Related Experiment Video
Updated: Sep 19, 2025
Confocal Time Lapse Imaging as an Efficient Method for the Cytocompatibility Evaluation of Dental Composites
Published on: November 9, 2014
Effect of at-home bleaching agents and concentrations on tooth sensitivity: A systematic review and network
Renata Maria Oleniki Terra1, Michael Willian Favoreto2, Tom Morris3
1Department of Restorative Dentistry, School of Dentistry, State University of Ponta Grossa, Uvaranas, Ponta Grossa, PR, Brazil.
Introduction/Objectives:
This systematic review and network meta-analysis (NMA) evaluated the risk and intensity of tooth sensitivity (TS) of at-home bleaching agents and concentrations in patients with permanent dentition (PROSPERO 2021 CRD42021265220).
Data:
Randomized clinical trials (RCTs) comparing any two at-home bleaching systems were considered eligible. A Bayesian NMA assessed TS risk and intensity for different hydrogen peroxide (HP) and carbamide peroxide (CP) concentrations, using two pain scales: the 0-10 Visual Analog Scale (VAS) and the 0-4 Numerical Rating Scale (NRS). The risk of bias (RoB) was assessed using the Cochrane Collaboration's tool 2.0, and the quality of evidence (QoE) was evaluated by the GRADE approach.
Sources:
A comprehensive search was conducted in PubMed, Cochrane Central, LILACS/BBO, SCOPUS, Web of Science, EMBASE, and grey literature.
Study Selection/Results:
77 studies were included, and 50 of these were eligible for meta-analysis. Most studies had high RoB. The NMA showed a higher TS risk with CP 20-22 % and HP 14-16 % compared to HP 2-4 % (RR [95 % CrI]: 2.8 [1.15-8.16], 2.9 [1.06-9.21]) and CP 20-22 % vs. CP 10-11 % (2.0 [1.07-4.31]). On the NRS scale, CP 20-22 % (MD [95 % CrI]: 0.51 [0.14-0.91]) and HP 7-8 % (0.50 [0.10-0.84]) had greater TS intensity than CP 10-11 %. No statistically significant differences were found on the VAS scale. The QoE was low.
Conclusions:
High at-home bleaching concentrations increase the risk and intensity of TS. On average, TS is mild for all bleaching agents and concentrations. The findings should be interpreted cautiously due to the low QoE and variability in the study protocols.
Clinical Significance:
At-home bleaching agents typically cause low tooth sensitivity. However, higher concentrations, such as HP 14-16 % and CP 20-22 %, may slightly increase the risk compared to lower concentrations like CP 10 %, and should be prescribed with care and under closer supervision.
More Related Videos
Related Concept Videos
01:24Local Anesthetics: Differential Sensitivity of Nerve Fibers
01:12Local Anesthetics: Adverse Effects
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
01:18Effects of EDTA on End-Point Detection Methods
In the visual method, metal-ion indicators (metallochromic dyes), which have distinct colors in their free and complex forms, are added to the mixture to signal the titration's end point. They form stable complexes with metal ions, but these complexes are weaker than the corresponding metal–EDTA complexes. As a...
01:21Tooth Anatomy
The Crown, Neck, and Root
The visible part of the tooth is referred to as the crown. It's covered by enamel, the hardest substance in the human body. The crown is uniquely shaped for each type of tooth, allowing for different functions such as cutting, tearing, or...
01:23Local Anesthetics: Mechanism of Action
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...