The effect of preoperative ibuprofen on tooth sensitivity caused by in-office bleaching

This study determined the effect of Ibuprofen on tooth sensitivity from in-office bleaching with 38% hydrogen peroxide. A double-blind, randomized-controlled clinical trial was performed on healthy non-smoker patients who retain all anterior teeth (N=31). Patients with anterior restorations, calculus or heavy stain, and those who were taking medications or desensitizer products were excluded. After signing the informed consent, the patients were randomly divided into a Placebo group (n=16) that received a placebo (tinted oil in clear capsule) (Health Dimensions Inc, Compound Pharmacy, Farmington Hills, MI, U.S.A.) or an Ibuprofen group (n=15) that received a 600 mg, PO single dose of Ibuprofen (Advil Liquid Gel, Wyeth, Madison, NJ, USA). The patients were watched while taking the capsules 30 minutes prior to treatment. A single operator applied the 38% hydrogen peroxide (Opalescence Xtra Boost, Ultradent Products Inc) for 20 minutes on 12 anterior teeth. The hydrogen peroxide solution was then rinsed, the teeth were gently dried and the cycle was repeated, for a total application time of 40 minutes. A Visual Analog Scale (VAS) was used to evaluate the level of sensitivity 30 minutes before treatment, immediately after treatment, then 1 hour and 24 hours post-bleaching. The patients graded their maximum sensitivity levels during each period on a scale from 0 to 100 (0=no sensitivity, 100=unbearable sensitivity). The VAS scores were statistically analyzed to compare the groups' scores at different times and to compare the scores within each group at various times (Wilcoxon rank sum tests). The mean score and standard deviation of the Ibuprofen group immediately after bleaching was 5.0 +/- 9.9, at 1 hour--31.5 +/- 32.1 and at 24 hours--25.8 +/- 30.8; the placebo group at the time of treatment was 26.6 +/- 31.0, at 1 hour--30.9 +/- 30.5 and at 24 hours--31.1 +/- 32.6. When comparing the two groups at different times, the Ibuprofen group showed statistically significantly lower sensitivity scores immediately post-bleaching than the placebo group (p = 0.0216) but not at 1 hour (p = 0.84) or 24 hours post-bleaching (p = 0.54). When comparing times within the Ibuprofen group, the mean VAS score immediately after bleaching was significantly lower than 1 hour post-bleaching (p = 0.0024) and 24-hours post-bleaching (p = 0.0110), but the mean VAS score at 1 hour post-bleaching and 24-hours post-bleaching were not significantly different (p = 0.64). For the placebo group, the intragroup time effect was not significant. Within the limitations of the current study, the authors concluded that the use of an analgesic may help to reduce tooth sensitivity during in-office bleaching. In the current study, Ibuprofen (600 mg, PO single dose) reduced tooth sensitivity during but not after the treatment period.