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White diet is not necessary during dental bleaching treatment: A systematic review and network meta-analysis of
Eliseu Aldrighi Münchow1, Walkiria Schereschewsky Távora2, Henrique Tedesco de Oliveira3
1Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos 2492, Porto Alegre, RS 90035-003, Brazil; Department of Conservative Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Objectives:
This systematic review with network meta-analysis (NMA) answered whether a white diet is necessary during dental bleaching and if there was any coloring food impacting more significantly the bleaching potential.
Data Sources:
The review followed the PRISMA Extension Statement for NMA. Six electronic databases and gray literature were searched until April 2024.
Study Selection:
The eligibility criteria considered clinical trials comparing the bleaching efficacy in participants that followed a white diet (control) and those who had either a supplemented intake of pigments or an unrestricted diet. Risk of bias was assessed using RoB2 (randomized clinical trials/RCT) and ROBINS-I (non-randomized clinical trials/NRCT), and the quality of evidence was checked using GRADE. Color change data were compared using both standard pairwise meta-analysis (SPMA) and Bayesian NMA.
Results:
From 1051 records, seven studies were included in the review (four RCT, three NRCT). All studies were classified as having low risk of bias. Regarding NMA, the control group achieved similar color change than the other groups that received pigment supplementation with grape juice, coffee, tea, wine, cola, or an unrestricted diet (p>0.05). The GRADE analysis revealed a moderate quality of evidence.
Conclusions:
The consumption of soft cola, coffee, black tea, grape juice, and red wine, as well as the consumption of a totally unrestricted diet, do not have a significant influence on the effectiveness of bleaching as compared to a white diet regimen.
Clinical Significance:
The accumulated evidence suggests that restricting the intake of dietary pigments during dental bleaching is not essential.
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