scholar 

  10. Perdigão J (2009) Dental whitening—revisiting the myths. Northwest Dent 89:19–21

    Google Scholar 

  11. Tay LY, Kose C, Loguercio AD, Reis A (2009) Assessing the effect of a desensitizing agent used before in-office tooth bleaching. J Am Dent Assoc 140:1245–1251

    Article  PubMed  Google Scholar 

  12. Marson FC, Sensi LG, Vieira LCC, Araújo E (2008) Clinical evaluation of in-office dental bleaching treatments with and without the use of light-activation sources. Oper Dent 33:15–22. https://doi.org/10.2341/07-57

    Article  PubMed  Google Scholar 

  13. Reis A, Kossatz S, Martins GC, Loguercio AD (2013) Efficacy of and effect on tooth sensitivity of in-office bleaching gel concentrations: a randomized clinical trial. Oper Dent 38:386–393. https://doi.org/10.2341/12-140-C

    Article  PubMed  Google Scholar 

  14. Alomari Q, El Dara E (2010) A randomized clinical trial of in-office dental bleaching with or without light activation. J Contemp Dent Pract 11:E017–E024

    Article  Google Scholar 

  15. Gurgan S, Cakir FY, Yazici E (2010) Different light-activated in-office bleaching systems: a clinical evaluation. Lasers Med Sci 25:817–822. https://doi.org/10.1007/s10103-009-0688-x

    Article  PubMed  Google Scholar 

  16. Tay LY, Kose C, Herrera DR, Reis A, Loguercio AD (2012) Long-term efficacy of in-office and at-home bleaching: a 2-year double-blind randomized clinical trial. Am J Dent 25:199–204

    PubMed  Google Scholar 

  17. De Paula EA, Nava JA, Rosso C, Benazzi CM, Fernandes KT, Kossatz S, Loguercio AD, Reis A (2015) In-office bleaching with a two-and seven-day intervals between clinical sessions: a randomized clinical trial on tooth sensitivity. J Dent 43:424–429. https://doi.org/10.1016/j.jdent.2014.09.009

    Article  PubMed  Google Scholar 

  18. Giachetti L, Bertini F, Bambi C, Nieri M, Russo DS (2010) A randomized clinical trial comparing at-home and in-office tooth whitening techniques: a nine-month follow-up. J Am Dent Assoc 141:1357–1364

    Article  PubMed  Google Scholar 

  19. He LB, Shao MY, Tan K, Xu X, Li JY (2012) The effects of light on bleaching and tooth sensitivity during in-office vital bleaching: a systematic review and meta-analysis. J Dent 40:644–653. https://doi.org/10.1016/j.jdent.2012.04.010

    Article  PubMed  Google Scholar 

  20. De Paula EA, Kossatz S, Fernandes D, Loguercio AD, Reis A (2013) The effect of perioperative ibuprofen use on tooth sensitivity caused by in-office bleaching. Oper Dent 38:601–608. https://doi.org/10.2341/12-107-C

    Article  PubMed  Google Scholar 

  21. De Paula EA, Loguercio AD, Fernandes D, Kossatz S, Reis A (2013) Perioperative use of an anti-inflammatory drug on tooth sensitivity caused by in-office bleaching: a randomized, triple-blind clinical trial. Clin Oral Invest 17:2091–2097. https://doi.org/10.1007/s00784-013-0918-2

    Article  Google Scholar 

  22. Mehta D, Venkata S, Naganath M, LingaReddy U, Ishihata H, Finger WJ (2013) Clinical trial of tooth desensitization prior to in-office bleaching. Eur J Oral Sci 121:477–481. https://doi.org/10.1111/eos.12067

    Article  PubMed  Google Scholar 

  23. Bonafé E, Bacovis CL, Iensen S, Loguercio AD, Reis A, Kossatz S (2013) Tooth sensitivity and efficacy of in-office bleaching in restored teeth. J Dent 41:363–369. https://doi.org/10.1016/j.jdent.2013.01.007

    Article  PubMed  Google Scholar 

  24. Caviedes-Bucheli J, Ariza-García G, Restrepo-Méndez S, Ríos-Osorio N, Lombana N, Muñoz HR (2008) The effect of tooth bleaching on substance P expression in human dental pulp. J Endod 34:1462–1465. https://doi.org/10.1016/j.joen.2008.09.013

    Article  PubMed  Google Scholar 

  25. De Souza Costa CA, Riehl H, Kina JF, Sacono NT, Hebling J (2010) Human pulp responses to in-office tooth bleaching. Oral Surg Oral Med Oral Pathol Oral Rad Endod 109:e59–e64. https://doi.org/10.1016/j.tripleo.2009.12.002

    Article  Google Scholar 

  26. Reis A, Dalanhol AP, Cunha TS, Kossatz S, Loguercio AD (2011) Assessment of tooth sensitivity using a desensitizer before light-activated bleaching. Oper Dent 36:12–17. https://doi.org/10.2341/10-148-CR

    Article  PubMed  Google Scholar 

  27. Bortolatto JF, Pretel H, Floros MC, Luizzi ACC, Dantas AA, Fernandez E, Moncada G, De Oliveira OB Jr (2014) Low concentration H2O2/TiO_N in office bleaching: a randomized clinical trial. J Dent Res 93(Suppl):66S–71S. https://doi.org/10.1177/0022034514537466

    Article  PubMed  PubMed Central  Google Scholar 

  28. Markowitz K (2010) Pretty painful: why does tooth bleaching hurt? Med Hypotheses 74:835–840. https://doi.org/10.1016/j.mehy.2009.11.044

    Article  PubMed  Google Scholar 

  29. Wang T, Gao J, Jiang T, Liang S, Zhou Y, Matis BA (2015) Evaluation of the efficacy of potassium nitrate and sodium fluoride as desensitizing agents during tooth bleaching treatment—a systematic review and meta-analysis. J Dent 43:913–923. https://doi.org/10.1016/j.jdent.2015.03.015

    Article  PubMed  Google Scholar 

  30. Palé M, Mayoral JR, Llopis J, Vallès M, Basilio J, Roig M (2014) Evaluation of the effectiveness of an in-office bleaching system and the effect of potassium nitrate as a desensitizing agent. Odontology 102:203–210. https://doi.org/10.1007/s10266-013-0132-3

    Article  PubMed  Google Scholar 

  31. Loguercio AD, Martins LM, da Silva LM, Reis A (2016) In-office whitening. In: Perdigão J (ed) Tooth whitening., 1st edn. Springer Int. Pub, Switzerland, pp 145–167

    Chapter  Google Scholar 

  32. Moura GF, Teixeira DNR, Machado AC, Spini PH, Soares PV (2016) Analysis of bleaching products associated with desensitizing agents in experimental whitening gel—randomized clinical trial. Biosci J 32:279–287

    Article  Google Scholar 

  33. Hewlett ER (2007) Etiology and management of whitening-induced tooth hypersensitivity. J Calif Dent Assoc 35:499–506

    PubMed  Google Scholar 

  34. Kossatz S, Martins G, Loguercio AD, Reis A (2012) Tooth sensitivity and bleaching effectiveness associated with use of a calcium-containing in-office bleaching gel. J Am Dent Assoc 143:e81-e87

    Article  Google Scholar 

  35. Charakorn P, Cabanilla LL, Wagner WC, Foong WC, Shaheen J, Pregitzer R, Schneider D (2009) The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching. Oper Dent 34:131–135. https://doi.org/10.2341/08-33

    Article  PubMed  Google Scholar 

  36. Rezende M, Bonafé E, Vochikovski L, Farago PV, Loguercio AD, Reis A, Kossatz S (2016) Pre and postoperative dexamethasone does not reduce bleaching-induced tooth sensitivity: a randomized, triple-masked clinical trial. J Am Dent Assoc 147:41–49

    Article  PubMed  Google Scholar 

  37. Sugimoto MA, Vago JP, Teixeira MM, Sousa LP (2016) Annexin A1 and the resolution of inflammation: modulation of neutrophil recruitment, apoptosis, and clearance. J Immunol Res 2016(8239258):1–13. https://doi.org/10.1155/2016/8239258

    Article  Google Scholar 

  38. Navari RM, Aapro M (2016) Antiemetic prophylaxis for chemotherapy-induced nausea and vomiting. New Eng J Med 374:1356–1367. https://doi.org/10.1056/NEJMra1515442

    Article  PubMed  Google Scholar 

  39. Rhen T, Cidlowski JA (2005) Antiinflammatory action of glucocorticoids - new mechanisms for old drugs. New Eng J Med 353:1711–1723. https://doi.org/10.1056/NEJMra050541

    Article  PubMed  Google Scholar 

  40. Falci SGM, Lima TC, Martins CC, Santos CRRD, Pinheiro MLP (2017) Preemptive effect of dexamethasone in third-molar surgery: a meta-analysis. Anesth Prog 64:136–143. https://doi.org/10.2344/anpr-64-05-08

    Article  PubMed  PubMed Central  Google Scholar 

  41. Paravina RD, Johnston WM, Powers JM (2007) New shade guide for evaluation of tooth whitening-colorimetric study. J Esthet Restor Dent 19:276–283. https://doi.org/10.1111/j.1708-8240.2007.00118_1.x

    Article  PubMed  Google Scholar 

  42. Nahsan FP, Fernandes MT, Martins-Filho PR (2015) Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching: a systematic review and meta-analysis. J Am Dent Assoc 146:87–93. https://doi.org/10.1016/j.adaj.2014.10.007

    Article  PubMed  Google Scholar 

  43. Paravina RD (2008) New shade guide for tooth whitening monitoring: visual assessment. J Prosthet Dent 99:178–184. https://doi.org/10.1016/S0022-3913(08)60041-4

    Article  PubMed  Google Scholar 

  44. Brännström M (1986) The hydrodynamic theory of dentinal pain: sensation in preparations, caries, and the dentinal crack syndrome. J Endod 12:453–457. https://doi.org/10.1016/S0099-2399(86)80198-4

    Article  PubMed  Google Scholar 

  45. Pinheiro HB, Lopes B, Klautau EB, Cardoso J, Silva BR, Cardoso PEC (2010) Influence of bioactive materials used on the dentin surface whitened with carbamide peroxide 16%. Mat Res 13:273–278

    Article  Google Scholar 

  46. Gjorgievska E, Nicholson JW (2011) Prevention of enamel demineralization after tooth bleaching by bioactive glass incorporated into toothpaste. Aust Dent J 56:193–200. https://doi.org/10.1111/j.1834-7819.2011.01323.x

    Article  PubMed  Google Scholar 

  47. Rezende M, Loguercio AD, Kossatz S, Reis A (2016) Predictive factors on the efficacy and risk/intensity of tooth sensitivity of dental bleaching: a multi regression and logistic analysis. J Dent 45:1–6. https://doi.org/10.1016/j.jdent.2015.11.003

    Article  PubMed  Google Scholar 

  48. De Geus JL, Wambier LM, Kossatz S, Loguercio AD, Reis A (2016) At-home vs in-office bleaching: a systematic review and meta-analysis. Oper Dent 41:341–356. https://doi.org/10.2341/15-287-LIT

    Article  PubMed  Google Scholar 

  49. Pintado-Palomino K, Peitl Filho O, Zanotto ED, Tirapelli C (2015) A clinical, randomized, controlled study on the use of desensitizing agents during tooth bleaching. J Dent 43:1099–1105. https://doi.org/10.1016/j.jdent.2017.05.019

    Article  PubMed  Google Scholar 

  50. Loguercio AD, Tay LY, Herrera DR, Bauer J, Reis A (2015) Effectiveness of nano-calcium phosphate paste on sensitivity during and after bleaching: a randomized clinical trial. Braz Oral Res 29:1–7. https://doi.org/10.1590/1807-3107BOR-2015.vol29.0099

    Article  PubMed  Google Scholar 

  51. De Paula EA, Kossatz S, Fernandes D, Loguercio AD, Reis A (2014) Administration of ascorbic acid to prevent bleaching-induced tooth sensitivity: a randomized triple-blind clinical trial. Oper Dent 39:128–135. https://doi.org/10.2341/12-483-C

    Article  PubMed  Google Scholar 

  52. Hall JE (2016) Red blood cells, anemia, and polycythemia. In: Guyton AC, Hall JE (eds) Textbook of medical physiology, 13th edn. Elsevier Saunders, Philadelphia, pp 445–543

    Google Scholar 

  53. Filipsson Nyström H, Barbosa EJ, Nilsson AG, Norrman LL, Ragnarsson O, Johannsson G (2012) Discontinuing long-term GH replacement therapy—a randomized, placebo-controlled crossover trial in adult GH deficiency. J Clin Endocrinol Metab 97:3185–3195. https://doi.org/10.1210/jc.2012-2006

    Article  PubMed  Google Scholar 

  54. Cronin J, Kennedy U, McCoy S, Fhailí SN, Crispino-O’Connell G, Hayden J, O’Sullivan R (2012) Single dose oral dexamethasone versus multi-dose prednisolone in the treatment of acute exacerbations of asthma in children who attend the emergency department: study protocol for a randomized controlled trial. Trials 13:141. https://doi.org/10.1186/1745-6215-13-141

    Article  PubMed  PubMed Central  Google Scholar 

  55. Bjornson CL, Klassen TP, Williamson J, Brant R, Mitton C, Plint A, Johnson DW (2004) A randomized trial of a single dose of oral dexamethasone for mild croup. New Eng J Med 351:1306–1313. https://doi.org/10.1056/NEJMoa033534

    Article  PubMed  Google Scholar 

  56. Laureano Filho JR, Maurette PE, Allais M, Cotinho M, Fernandes C (2008) Clinical comparative study of the effectiveness of two dosages of dexamethasone to control postoperative swelling, trismus and pain after the surgical extraction of mandibular impacted third molars. Med Oral Pathol Oral Cir Bucal 13:E129–E132

    Google Scholar 

  57. Kravitz J, Dominici P, Ufberg J, Fisher J, Giraldo P (2011) Two days of dexamethasone versus 5 days of prednisone in the treatment of acute asthma: a randomized controlled trial. Ann Emerg Med 58:200–204. https://doi.org/10.1016/j.annemergmed.2011.01.004

    Article  PubMed  Google Scholar 

  58. Haas ET, Rowland K, Gautam M (2011) Tooth injury increases expression of the cold sensitive TRP channel TRPA1 in trigeminal neurons. Arch Oral Biol 56:1604–1609. https://doi.org/10.1016/j.archoralbio.2011.06.014

    Article  PubMed  Google Scholar 

  59. Bae YC, Yoshida A (2011) Ultrastructural basis for craniofacial sensory processing in the brainstem. Int Rev Neurobiol 97:99–141. https://doi.org/10.1016/B978-0-12-385198-7.00005-9

    Article  PubMed  Google Scholar 

  60. Antunes AA, Avelar RL, Neto ECM, Frota R, Dias E (2011) Effect of two routes of administration of dexamethasone on pain, edema, and trismus in impacted lower third molar surgery. Oral Maxillofac Surg 15:217–223. https://doi.org/10.1007/s10006-011-0290-9

    Article  PubMed  Google Scholar 

  61. El Karim I, McCrudden MT, Linden GJ, Abdullah H, Curtis TM, McGahon M, Lundy FT (2015) TNF-α–induced p38MAPK activation regulates TRPA1 and TRPV4 activity in odontoblast-like cells. Am J Pathol 185:2994–3002. https://doi.org/10.1016/j.ajpath.2015.07.020

    Article  PubMed  Google Scholar 

  62. Brone B, Peeters PJ, Marrannes R, Mercken M, Nuydens R, Meert T, Gijsen HJ (2008) Tear gasses CN, CR, and CS are potent activators of the human TRPA1 receptor. Toxicol Appl Pharmacol 231:150–156. https://doi.org/10.1016/j.taap.2008.04.005

    Article  PubMed  Google Scholar 

  63. Ferrer-Montiel A, Fernández-Carvajal A, Planells-Cases R, Fernández-Ballester G, González-Ros JM, Messeguer A, González-Muñiz R (2012) Advances in modulating thermosensory TRP channels. Expert Opin Ther Pat 22:999–1017. https://doi.org/10.1517/13543776.2012.711320

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors thank SDI Dental Limited for the donation of the bleaching gel used, and Bem Viver laboratory Ltda. for the donation of dexamethasone capsules and the gel placebo in this investigation.

Informed consent

Informed consent was obtained from all individual participants included in this study.

Funding

This work was supported by the National Council for Scientific and Technological Development (CNPq IC 166520) and Coordination for the Improvement of Higher Level Personnel (CAPES), in Brazil.

Author information

Authors and Affiliations

  1. Fluminense Federal University / School of Dentistry, R. Dr. Silvio Henrique Braune, 22 – Centro, Nova Friburgo, RJ, 28625-650, Brazil

    Luiz Augusto da Costa Poubel, Fernanda Signorelli Calazans, Etyene Castro Dip, Wesley Veltri Alves, Stella Soares Marins, Roberta Barcelos & Marcos Oliveira Barceleiro

  2. Fluminense Federal University / School of Dentistry, R. Mario Santos Braga, 28 – Centro, Niterói, RJ, 24020-140, Brazil

    Cresus Vinicius Deppes de Gouvea

Authors
  1. Luiz Augusto da Costa Poubel
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cresus Vinicius Deppes de Gouvea
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fernanda Signorelli Calazans
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Etyene Castro Dip
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Wesley Veltri Alves
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Stella Soares Marins
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Roberta Barcelos
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Marcos Oliveira Barceleiro
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Marcos Oliveira Barceleiro.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in this study were in accordance with the ethical standards of the national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

da Costa Poubel, L.A., de Gouvea, C.V.D., Calazans, F.S. et al. Pre-operative use of dexamethasone does not reduce incidence or intensity of bleaching-induced tooth sensitivity. A triple-blind, parallel-design, randomized clinical trial. Clin Oral Invest 23, 435–444 (2019). https://doi.org/10.1007/s00784-018-2452-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00784-018-2452-8

Keywords

Search

Navigation