THE SPECIALIST

When bleaching vital teeth should desensitizing agents be used prophylactically and if so which one is preferred?

By Dr. Barry H. Korzen

The bleaching of teeth with vital pulps is a commonly accepted procedure but is often associated with tooth sensitivity as well as changes to the mineralization of the tooth and the efficacy of bonding procedures.

A review of the literature carried out by Po and Wilson and published in June 2014 in the European Journal of General Dentistry concluded “Most desensitizing agents may help to reduce the duration and intensity of tooth sensitivity caused by dental bleaching. Desensitizing agents may also limit changes in enamel morphology and surface hardness caused by bleaching and promotes the remineralization of bleached enamel and dentine.

The inclusion of desensitizing agents in bleaching agents may allow a patient to continue and complete a bleaching treatment with relatively little sensitivity and other side-effects. Of the desensitizing agents tested to date, potassium nitrate would appear to offer the greatest advantage. It is suggested that further research is required to investigate the inclusion of different desensitizing agents in bleaching materials and regimens.” (Emphasis added)

The authors’ abstract appears below and the complete paper can be accessed by clicking here

Abstract

The objective of this paper was to bring together and summarize the available information on the effects of different desensitizing agents on bleaching treatments. Information from all scientific papers and reviews identified in the Institute for Scientific Information Web of Science and PubMed using the search terms: Bleaching, whitening, brightening or color and desensitizing, fluoride, potassium nitrate, or amorphous calcium phosphate was included in the data collected and synthesized to produce the summary of findings and recommendations. The use of desensitizing agents in bleaching treatments may limit or control sensitivity, promote remineralization, increase enamel microhardness, and enhance the efficacy of the bleaching treatment. The use of desensitizing agents may exert a positive influence on the outcome of bleaching treatments.

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