Everyday we hear more and more about bleaching treatments in the dental office. What scientific evidence exists about its effectiveness?

A recent survey reported a high percentage of dentists offer bleaching services in-office. Even though the rate of usage suggests effectiveness, there is always doubt about the scientific support on the advantages some companies claim their products have.

Bleaching in the dental office was the first accepted method of teeth whitening. When at-home bleaching materials started to be developed, they gradually supplanted, in a high percentage of dental offices, the in-office bleaching techniques. Recently, however, there has been a marked increase in publicity and marketing of in-office bleaching, with a particular emphasis in light or laser application to improve the procedure.

Numerous studies have indicated that the use of light for its activation has almost no effect in the bleaching procedures with various in-office materials. Only one published clinical study has compared the efficacy of at-home with in-office bleaching. The study compared one at-home bleaching product with one in-office.
The at-home product, used for 2 weeks, was signifcatively more effective than the in-office product, used 3 times in 3 different appointments.

At the Department of Clinical Research of Indiana University School of Dentistry, a pilot study has been finished with 8 of the most frequently used in-office products. None of the products was as effective, at any stage, than a 10% carbamide peroxide used at-home for 2 weeks.

Surveys have been done to determine the acceptance response of at-home and in-office bleaching procedures. Surveyed dentists responded that 73% were "very satisfied" with at-home treatments. In contrast, only 40% were "very satisfied" with in-office bleaching results.

Is there a place for in-office bleaching procedures? Of course! it is an accepted bleaching procedure for those patients that need a fast bleaching of their teeth or for those that do not want to use the "mouth guards", celluloid strips or other products. However, when the dentist uses an in-office bleaching product, he (she) must recommend the use of an at-home product to improve the bleaching result.