Study of Whitening Strips on Application and Technology

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Whitening strips were introduced to the dental profession in 2000. The technology behind whitening strips is based on the use of barrier (a flexible strip) that holds a peroxide-containing gel. Developed as an easy-to-use option, these strips can be readily self-applied directly to the teeh daily for at home whitening.

Whitening strips have become a very popular overthe-counter choice for whitening teeth. Patients generally  feel comfortable using strips and confident in their success. Since the introduction of these whitening strips,  there have been numerous clinical studies on their efficacy and safety demonstrating significant whitening of teeth and minimal side effects (Garcia-Godoy et al. 2004,  Swift et al. 2004, Farrell et al. 2008, Gerlach et al. 2009).  Studies have generally shown significant whitening even after a few days of use, with the minor occurrence of adverse events mainly consisting of localized irritation or sensitivity (Gerlach et al. 2009).

Summary of advantages and disadvantages of whitening strips versus others.

Potential advantagesPotential disadvantages
Whitening strips—pretreatment effects
Convenience and costAvoiding routine diagnosis
Easy introduction to esthetic dentistryAvoiding other dental care
Whitening strips—treatment effects
Easy in-use experienceMandibular retention (some strips)
Gentle whitening with few side effectsStrip adaptation with severe malocclusion
Whitening strips—post-treatment effects
Uniform whiteningPosterior teeth not treated
No persistent, severe problemsPossible mismatch with existing restorations

Examples of whitening strips used to address specific practice needs

ApplicationHow whitening strips may be used in the dental practice
In-office treatmentInstead of a take-home tray after in-office whitening for color stability
Re-treatmentPeriodic touch-up to help maintain original whitening
Usage concernsOption for temporomandibular joint disorder, bruxism, or gagging patients who cannot use trays
SensitivityTooth sensitivity involving the posterior or lingual dentition
FailuresAlternative for patients whose compliance may be limited
EstheticsWhitening to match existing restorations (that are not being replaced)
Patient relationsPatient recognition for milestones (e.g., graduations, weddings)

Product Design

Whitening strips were originally introduced in the United States by the Procter and Gamble Company (Cincinnati, OH) in 2000 under the brand name Crest Whitestrips. Subsequently, this technology has been modified through research and development and expanded to various geographic locations (sometimes under different brand names tied to Whitestrips) (Gerlach 2007). In total, there are approximately a dozen marketed variations of the Whitestrips technology that were designed to address different aspects of the desired whitening experience.

In general, there are three main variations of Whitestrips that may be encountered in the marketplace and/or the academic literature. All three rely on a common flexible barrier approach to maintain peroxide contact with teeth over a sufficient period for diffusion and intrinsic whitening . In brief, the three major variations include (1) original strips, (2) very thin gel strips, and (3) high-adhesive strips.

Over view of teeth whitening strips

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