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Results of this study should reassure dentists that nightguard vital bleaching is a safe, effective, and predictable method to lighten teeth. The whitening effect lasted up to 47 months in 82% of the patients, with no adverse side effects reported at the end of the study.

Bentley CD, Disney JA: A comparison of partial and full mouth scoring of plaque and gingivitis in oral hygiene studies, J Clin Periodontol 1995; 22: 151-135. © Munksgaard, 1995. Abstract, The clinical testing necessary to demonstrate the safety and efficacy of new toothbrushes is complex and expensive. Any moditication of methodology that could reduce complexity and cost without compromising quality would benefit both investigators and the public. Results from an 8-week toothbrush study were assessed for the use of partial as compared to full-mouth evaluations. The potential utility of an objective, minimally-invasive bleeding index for the evaluation of gingivitis was also tested. 2 partial evaluations, half-mouth and molar/anteriors, revealed decrements in modified gingival index (MGI), bleeding index and plaque index that were statistically significant and similar in rnagnitude to those derived from full-mouth examinations. % decrements in MGI and bleeding index based on the Ramfjord teeth were not significant statistically. Results for the new sulcular bleeding index were essentially similar to those for the MGL However, the bleeding index offered the advantage of improved objectivity for use in both white and non-white subjects. These results suggest that partial evaluations and the new bleeding index may be useful elements in the design of toothbrush efficacy studies.

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Purpose: The purpose of this study was to investigate the in vitro antibacterial effects of three different carbamide peroxide products (Nitewhite®, Opalescence®, and Proxigel®) on cariogenic microorganisms (mutans streptococci [MS] and lactobacilli), and to evaluate the effects of a 10% carbamide peroxide solution (Proxigel®) on salivary levels of MS and lactobacilli clinically. Materials and Methods: Growth inhibition studies were performed to determine the concentration and exposure time of carbamide peroxide to give total inhibition of recoverable growth of MS lactobacilli. Paraffin‐stimulated saliva samples were collected from subjects before and after 6 weeks of treatment with 10% carbamide peroxide in bleaching trays, and levels of MS and lactobacilli were determined. Results: The growth inhibition studies showed no visible growth of MS or lactobacilli at 24‐, 48‐, or 72‐hour incubation, after a 2‐hour exposure to 1% carbamide peroxide. Identical results were obtained with all three carbamide peroxide products. In the clinical study, the mean salivary MS levels, expressed as logarithm colony‐forming units per milliliter (CFU/mL), were 5.38 for the pretreatment samples and 5.23 for the post‐treatment samples. The differences were not statistically significant (p > .05). However, there was a reduction in logarithm lactobacilli counts from a mean of 4.12 pretreatment to a mean of 2.74 post‐treatment. This was statistically significant (p < .05). CLINICAL SIGNIFICANCE This study indicates that carbamide peroxide solution is bacteriostatic for MS and lactobacilli in vitro and could reduce salivary levels of lactobacilli in vivo. Ten percent carbamide peroxide solution, when used in nightguard vital bleaching, is an antimicrobial that may be useful as an anticariogenic agent.