Bleaching in vital teeth: A systematic review

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 which treatments are most effective and stable over time, and on which ones give greater dental sensitivity during the whitening treatment, this being the main adverse effect of the treatment. The objective of this review was 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 undergoing whitening treatment, in order to evaluate which is the most effective and safest whitening approach for patients. 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 related to the studies included in this review have shown that they can produce satisfactory post-treatment whitening efficacy and, albeit with less data available, also in the long term; furthermore, dental sensitivity is present in the first days of application, and tends to disappear after a few days, and its intensity is generally mild to moderate for all the whitening techniques tested. For a better evaluation of the stability over time with the different techniques, it could also be useful to check the eating habits of the patients since the diet could be an important factor that influences the extrinsic staining of the teeth; it is necessary to undertake further research into desensitizing protocols that can further improve patient comfort.