Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching A systematic review and meta-analysis

Background. Tooth sensitivity associated with bleaching remains a challenge for clinicians. Inflammatory mediators released by the penetration of bleaching agents into dental tissues can sensitize nociceptors, leading to tooth sensitivity. Type of Studies Reviewed. In this systematic review, the authors included randomized clinical trials in which the investigators compared the preventive use of nonsteroidal anti-inflammatory drugs (NSAIDs) with a placebo for sensitivity after dental bleaching. The authors included only studies in which the investigators evaluated in-office tooth bleaching with high-concentration hydrogen peroxide and reported the risk or the level of tooth sensitivity after bleaching. Results. The authors included 3 studies and evaluated the levels of sensitivity reported at up to 1 hour after the procedure and from 1 to 24 hours after bleaching. The authors also calculated the pooled relative risk for the effect of preventive use of NSAIDs on sensitivity after dental bleaching. Preventive analgesia with NSAIDs did not have a significant effect on the risk of sensitivity after dental bleaching or on the levels of sensitivity reported by patients. Practical Implications. There is insufficient evidence about the use of NSAIDs to prevent tooth sensitivity caused by in-office bleaching procedures.