Objectives: Direct-to-consumer tooth whitening systems use various devices and treatment regimens to deliver peroxide to the tooth surface. This 7-day clinical trial was conducted to evaluate the clinical response of a two marketed strip systems. Methods: A total of 52 healthy adults were randomized to either Oral-B® Rembrandt Whitening Strips (tab strips worn once daily for 5 days) or Crest® Whitestrips® Premium (10% hydrogen peroxide whitening strips applied twice daily for 7 days), following manufacturers written instructions. The maxillary arch was treated for 30 minutes per application, and all treatment was unsupervised. Efficacy was measured at baseline and Day 8 using L*a*b* color change collected from digital images of the anterior dentition. Tooth color change was compared between the treatment groups using analysis of covariance adjusting for baseline and age. Results: Age ranged from 18 to 81 with a mean of 36 years. Tobacco users accounted for 29% of the subjects. Groups were balanced for demographic and baseline tooth color. Day 8 adjusted means ± SE for Δb* (yellowness) were –0.96 ± 0.19 for the once daily group compared to –1.64 ± 0.21 for the twice daily group. Similarly for ΔL* (lightness), the Day 8 adjusted means ± SE were 1.03 ± 0.15 for the once daily group compared to 1.75 ± 0.16 for the twice daily group. Between-group comparisons showed significant (p < 0.05) improvement favoring the twice daily strips for Δb* and ΔL*. Both products were well tolerated. Conclusion: Head-to-head testing of the 10% hydrogen peroxide twice daily strips resulted in significantly whitening improvement relative to the once daily tab strips.

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