In the Indiana University studies, pooled saliva and
whitening gels were used to simulate actual use. The
calcium peroxide/carbamide peroxide gel mixture of
Forte was compared to a pooled saliva mixture.
Remineralization was determined by comparing the
surface hardness and calcium mineral uptake within the
body of incipient lesions in tooth enamel before and
after treatment. The surface hardness increase using
Forté was more than double the hardness increase
achieved using saliva. The mineral content increase
within the incipient lesion was 33,000 μg of calcium/g
of enamel within 100 μm depth of the subsurface body
of the lesion, about a 15% increase in mineral content.
There was no mineral content increase within the body
of the incipient lesion with the saliva-only treatment.
Sensitivity
The same mechanism that promotes remineralization
of teeth with precaries lesions, as found in the
Indiana University study, also reduces tooth sensitivity.
When the 9 dentists and hygienists who participated in
this evaluation were asked about the importance of
sensitivity reduction with purchasing a whitening system,
they all said it was very important to important.
The evaluators were then asked to rate Forté on its
ability to eliminate sensitivity. Six evaluators rated the
whitening system as excellent and 3 rated it as very
good. One evaluator said, “Two patients who used this
product did have sensitivity but not to the degree [they
had] with other products.” Another evaluator reported
“absolutely no sensitivity.”
Gingival Irritation
When asked to rate their patients’ experiences
with gingival irritation when using Forté, 5 rated the
product as excellent, 2 rated it as very good, and 2
rated it as good. One evaluator said, “My patients
did not experience ulcers, but they did have some
sensitivity to sulcular brushing during the testing
period. Nothing that would inhibit the process
though.” Another evaluator reported “slight gingival
discomfort if not wiped off gingival tissues—but
doesn’t last once removed.” A third evaluator said
that his patients reported no gingival irritation at all.
Efficacy of Whitening
According to the manufacturer, the 14% calcium
peroxide and 30% carbamide peroxide formulation of
Forté whitens teeth fast. When the evaluators
were asked to rate the product on
whitening efficacy, 3 rated it as excellent
and 6 rated it as very good. One evaluator
said that his patients “experienced
immediate whitening…They were very
satisfied. One reported a difference after
the first [application].” Another evaluator
said that the “initial results are very
promising.”
Other Comments
In addition to gel viscosity, sensitivity
reduction, gingival irritation, and
whitening efficacy, the evaluators were
also asked to rate Forté on efficacy of
whitening tetracycline-stained teeth,
whitening of teeth with white spots,
length of whitening, and effect on
“sticky” areas. Unfortunately, many of
the evaluators did not have an opportunity
to treat patients with tetracycline
stains, white spots, or sticky areas, and
the length of the evaluation wasn’t conducive
to commenting on long-term
results. For that reason, the scores for
these items are not included. However,
of those few evaluators who did treat
patients with white spots, they all rated
Forté as excellent to good. One evaluator
said, “One of my patients had a
small amount of hypoplasia and the
lesion was muted quite nicely.”
With regard to Forté’s effect on
“sticky” areas, one evaluator said, “I
didn’t witness any of this first hand, but
I did have a patient who has a thin,
‘translucent’ look to her upper anterior
teeth…like an acidic type of wear (she
is a wine drinker). [The patient] noticed
an improvement in the luster of her
enamel and so did I.” Another evaluator
said, “Since my patient’s white spot
lesions muted nicely, I have to assume
there is remineralization occurring. It’s
just a bit too soon to tell.”
Overall Satisfaction
When the evaluators were asked how
Forté compares to similar whitening systems
offered by other manufacturers, all 9
said it is much or somewhat better. When
asked if they would recommend Forté to
colleagues, they all said definitely or
probably. Seven of the evaluators said
they would definitely or probably purchase
the whitening system in the future.
With regard to overall satisfaction
with Forté, 8 evaluators rated the system
as excellent to very good and 1 rated it as
good. One evaluator said that his
patients “loved the no sensitivity.”
Another evaluator described his “initial
results [with Forté] very promising.”
Reference
1. Schemehorn BR, Novak ED. Use of a calcium
peroxide whitening agent for remineralization
and recalcification of incipient lesions. J Clin
Dent. 2007;18:126-130.
