Clinical performance of at-home dental bleaching in younger and older adults: A non-randomized, double-blind trial

This non-randomized, parallel, double-blind controlled trial evaluated the equivalence of bleaching efficacy 1-month post-bleaching after at-home bleaching among younger (15-24 years) and older participants (45-78 years). The secondary outcomes: intensity and risk of tooth sensitivity (TS), gingival irritation (GI), and esthetic self-perception were compared.

130 participants (65 per group) underwent bleaching with 10% carbamide peroxide for 2h daily/21 days. Color change was assessed using the spectrophotometer (ΔE_ab, ΔE₀₀, ΔWI_D), and shade guides (ΔSGUs). The intensity and risk of TS and GI were recorded using a 0-10 VAS. The Orofacial Esthetic Scale (OES) was applied for both groups.

Non-equivalent bleaching outcomes were observed between the groups across all instruments (p = 1.00); younger participants showed significantly greater efficacy (p < 0.001). The TS risk was around 64 % for all participants, with no statistical difference between groups (p = 0.361; RR=0.9; 95%CI 0.7 to 1.2). Older participants had significantly 30% lower risk of GI (RR=0.7; 95%CI 0.5 to 2). No statistical difference for TS intensity was observed (p > 0.415) but found for GI (p = 0.019) favoring older participants. Significant improvements were observed for all OES items after bleaching (p < 0.001).

Younger individuals experienced greater whitening effects from at-home bleaching treatments compared to older adults. However, both age groups reported similar rates of tooth sensitivity and gum irritation. Regardless of age, the treatment improved aesthetic self-perception.

Greater whitening efficacy was observed in younger participants with comparable adverse effects across groups, and the procedure positively impacted self-perception in both age groups.