Nightguard Vital Bleaching: Side Effects and Patient Satisfaction 10 to 17 Years Post‐Treatment

Statement of the Problem:  The long‐term patient satisfaction and safety of nightguard vital bleaching (NGVB) requires further evaluation. Purpose of the Study:  The purpose of this study was to evaluate patients' satisfaction and identify side effects of NGVB up to 17 years post‐treatment. Materials and Methods:  Thirty‐one participants who had completed previous NGVB studies using 10% carbamide peroxide were contacted at least 10 years post‐treatment (range 10–17 years, average 12.3 years). Participants reported shade satisfaction (very satisfied [VS], partially satisfied [PS], or not satisfied [NS]) as well as potential complications. Participants had teeth # 6 to 11 examined for tooth vitality, gingival inflammation (Löe's Gingival Index [GI]), and radiographically for external cervical resorption (ECR). Results:  All of the participants had successful lightening of their teeth. Sixty‐one percent (19) had not retreated their teeth. Of those who had not retreated their teeth and who responded to the question of whitening satisfaction, 31% (4/13) were VS, 54% (7/13) were PS, and 15% (2/13) were NS with their current shade. Of those who had retreated their teeth, all were VS or PS. Ninety‐one percent of the examined teeth had GI = 0 (normal), 7% had GI = 1 (mild inflammation), and 2% had GI = 2 (moderate inflammation). Sixty‐nine percent of teeth tested responded to a cold stimulus. Radiographs did not detect ECR or apical lesions. No participant reported having a gingival biopsy post‐treatment, and 87% would whiten again. Conclusions:  Patient satisfaction with NGVB may last as long as 12.3 years in average (range 10–17 years) post‐treatment. GI and ECR findings were considered within the normal expectations for the sample studied, suggesting minimal clinical post‐NGVB side effects up to 17 years. CLINICAL SIGNIFICANCE Nightguard vital bleaching provides patient satisfaction with minimal side effects up to 17 years post‐treatment. (J Esthet Restor Dent ••:••–••, 2011)