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At-home vs In-office Bleaching: An Updated Systematic Review and Meta-analysis.

J L de Geus, Acr Martins, A Reis

    Operative Dentistry
    |June 9, 2025
    PubMed
    Summary
    This summary is machine-generated.

    At-home bleaching offers lower tooth sensitivity intensity and greater color change (ΔE) compared to in-office treatments. However, the risk of sensitivity and overall bleaching efficacy (ΔSGU) showed no significant differences between methods, with low-quality evidence supporting these findings.

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    Area of Science:

    • Dental Aesthetics
    • Evidence-Based Dentistry

    Background:

    • Tooth bleaching is a common cosmetic dental procedure.
    • Both at-home and in-office bleaching methods are widely used.
    • Previous reviews have compared these techniques, necessitating an update with new evidence.

    Purpose of the Study:

    • To systematically review and meta-analyze the efficacy, risk, and intensity of tooth sensitivity for at-home versus in-office bleaching.
    • To update existing systematic review data with recent randomized clinical trials.

    Main Methods:

    • A comprehensive literature search was conducted across multiple databases (MEDLINE, EMBASE, Cochrane Library) and manual searches.
    • Included randomized clinical trials comparing at-home and in-office bleaching in adult patients.
    • Data were extracted, risk of bias assessed, and meta-analyses performed using standardized mean differences (SMD) and relative risks (RR).

    Main Results:

    • At-home bleaching demonstrated significantly lower tooth sensitivity intensity (SMD -0.78; p=0.04) and greater color change in ΔE (SMD 0.49; p=0.006).
    • No significant differences were found in the risk of tooth sensitivity (RR 0.82; p=0.19) or bleaching efficacy in ΔSGU (SMD 0.04; p=0.68).
    • A total of 32 studies were included for qualitative analysis, with 23 used for meta-analysis.

    Conclusions:

    • At-home bleaching may offer advantages in reduced sensitivity intensity and improved color change (ΔE).
    • The risk of tooth sensitivity and bleaching efficacy measured by ΔSGU were not significantly different between the two methods.
    • The overall quality of the evidence supporting these findings was considered low.