Bleaching in vital teeth: a systematic review

Abstract

There are mainly three approaches by which teeth whitening treatments can be carried out: in-office,at-home and via over-the-counter (OTC) products. There are conflicting opinions in the literature on whichtreatments are most effective and stable over time, and on which ones give greater dental sensitivity duringthe whitening treatment, this being the main adverse effect of the treatment. The objective of this reviewwas to evaluate the efficacy of post-treatment whitening (primary outcome), its stability after several weeks(secondary outcome) and the prevalence of dental sensitivity (tertiary outcome) in patients undergoingwhitening treatment, in order to evaluate which is the most effective and safest whitening approach forpatients. The following systematic review was conducted on the basis of the indications of the Prisma protocol;10 studies were identified through literature searches on the PubMed database. The various procedures relatedto the studies included in this review have shown that they can produce satisfactory post-treatmentwhitening efficacy and, albeit with less data available, also in the long term; furthermore, dental sensitivity ispresent in the first days of application, and tends to disappear after a few days, and its intensity is generallymild to moderate for all the whitening techniques tested. For a better evaluation of the stability over time withthe different techniques, it could also be useful to check the eating habits of the patients since the diet couldbe an important factor that influences the extrinsic staining of the teeth; it is necessary to undertake furtherresearch into desensitizing protocols that can further improve patient comfort.