authors conducted a 2-center controlled clinical study to show the
equivalence of at-home bleaching in smokers and nonsmokers at 1 week and
1 month and evaluate tooth sensitivity (TS).
authors selected 60 smokers and 60 nonsmokers with central incisors of
shade A2 or darker. The participants performed bleaching with 10%
carbamide peroxide for 3 hours daily for 3 weeks. The authors evaluated
the color by using a shade guide and a spectrophotometer before, during,
and after bleaching (1 week and 1 month). Patients recorded TS by using
a 0-4 scale and a visual analog scale. The authors used multivariable
regression analysis to test factors associated with color change and TS
(α = .05).
and nonsmokers showed significant color change statistically equivalent
to within ± 2.0 units at 1 week after bleaching. Overall, color shade
improved by 4.1 shade guide units (95% confidence interval [CI],
3.7-4.5) and 7.8 units of color change measured with the
spectrophotometer (95% CI, 7.1-8.5) at 1 month. None of the factors
affected the TS risk. TS absolute risk and intensity were similar
between groups (P > .05), with an overall estimate of 47% (95% CI,
The immediate effectiveness of whitening- and bleaching-related TS were not affected by smoking.
did not affect the immediate color change (1 week). Effective whitening
was achieved regardless of whether the patient was a smoker. However,
this equivalence was not apparent 1 month after bleaching, with smokers
having slightly darker teeth.