Vital and non-vital tooth bleaching may be a safe procedure for children and adolescents, offering effective color change with minimal side effects. This study was published in May in the Journal of Dentistry.
However, the bleaching techniques, agents, and concentrations that are most effective don’t have consensus, the authors wrote.
“Tooth bleaching of vital teeth is a safe and effective treatment in children and adolescents,” wrote the authors, led by CĂntia Mayara Medeiros Teixeira Lopes of the Federal University of Rio Grande do Norte (J Dent, May 1, 2025).
For this review, 40 studies involving 1,042 patients ages 3 to 18 using bleaching agents such as hydrogen peroxide (6% to 36%), carbamide peroxide (10% to 44%), sodium perborate, 5% sodium hypochlorite, and a McInnes solution delivered via in-office treatments, at-home kits, over-the-counter strips, walking bleach, or inside/outside techniques were analyzed.
The studies demonstrated that higher concentrations of bleaching agents, such as 9.5% hydrogen peroxide, often resulted in a more significant color change but also increased sensitivity. While higher concentrations generally yielded better results, the differences were not always statistically significant. In cases of moderate fluorosis, the combination of bleaching and enamel microabrasion was most effective, they wrote.
Furthermore, most studies revealed that sensitivity was mild and transient, though two reported that some patients discontinued treatment due to discomfort, particularly with over-the-counter strips and at-home bleaching. Gingival irritation was more common with higher concentrations of hydrogen peroxide and with at-home or over-the-counter products.
Nevertheless, this study had limitations. The included studies lacked standardization in assessing tooth color change after bleaching, the authors noted.
“Based on the synthesis obtained in the present scoping review, both vital and non-vital bleaching with at-home or in-office techniques, over-the-counter strips, walking bleach, internal and external bleaching, and inside/outside techniques appear to be effective and safe bleaching treatments for achieving a brighter smile in children and adolescents with minimal side effects,” they concluded.
