Tooth bleaching good for aesthetics but bad for oral hygiene: JOD

Tooth bleaching good for aesthetics but bad for oral hygiene, reported a study published in the Journal of Dentistry.

Teeth discoloration is common these days which has resulted in the widespread popularity of the tooth bleaching treatment. Tooth bleaching is the process of teeth whitening beyond their natural color. Hydrogen peroxide and carbamide peroxide are bleaching agents often used in tooth bleaching processes. Despite the benefits of tooth bleaching, its side effects are the main concern to the dentists as well as to the recipient of the treatment.

The systemic review published in the Journal of Dentistry revealed that while tooth bleaching treatment yields positive changes in young participants in aesthetic areas such as smiling, laughing, and showing teeth without embarrassment, it causes tooth sensitivity which is the main side-effect of tooth bleaching treatment and can affect the quality of life, and thus oral health.

The authors of the study have recommended clinicians to treat patients with care when providing bleaching treatment so as to obtain the best improvement in aesthetics with a minimal adverse side effect.

The study was conducted with the purpose of investigating changes in perceived quality of life following vital tooth bleaching. The authors did online searches (Medline, PubMed, the Cochrane database of systemic reviews and Google scholar) and bibliographic, and manual search for the meta-analysis of previously conducted studies on tooth bleaching. Two authors independently screened the 313 articles identified from the searches and two authors extracted data, including the risk of bias using the Cochrane data collection form. Random effects meta-analysis was used to estimate the pooled standardized mean difference (with 95% CI) and the 95% prediction interval.

The authors found that only four studies met the inclusion criteria, two showing statistically significant improvement, one worsening, and one inconclusive. The pooled standardized estimate for change in the quality of life after bleaching was 0.04 with substantial heterogeneity. Within these studies, there was a pattern of improvement in aesthetic-related domains (e.g. smiling and psychological discomfort) and deterioration in function-related domains (e.g. hygiene and pain).

The authors concluded that tooth bleaching was not associated with improvements in overall Oral Health-Related Quality of Life (OHRQoL) in these heterogeneous populations. Tooth bleaching appeared to impact some domains of OHRQoL positively and some negatively, indicating the need for clinicians to treat patients receiving bleaching treatment so as to obtain the best improvement in aesthetics with minimal side effects.

Lastly, the authors recommended that clinicians should be aware of the potential impact caused by tooth sensitivity and offer proper instruction to prevent it or treatment to reduce its impact.

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https://doi.org/10.1016/j.jdent.2019.03.007