case_images: PMC10837807_01
case_images: A. Whitening gel provided by the dentist for self-administration. B. gel provided by the dentist for relieving the pain elicited by the bleaching procedure. C. Thermoformed trays provided by the dentist for the application of the bleaching agent.
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case_images: PMC10837807_01_jced-16-e90-g001.jpg
case_images: F1
case_images: On 05/05/2021, she started a whitening procedure, provided by her dentist, consisting of the daily application of 10% carbamide peroxide gel (Fig. 1A) in thermoformed trays (Fig. 1C,D.). She consulted her dentist who prescribed Elugel  (a water-based gel containing glycerin, sorbitol, hydroxymethyl cellulose, benzyl alcohol, carmine (CI 75470), chlorhexidine digluconate, aroma, glucose, limonene, sodium hydroxide) and a gel containing 0.1 % fluoride ions and 6 % potassium nitrate (Fig. 1B), without any noticeable improvement. Upon examination, the trays given by the dentist (Fig. 1C,D.) covered the gingival margins and therefore allowed the spreading of the bleaching gel on the soft tissues.
case_images: Translated DN4 questionnaire filled at the pain consultation. The total score was 5/10. The DN4 is used as a diagnostic tool and the cut-off for neuropathic pain is 4 (3).
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case_images: PMC10837807_01_jced-16-e90-g002.jpg
case_images: F2
case_images: The DN4 questionnaire score was 5/10 (Fig. 2).
case_images: Photographic views of extra and intraoral tissues.
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case_images: PMC10837807_01_jced-16-e90-g003.jpg
case_images: F3
case_images: Clinical examination (Fig. 3) revealed no cutaneous, mucosal, dental, or periodontal lesion.
case_images: A. Panoramic radiography. B. Retroalveolar radiography teeth 32-43. C. Retroalveolar radiography, teeth 32-34.
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case_images: PMC10837807_01_jced-16-e90-g004.jpg
case_images: F4