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
no estimate extracted
3 studies
GRADE not reported
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
no estimate extracted
5 studies
GRADE not reported
Enamel microhardness / caries susceptibility · Permanent teeth / enamel specimens (in vitro)
Low-quality in vitro evidence found no support for adding lasers to in-office bleaching; laser-activated bleaching did not appear to affect enamel microhardness or caries risk versus conventional bleaching (ungraded).
1 finding from 1 review
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
no estimate extracted
4 studies
GRADE not reported
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
Patient/dentist satisfaction · Patients with dental fluorosis
Patient/dentist satisfaction did not differ between bleaching-then-infiltration and infiltration alone (SMD -1.53, 95% CI -4.75 to 1.70; ungraded).
1 finding from 1 review
SMD -1.53 [-4.75, 1.70]
2 studies
GRADE not reported
Masking effect (esthetic improvement) · Patients with dental fluorosis
Bleaching before resin infiltration did not improve masking of fluorosis compared with infiltration alone (MD -0.30, 95% CI -0.98 to 0.39; moderate certainty).
1 finding from 1 review
MD -0.30 [-0.98, 0.39]
2 studies
Moderate
Caries susceptibility, enamel demineralisation, erosion, or microhardness · Permanent teeth / enamel specimens (in vitro)
Low-quality in vitro evidence suggests that bleaching of permanent teeth does not increase susceptibility to caries, demineralisation or erosion (ungraded); the clinical question could not be answered because only in vitro studies were available.
1 finding from 1 review
Colour change / camouflage of white spot lesions (reduction of colour disparity between carious and sound enamel) · Permanent teeth with post-orthodontic white spot lesions (orthodontic patients and in vitro enamel specimens)
Bleaching may diminish colour disparities and camouflage post-orthodontic white spot lesions, but the certainty of the evidence is very low; the findings could neither support nor refute bleaching.
1 finding from 1 review
Whitening (bleaching) efficacy · Demineralised / white-spot-lesion enamel (in vitro specimens)
Low-quality in vitro evidence indicates that adding fluoride or other remineralising agents does not impair the whitening/bleaching effect (ungraded).
1 finding from 1 review
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