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Evidence found and GRADE certainty

113 questions · 141 findings · 6 reviews · Esthetic dentistry

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No studies found 16 · 11.3%GRADE not reported 64 · 45.4%Very low 54 · 38.3%Low 7 · 5%Moderate 0 · 0%High 0 · 0%

Bleaching vs No bleaching (untreated control)

Caries susceptibility, enamel demineralisation, erosion, or microhardness · Permanent teeth or extracted human teeth with artificial lesions

The laboratory studies did not find increased susceptibility to caries or enamel demineralisation, but no firm conclusions can be drawn because of high risk of bias.

1 finding from 1 review

Tooth bleaching (combined in-office and home bleaching) vs No bleaching (untreated control)

Patient satisfaction (measured by patient satisfaction or aesthetic scales) · Patients with post-orthodontic white spot lesions and permanent dentition

In the single RCT, all bleached patients were satisfied with the aesthetic outcome, though the trial was at high risk of bias (ungraded).

1 finding from 1 review

Bleaching vs No bleaching or alternative control

Colour disparity between carious and non-affected enamel · Permanent teeth with post-orthodontic or artificial white spot lesions

Bleaching may diminish colour disparities between carious and non-affected areas (very low certainty).

1 finding from 1 review

Bleaching gel with added remineralising agent (fluoride, calcium, or CPP-ACP) vs Bleaching alone (no remineralising agent)

Enamel resistance to demineralization (microhardness / lesion depth) · Extracted human teeth with early/artificial enamel lesions (in vitro)

Low-quality in vitro evidence suggests remineralising additives may reduce mineral loss, but no firm conclusion can be drawn.

1 finding from 1 review

Bleaching gel with added remineralising agent (fluoride, calcium, or CPP-ACP) vs Bleaching alone (no remineralising agent)

Enamel mineral loss / remineralisation · Demineralised / white-spot-lesion enamel (in vitro specimens)

Low-quality in vitro evidence indicates that adding fluoride, calcium or CPP-ACP to bleaching agents can reduce enamel mineral loss (ungraded).

1 finding from 1 review

6% HP strip vs 10% CP gel in tray

Tooth whitening - assessed by the dentist · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 6% HP strip changes tooth whitening - assessed by the dentist compared with 10% CP gel in tray (very low certainty).

2 findings from 1 review

5.3% HP strip vs 5% HP gel in tray

Patient comfort / acceptability · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 5.3% HP strip changes patient comfort / acceptability compared with 5% HP gel in tray (very low certainty).

1 finding from 1 review

10% CP gel in tray vs placebo

Tooth whitening - assessed by the dentist · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 10% CP gel in tray changes tooth whitening - assessed by the dentist compared with placebo (very low certainty).

4 findings from 1 review
Show 1 more finding

5.6% SHMP chewing gum vs placebo

Tooth whitening - assessed by the dentist · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 5.6% SHMP chewing gum changes tooth whitening - assessed by the dentist compared with placebo (very low certainty).

1 finding from 1 review

6% HP paint-on gel + KF vs 6% HP paint-on gel

Tooth whitening - assessed by the dentist · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 6% HP paint-on gel + KF changes tooth whitening - assessed by the dentist compared with 6% HP paint-on gel (very low certainty).

1 finding from 1 review

18% CP paint-on gel vs placebo

Tooth whitening - assessed by the dentist · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 18% CP paint-on gel changes tooth whitening - assessed by the dentist compared with placebo (very low certainty).

1 finding from 1 review

6% HP gel in tray vs placebo

Tooth whitening - assessed by the dentist · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 6% HP gel in tray changes tooth whitening - assessed by the dentist compared with placebo (very low certainty).

1 finding from 1 review

CP gel in tray vs placebo

Adverse effects · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)
1 finding from 1 review

6% HP strip vs 10% CP gel in tray

Tooth whitening - reported by the patient · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

6% HP strip showed no clear difference in tooth whitening - reported by the patient compared with 10% CP gel in tray; GRADE not reported.

1 finding from 1 review

5.9% HP strip vs 5.9% HP paint-on gel

Tooth whitening - reported by the patient · Adults (>=18 years) undergoing home-based bleaching (including tetracycline- and smoking-stained teeth, any baseline shade)

It is very uncertain whether 5.9% HP strip changes tooth whitening - reported by the patient compared with 5.9% HP paint-on gel (very low certainty).

1 finding from 1 review