Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

76 questions · 85 findings · 2 reviews · Esthetic dentistry · All outcomes

No studies found 7 · 8.2%GRADE not reported 25 · 29.4%Very low 50 · 58.8%Low 3 · 3.5%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

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

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

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
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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