A randomized clinical trial investigating the effect of three vital tooth bleaching protocols on oral health-related quality of life

Abstract

Objectives: This study aimed to compare changes in oral health-related quality of life (OHRQoL) resulting from three vital tooth bleaching protocols. Methods: The participants (n = 105) were randomly assigned to one of three vital bleaching treatment groups: home bleaching (HB), in-office bleaching (IOB), or combined bleaching (CB). HB involved the use of custom-made trays and 10% carbamide peroxide for a 14-day treatment period. IOB utilized 37.5% hydrogen peroxide applied in three cycles. CB treatment involved the use of IOB followed by HB. Tooth colour change was evaluated using a shade guide (ΔVS) and a digital spectrophotometry device (ΔES). The Oral Health Impact Profile-14 (OHIP-14) and Oral Impact on Daily Performance-22 (OIDP-22) instruments were used to assess changes in OHRQoL at baseline, 15-days and 6-month recalls. Linear mixed models were used to estimate between- and within-group differences. Results: All bleaching protocols led to significant improvements in overall OHIP-14 scores at the 6-month recall (p ≤ 0.037). CB and IOB treatments were associated with more substantial positive impacts on overall scores, psychological discomfort, physical disability (CB only), and psychological disability (CB only) compared to HB (p ≤ 0.011). Significant enhancements in OIDP-22 scores were observed in the CB and HB groups at the 6-month recall compared to baseline (p ≤ 0.006), with evidence indicating that these improvements were greater in the CB group compared to the IOB group (p = 0.007). Conclusion: All bleaching treatments demonstrated a positive impact on OHRQoL. However, the positive impact was most consistent across domains and age groups in the CB group. The positive impact was less pronounced in older age groups.