Changes in quality of life induced by tooth whitening are not influenced by global self-esteem: a randomized double-blind placebo-controlled trial


The purpose of this paper is to investigate which elements of tooth colour are most influenced by whitening and to identify the short-term changes in satisfaction with smile aesthetics and quality of life induced by tooth whitening and the role of global self-esteem. Sixty participants were randomly assigned to a treated or a placebo group (each group N = 30). Their anterior teeth were bleached with a photo-activated whitening gel, or subjected to a placebo. Lightness, chroma and the translucency of teeth were assessed before and 1 week after the procedure using a spectrophotometer. The Self-Esteem Scale, Psychosocial Impact of Dental Aesthetics Questionnaire, the Orofacial Aesthetic Scale and the Oral Health Impact Profile were administered to subjects. Changes in colour and chroma were greater in the treated than the placebo group (3.8 ± 1.5 vs. 1.7 ± 1.5 and − 3.2 ± 1.5 vs. 0.0 ± 1.1; p < 0.001). The treated group reported increased satisfaction with appearance and a decrease in psychological and social impacts (p < 0.05). In the placebo group there was no objective change in colour but the subjects reported an increase in satisfaction and dental self-confidence, as well as a decrease in psychological impact (p < 0.05). Self-esteem did not have a moderation nor a mediation effect. In conclusion, patients are not able to accurately detect the colour change induced by tooth whitening after 1 week, but they are also largely suggestible when evaluating the changes in quality of life. Changes in quality of life induced by tooth whitening are not influenced by global self-esteem. Identifier NCT03380702.

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Financed by University of Rijeka Grant no: and uniri-biomed-18-22.

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Correspondence to Daniela Kovacevic Pavicic.

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Kovacevic Pavicic, D., Kolceg, M., Lajnert, V. et al. Changes in quality of life induced by tooth whitening are not influenced by global self-esteem: a randomized double-blind placebo-controlled trial. Odontology 108, 143–151 (2020).

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  • Colour
  • Perceptions
  • Life quality
  • Tooth bleaching
  • Self-esteem