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Tooth sensitivity is a common side effect of carbamide peroxide and hydrogen peroxide tooth whitening solutions, especially those applied in custom-fitted arch trays. Some suggestions for treatment and prevention of such sensitivity are use of ingested analgesics, inclusion of desensitizing agents in the bleaching solution (for example, potassium nitrate), use of over-the-counter desensitizing dentifrices, placement of fluoride solutions in the custom trays for patient-applied topical application and decreased exposure to the bleaching gels (for example, bleaching for one- to two-hour periods rather than overnight). In short, treatment approaches all seem to assume that the discomfort is inflammatory in origin.

I would like to suggest that bleaching sensitivity is perhaps a result of fluid dynamics. Just like gas or breath blown into a balloon results in pressure that inflates the balloon, the oxygen molecules released from carbamide peroxide or hydrogen peroxide bleaching solution diffuse through and accumulate in the enamel and dentin. When a sufficient amount occupies enough intracoronal space, pressure could be applied to pain receptors in the dentinal tubules and maybe the pulp. The fact that higher concentrations of bleaching solutions are known to cause more sensitivity than those with lower concentrations lends credence to this theory.

I am hoping that an interested researcher might see logic in this supposition, and be interested in investigating its veracity with the ultimate goal of solving the bleaching sensitivity problem.

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				Z. N. Kain The Legend of the P Value Anesth. Analg., November 1, 2005; 101(5): 1454 - 1456. [Full Text] [PDF]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Croll, T. P. Search for Related Content PubMed Articles by Croll, T. P.