What do systematic reviews say?

4 questions · 4 findings · 1 reviews · Esthetic dentistry

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No studies found 0 · 0%GRADE not reported 4 · 100%Very low 0 · 0%Low 0 · 0%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

Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. 2020 All outcomes
Varied or not stated · laboratory setting
no estimate extracted
5 studies
GRADE not reported

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

Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. 2020 All outcomes
28 days · Orthodontic patients (Knösel 2007 RCT, Germany)
All patients in the bleaching group were satisfied with the outcome; the patients were pleased with the aesthetic outcome of bleaching (Knösel 2007).
1 study · 10 participants
GRADE not reported

Tooth bleaching (carbamide or hydrogen peroxide; home and/or in-office) vs No bleaching (untreated or pH-cycling control)

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

Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. 2020 All outcomes
In vitro laboratory studies
Four studies at high risk of bias and one study at moderate risk reached the overall conclusion that neither home- nor in-office bleaching of permanent teeth was associated with an increased susceptibility to…
5 studies
GRADE not reported

Tooth bleaching (carbamide or hydrogen peroxide; home and/or in-office) vs No bleaching (untreated control)

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

Is Bleaching Effective in Managing Post-orthodontic White-spot Lesions? A Systematic Review. 2020 All outcomes
Orthodontic patients (Knösel 2007 RCT, Germany) and in vitro laboratory studies
The results showed that bleaching of WSL can diminish colour disparities between carious and non-affected areas, but the certainty of the evidence was very low.
3 studies
GRADE not reported