What is the difference between hydrogen-peroxide (HP) and carbamide-peroxide (CP) products commonly used for take-home tooth whitening?  Take the short quiz below to test your knowledge, and discern between fact and some common misperceptions. 

1.     CP requires longer daily wear-time. (Fact or Fiction)

2.     CP gels are stronger since they are available in higher percentages. (Fact or Fiction)

3.     CP products are safer to use than HP products. (Fact or Fiction)

4.     HP products are unstable and have shorter shelf lives. (Fact or Fiction)

5.     Most tooth-whitening gels achieve the same results. (Fact or Fiction)

Answers:

1. CP requires longer daily wear-time.

Fact! All whitening gels eventually break down into water, oxygen, and the perhydroxyl anion. HP products begin this break down process immediately while the CP products have an added step in their break down process. CP first must break down into urea and H2O2.  For this reason, HP products only require ½ hour of wear-time per treatment while CP products require 2-3 hours for complete breakdown.

2. CP gels are stronger since they are available in higher percentages.

Fiction! Since the CP products initially break down into urea and H2O2 to be effective, a 10% CP product is equivalent to a 3% HP product.  Rule of thumb: the listed percentage on a HP product is equivalent to a CP product with a listed percentage 3.3 times higher.
3% HP = 10% CP
6% HP = 20% CP
9% HP = 30% CP

3. CP products are safer to use than HP products.

Fiction! Perfecta Bravó, a 9% HP formulation, was tested with a 16% CP formulation to specifically evaluate this issue. When used correctly, it was proven there is no more pulpal or gingival sensitivity when using Bravó than with a 16% CP.  This is significant, considering the substantially higher percentage of active ingredient in Bravó.*

4. HP products are unstable and have shorter shelf lives.

Fiction! Most manufacturers would like for you to believe that. However, Premier 's Perfecta Bravó is a patented water-based formula that contains 9% H2O2, yet has a shelf life of 2 years without refrigeration. Other Hydrogen Peroxide products are very unstable and without refrigeration they begin to break down within a year. This can be witnessed by the amount of bubbles that form in the syringe. The bubbles indicate the hydrogen peroxide is breaking down.

5. Most tooth-whitening gels achieve the same results.

Fact! If used as intended, at the end of a 2-week treatment, patients using CP products will achieve the same level of whiteness as patients using HP products. Therefore, choosing the right product for your patients depends on their lifestyle, their age, and their dental-treatment needs. Compliance is the key to success. Perfecta's complete line of tooth-whitening products - carbamide peroxide in 11%, 16%, 21% concentrations and Trio (11, 13 and 16% in one Patient Pak) as well as Perfecta Bravó 9% and Perfecta Ultra 6% Hydrogen Peroxide – provide you with sufficient choices to meet the needs of all your patients.

* Clinical Evaluation of the Bleaching Efficacy of Two Concentrations, Shelia H. Koh, DDS, FAGD UTHUS-Dental Branch, July 2002.
A Clinical Evaluation of Carbamide Peroxide and Hydrogen Peroxide Whitening Agents During Daytime Use, Ghassen Mokhlis, DDS, MSD; Bruce Matis, DDS, MSD; Michael Cochran, DDS, MSD; George Eckhart, MAS, JADA Sep 2000 Vol. 131