Effect of anti-inflammatory and analgesic drugs for the prevention of bleaching-induced tooth sensitivity: A systematic review and meta-analysis

Background. In-office dental bleaching results in a high risk of tooth sensitivity caused by the inflammatory process of the pulpal tissue. In this systematic review, the authors aimed to evaluate the effect of administering anti-inflammatory and analgesic drugs for the prevention of tooth sensitivity associated with in-office dental bleaching. Types of Studies Reviewed. The authors searched the databases MEDLINE via PubMed, Scopus, Web of Science, and Cochrane Library for clinical trials. They searched in ClinicalTrials. gov for unpublished trials. The authors included only randomized clinical trials comparing anti-inflammatory and analgesic drugs with a placebo and evaluating tooth sensitivity after in-office bleaching. They imposed no restrictions regarding publication dates or languages. Results. The authors identified 5,050 studies after the removal of duplicates. They qualitatively and quantitatively analyzed the 11 studies remaining after the title and abstract screening. Nine studies showed a low risk of bias. The authors found no effect of the drugs on the risk (9 studies evaluated this outcome). Using a visual analog scale, the authors identified a similar level of sensitivity evaluated up to 1 hour (10 studies evaluated this outcome) and 24 hours (8 studies evaluated this outcome). They observed similar results using the numeric rate scale (8 and 6 studies used this tool, up to 1 hour and 24 hours respectively). The Grading of Recommendations Assessment, Development, and Evaluation approach showed a high level of evidence for all outcomes. Conclusions and Practical Implications. The high level of evidence available does not support the administration of anti-inflammatory and analgesic drugs to prevent tooth sensitivity caused by in-office dental bleaching.