Objective: It has been suggested that bleaching of vital teeth might cause considerable pain during treatment with customized bleaching trays. The aim of the present study was to evaluate subjective intensities of pain during treatment of vital teeth with carbamide peroxide containing agents.

Methods: Thirty patients were treated for one week in a double-blind study design. Employing gels containing 17% and 10% (test groups) or 0% (control group) carbamide peroxide as bleaching agent, patients had to wear bleaching splints for two hours per day. Directly after application, patients had to describe subjective intensities of pain while wearing the splints by means of a visual analog scale ranging from "0" (no pain) up to "10" (high pain). Patients were advised to disregard any inconvenience caused by the splints themselves, and to consider only pain caused by the bleaching gel and affecting the teeth. For statistical analysis, Shapiro-Wilk with subsequent ANOVA and comparison of mean values (Scheffé) were used.

Results: Intensities of pain depended upon the concentration of carbamide peroxide and did not change during the one week treatment period within each group (p>0.05). Employing the 17% gel, the highest value for pain intensity could be observed (3.9 ± 2.2 U) with statistical difference to the lower value during use of the 10% gel (2.5 ± 2.2 U). Both test groups differed significantly from the control group (0.8 ± 1.0 U, p<0.05).

Conclusion: The present study indicates that the application of carbamide peroxide containing bleaching agents to vital teeth causes pain during the treatment. As higher concentrated gels cause more discomfort, it is prudent to assign the bleaching agent's concentration to the patient's individual objective concerning treatment outcome.

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