Effectiveness of Different Desensitizing Agents on In-office Tooth Whitening: A Systematic Review and Meta-Analysis

Abstract

Introduction: Teeth whitening is the most sought after aesthetic conservative treatment by patients, however, one of the side effects is the sensitivity caused by the technique. To promote the reduction of post-bleaching sensitivity, different presented and systemic protocols were presented. However, it is clear that there is still no desensitizer that controls tooth sensitivity during and after bleaching. Objective: To summarize the available evidence on the efficacy of desensitizing agents on dentin sensitivity following tooth whitening. Sources: On September 04, 2021, a comprehensive search of MEDLINE via PubMed, EMBASE, LILACS (Latin American and Caribbean Health Sciences Literature), LIVIVO, SCOPUS, Web of Science, and the gray literature by Google Scholar was performed. Study Selection: After removal of duplicates, title, and abstract screening by two reviewers (performed in the Rayyan tool for systematic reviews), 13 articles were included, selected only blinded randomized clinical trials, which present patients with discolored teeth submitted to in-office and/or home tooth whitening and desensitizing agents used. The following data were collected: authors, year of publication, objectives or research questions, desensitizing agent, number of participants, number of groups, control group description, study group description, whitening approach, outcomes evaluated, main results, main conclusions, the scale used for outcome measurement, risk of tooth sensitivity (outcome), statistical test used, odds ratio/IC results, dentin sensitivity intensity analysis (intergroup statistical test), dentin sensitivity intensity analysis (intragroup statistical test), and maximum analysis time. After applying readability criteria, a total of 11 articles were deemed suitable for inclusion in the meta-analysis. The overall analysis demonstrated a statistically significant difference in the impact of desensitizing agent use, with lower dental sensitivity scores observed compared to placebo treatment (p = 0.036, 95% CI: -0.273; -0.009). Conclusion: Based on the findings of this study, it was possible to verify that the desensitizing agents acted significantly reducing tooth sensitivity and the odds-ratio of patients submitted to in-office tooth whitening.