In-office Bleaching Technique Research Articles

Comparison of in-office and at-home bleaching techniques: An umbrella review of efficacy and post-operative sensitivity

ObjectivesThe objective of this umbrella review is to evaluate the efficacy and adverse effects of different teeth whitening techniques in-office (IO) and at-home (AH), regarding chromatic changes and teeth sensitivity. Materials and methodsThe search was carried out from several databases. The included studies were all systematic reviews with or without meta-analysis of RCT or quasi-RCT. The participants were patients that underwent external dental bleaching in permanent vital teeth. The interventions were in-office (IO) bleaching techniques and at-home (AT) bleaching techniques with different bleaching agents and concentrations. ResultsThe search resulted in a total of 257 articles, and 28 SR were included in the qualitative analysis and nine in the quantitative analysis. There is no difference between in-office and at-home techniques in terms of color change (p = 0.95) and post-treatment sensitivity (p = 0.85). There is similarity risk and intensity of teeth sensitivity between AH and IO bleaching. IO bleaching with light-activated systems with low concentrations of bleaching agent showed similar results to IO bleaching techniques with high concentrated bleaching gels. With the application of the criteria of the AMSTAR 2 tool, the reviews were considered critically low to high. ConclusionsThere are no significant differences in terms of color change between the different bleaching techniques compared. Teeth sensitivity is always present regardless of the technique used. The use of light activation systems did not increase the intensity and risk of post-operative sensitivity.

Effect of antioxidant on tooth sensitivity after bleaching.

This study aimed to investigate the effect of antioxidant (sodium ascorbate) on tooth sensitivity after two in-office bleaching techniques (light-activated and chemical bleaching). Ten patients aged 18-25 were bleached in four groups according to bleaching materials and/or antioxidant used. Group A: Maxillary right quadrant received light-activated bleaching with antioxidant. Group B: Maxillary left quadrant received light-activated bleaching without antioxidant. Group C: Mandibular right quadrant received chemical bleaching without antioxidant. Group D: Mandibular left quadrant received chemical bleaching with antioxidant. The tooth sensitivity was recorded using Numerical Rating Scale (NRS) and Schiff Scale (SS) immediately after treatment, 1 day, 1 week, 2 weeks, and 1 month follow-up periods. Group B exhibited higher sensitivity values than Group A. This difference was statistically significant on the first day after treatment (p = 0.027* in NRS and p = 0.046* in SS). Furthermore, antioxidant incorporation in Group D led to a reduction in teeth sensitivity values compared to Group C. This disparity was highly significant on the first day after treatment (p = 0.001* in NRS and p < 0.001** in SS). The antioxidant (10% sodium ascorbate) reduces the intensity of tooth sensitivity at the different follow-up periods, especially after 1 day from bleaching. Using 10% sodium ascorbate after bleaching is advisable to reduce post-operative tooth sensitivity.

Immunohistochemical Localization of Substance P in Pulp Tissue After In-Office Bleaching Technique in Rats

Currently in-office bleaching procedure is the most frequently used in dentistry which represents the most traditional way to modify the color of teeth. The objective of the study is to investigate the pulp response to in-office bleaching procedure with two different concentration of bleaching products by immunohistochemical assessment for Substance P which represent main neuropeptide located in the sensory nerves of the pulp. Twenty four male albino rats were randomly divided equally into two groups. The right maxillary molars were subjected to a single in-office bleaching session with 40% of hydrogen peroxide (Opalescence Boost, UT, USA) (group A) and with 30% of hydrogen peroxide (Philips Dash, USA) (group B). The left maxillary molars in both groups received no treatment used as (negative control). the pulp response were evaluated in 1st day (n=6) and 7th day (n=6) after bleaching procedure. The upper jaws were processed for H&amp;E stain and immunohistochemical localization of substance P. At 1st day there was high mean value of dental pulp cells that positively expressed for substance P antibody in both bleached groups and mostly in 40% bleached group (group A 30.133, group B 27.267) than control group (10.358) with significant p value (0.013) while at 7th day this expression was reduced in both groups(mean value of group A was 15.300 while the group B was 11.400). In conclusion the higher the concentration of hydrogen peroxide in bleaching products the further damage to the pulp represents in neurogenic inflammation which explain the increasing in substance P expression.

Dental Fluorosis Management Using Power Bleach – A Magic Wand

Dental fluorosis is a particular condition brought on by long-term, excessive fluoride consumption during the formation of enamel. Fluorosis staining is frequently seen as an aesthetic problem may have psychological effect of when seen on maxillary anterior teeth. Bleaching, microabrasion, veneering, and crowning are some of the treatment options. Bleaching is a conservative approach of restoring the colour of teeth with intrinsic discolouration. Among the various bleaching techniques, In-office or Power bleaching techniques are effective to obtain result immediately. The dentist is in complete control of the process throughout the treatment. It is a fast process and results are evident in single visit. Here we present a case of management of dental fluorosis using Power bleaching technique.

EVALUATION OF PH LEVELS AND THE EFFECT OF VIOLET LED LIGHT IN-OFFICE BLEACHING PROTOCOL ALONE OR ASSOCIATED WITH 6% H2O2 ON ENAMEL MICROHARDNESS

This in vitro study evaluated the effect of three different in-office bleaching techniques on bovine enamel microhardness and the pH variation of peroxide agents during the protocols. Methodology: For Knoop microhardness (KNH) analyses, enamel fragments were divided into 3 groups (n=10): LEDv–hybrid violet LED/Laser light (10x2’ LEDv + 10x30” light-off, 2 cycles); HP6%LEDv–6% HP gel + LEDv/Laser (15x1’ LEDv + 15x1’ light-off); HP35%- 35% HP (1x45’). For pH measurements, bovine teeth were divided into 2 groups (n=10): HP35% and HP6%LEDv. KHN was measured at baseline (T0), 24h after bleaching (T1) and after 7 days in artificial saliva (T7). Initial and final bleaching gels pHs were obtained utilizing a pH-meter. KHN was evaluated by the Wald-type permutation statistic, aligned rank transformation statistical test, Wilcoxon and Mann-Whitney tests; pH levels were evaluated by the Welch-James and Wilcoxon tests (p&lt;0.05). Results: HP35% and HP6%LEDv presented a decrease in KHN from T0 to T1, with no difference among them; baselines values were recovered at T7. For LEDv, no significant difference was found between KHN at T1 and T0; at T7 KHN increased in comparison to T0. The initial pH mean was 7.66 for HP35% and 9.28 for HP6%LEDv; the final pH mean was 7.53 and 8.68, respectively. Conclusions: Bleaching with LEDv alone was the only treatment that didn’t reduce enamel microhardness. HP6%LEDv led to a decrease in KHN values similar to the high-concentrated gel. After seven days in artificial saliva, initial KHN was recovered. Although the pH of both gels decreased during the treatment, it remained above the critical value.

The impact of the diode laser 940 nm photoactivated bleaching on color change of different composite resin restorations.

The study's main objective was to evaluate as well as compare the impact of diode laser 940 nm and conventional in-office bleaching technique on the color change of different composite resin restorations. A total of ninety composite resin discs (CRDs) were made from Filtek™ Bulk Fill, nanohybrid composite resin Filtek™ Z550 XT Universal Restorative, and flowable composite resin restoration Filtek™ Z350xt Flowable Composite. Group A: (30) CRD for Filtek™ Bulk Fill, group B: (30) CRD for Filtek™ Z550 XT Universal Restorative, and group C: (30) CRD for Filtek™ Z350xt Flowable Composite. A1, B1, and C1: (10 CRD in each group): Control group without bleaching. A2, B2, and C2: 10 CRD in each group bleached with Laser White20 without laser activation. A3, B3, and C3: 10 CRD in each group bleached with Laser White20 and activated by diode laser 940 nm. The color was evaluated using a dental spectrophotometer. One-way ANOVA was utilized for the comparison of the color stability of the CRD. P < 0.05 is regarded as statically significant. Both conventional and diode laser in-office vital tooth bleaching protocols affected the color stability of composite resin restorations. The result demonstrated that bleaching without laser activation produced color change (mean [8.30], standard deviation [SD] (1.95) P [< 0.001]), whereas the bleaching and activation by diode laser produced color change (mean [8.11], SD [1.99], P [< 0.001]). Both types of bleaching protocol affected composite resin restorations' color stability. In all tested materials, color changes after the bleaching protocol were clinically perceptible. The restorations following the bleaching procedure are required to be replaced by clinicians.

Evaluating the Effect of Diode Laser Irradiation on Microhardness of Bleached Enamel: An in Vitro Study

Aims: To investigate the effect of in-office dental bleaching techniques on the microhardness of enamel and the influence of post bleaching diode laser irradiation on the surface microhardness of bleached enamel. Materials and methods: Forty bovine teeth were prepared and then randomly allocated into two equal groups (n=20) according to bleaching technique as follows: CB: Conventional in-office bleaching technique and LB: Laser–assisted in-office bleaching technique. Each group was subdivided into two subgroups (n=10) according to laser irradiation setting as follows: C2: Conventionally bleached followed by diode laser irradiation at 2-Watt laser, C4: Conventionally bleached followed by diode laser irradiation at 4-Watt laser, L2: laser –assisted bleached followed by diode laser irradiation at 2-Watt laser and L4: Laser–assisted bleached followed by diode laser irradiation at 4-Watt laser. Vickers microhardness was assessed three times for all the specimens: before bleaching, 24 hours after bleaching and finally 24 hours after post bleaching diode laser irradiation. Paired samples t- test and independent samples t- test were utilized for statistical analysis. Results: Both bleached groups exhibited a significant decrease in micro harness after bleaching with no statistically significant differences between them. Post bleaching diode laser irradiation at 2Watt and 4Watt resulted in significant increase in microhardness with no significant difference was evident between them. Conclusions: Diode laser irradiation on bleached enamel had a positive influence on surface microhardness of enamel and it may represent a promising post bleaching treatment modality.

Evaluation of the effectiveness in teeth whitening of a single session with 6% hydrogen peroxide Laser/LED system

BackgroundDue to the current importance of dental whitening, multiple studies have been carried out in order to achieve an efficient, effective, and innocuous procedure. This study aimed to compare the effectiveness and sensitivity of in-office dental bleaching with one versus two applications of 6% hydrogen peroxide (HP) gel with nitrogen titanium dioxide (TiO2) nanoparticles activated by LED/Laser lamp in a single-session. MethodsThis RCT with a split-mouth design was performed in twenty-seven volunteers. The in-office dental bleaching technique was performed using 6% HP with nitrogen TiO2 nanoparticles. In each patient, groups were randomized by hemiarch: Group 1 received one application of 72 minutes and Group 2 received two applications of 36 minutes, both groups in a single-session. ResultsThere were no significant differences in the effectiveness of a single-session with one or two applications of 6% HP with nitrogen TiO2 nanoparticles between both groups(p>0.05). A positive and increase of ∆E value was observed in both groups. Group 1 showed an increase of 4.45 in the immediate measurement, remaining at 4.41 until the one-week control, to increase up to an ∆E of 4.99 at one-month control. Group 2 showed a sustained increase of 4.02 units in the immediate control until reaching the maximum value of 5.46 units of ∆E at one-month control. ConclusionOne session single application protocol of 6% Hydrogen Peroxide gel with nanoparticulate TiO2 activated by LED/Laser is effective and efficient for dental bleaching.

THE EFFECT OF VARIOUS DESENSITIZING AGENT APPLICATION ON IN-OFFICE BLEACHING ON THE NUMBER OF FIBROBLASTS

Background: Reactive Oxygen Species (ROS) released from hydrogen peroxide causes inflammation of the pulp. Remineralization action by fluoride-containing desensitizing agent (Casein Phosphopeptides-Amorphous Calcium Fluoride Phosphate/CPP-ACFP) occluding dentinal tubule, thereby minimizing the penetration of hydrogen peroxide into the pulp and affect the number of fibroblasts. The aim of this study was to determine the effect of fluoride-containing desensitizing agent (CPP-ACFP) application: before, after, and before-after in-office bleaching techniques using 40% hydrogen peroxide on the number of fibroblasts.Method: Twenty-eight maxillary molar teeth were divided into 4 groups, Control Group (bleaching treatment), Group I (CPP-ACFP application before bleaching), Group II (CPP-ACFP application after bleaching), and Group III (CPP-ACFP application before and after bleaching). Rats were sacrificed 5 days after and histological preparations were stained with HE. Fibroblasts counting was performed using a 1000x magnification light microscope.Result: ANOVA test showed that there were significant mean differences in the number of fibroblasts among the groups. The LSD test showed that there were statistically significant differences in almost all of the compared groups except between the Control Group and Group II.Conclusion: The number of fibroblasts in the pulp of rats applied CPP-ACFP before and after in-office bleaching was less than applied CPP-ACFP before or after in-office bleaching.

In-office tooth bleaching effectiveness with different soft-tissue barriers – randomized controlled trial

Objectives: To evaluate the tooth bleaching effectiveness of a 6% hydrogen peroxide paint-on varnish with two different types of soft-tissue protection materials. Methods: Twenty patients were screened according to inclusion and exclusion criteria, submitted to professional dental prophylaxis, and randomly allocated to one of the two groups. An in-office bleaching technique protocol was performed (VivaStyle Paint On PIus, lvoclar- Vivadent®, Liechtenstein) with two different soft-tissue protection materials: Group 1 – Vaseline; Group 2 – block-out resin. Bleaching effectiveness was evaluated with ΔE00 and ΔWID, calculated from the CIE L*a*b* values obtained by spectrophotometry analysis (SpectroShade). Appropriate statistical tests were performed to analyze intragroup differences in CIE L*a*b* and WID values and intergroup differences in ΔE00 and ΔWID with α=0.05. Results: Both groups presented statistically significant (P&lt;0.01) differences in CIE L*a*b* and WID. Both ΔE00 and ΔWID surpassed the acceptability threshold (ΔE00 &gt; 1.8; ΔWID &gt; 2.60), and the ΔWID was mostly classified as hardly acceptable differences. Group 2 presented higher statistically significant (P&lt;0.01) mean values with ΔE00 = 3.5 ± 1.5 and ΔWID = 8.6 ± 4.2. Conclusions: The 6% hydrogen peroxide paint-on varnish tooth bleaching technique showed clinical effectiveness. However, effectiveness varied with the soft-tissue protection material used, with better results when applying a block-out resin, thus suggesting its clinical recommendation.

The effect of laser-activated bleaching with 445 nm and 970 nm diode lasers on pulp chamber temperature rise: an in vitro study

The aim of this study was to determine the pulp chamber temperature changes during bleaching procedures with irradiation from 445 nm and 970 nm diode lasers at different powers. A total of 120 human maxillary central incisors were used for this study. Diode lasers at two different wavelengths were irradiated in this evaluation: 970 nm at 1.5 W of power, 970 nm at 2 W, 445 nm at 1 W and 445 nm at 1.5 W. A thermometer was inserted into the pulp chamber and the temperature increase after bleaching was recorded. The results indicated that there was not a significant difference between the groups at the same wavelengths (P > 0.05). However, there was a significant difference between groups at different wavelengths (P < 0.05). The highest recorded pulp temperature increase was for the 970 nm diode laser with 2 W of power (2.0 0.5), and the lowest pulp temperature rise was 0.1 0.2 for the 445 nm diode laser with 1 W of power. According to the results of this study it can be concluded that the temperature elevation after bleaching with the diode laser at the wavelengths 970 nm and 445 nm is in the safe range, and both wavelengths with the parameters applied in this study can be used as prudent in-office bleaching techniques.

In-Office Bleaching Techniques: Laboratory Investigation of the Effect on Color Change and EnamelMicromorphology

In-Office Bleaching Techniques: Laboratory Investigation of the Effect on Color Change and EnamelMicromorphology

At home and in-office bleaching techniques – A literature review

Hydrogen and carbamide peroxides have been successfully used for many years; in the past century, the dental bleaching technique suffered several changes and almost 10 years before new millennium, the technique was finally recognized by the international agencies of regulation. It is important that dentists handle the peroxides with the essential knowledge because it is demonstrated that satisfactory final results of this technique depend on the correct diagnosis of stains, management of the substrates (enamel and dentin) and as well sensitivity. Dentists are exposed to several dental bleaching techniques, products, and brands, and in the last 2 decades, the devices for light activation of the peroxides have become an extensive catalog. Today, the technique is also suffering changes based on the effectiveness of the different light sources for peroxide activation and its relation to satisfactory final results of the technique. The purpose of this literature review is to explain the determinant factors that influence satisfactory final results of the techniques and provide a general overview, to achieve a treatment decision based on evidence.

Combination of at-home and in-office bleaching techniques: case series

ABSTRACT Tooth bleaching is one of the most conservative aesthetic techniques. At-home and in-office bleaching may be performed, as well as the combination of both techniques. As this combination may be done in different manners, distinct orders of combinations were proposed in this report. A 24 years-old man, whose upper central incisor and canine shades were A2 and A3 respectively, was initially treated by chair-side with 40-min application of 40% hydrogen peroxide (HP) for two sessions. Afterwards, an two-week overnight at-home bleaching was performed with 10% carbamide peroxide (CP). The shade of upper central incisors changed to 1M1 and canine was B1. Conversely, a 30 years-old woman was firstly conducted with at-home bleaching (overnight 4-weeks 10% CP) and, subsequently, with a single appointment of in-office bleaching for 45 minutes (35% HP). The shade of her upper central incisor changed from A1 to 0.5M1 and the upper canine from A3 to B1. The VITA classical (A1-D4) shade guide and VITA Bleached guide 3D-MASTER were used to determine the tooth color during the treatments. In both bleaching treatments, patients reported no significant tooth sensitivity and the final outcomes met their expectation.

Triple-blinded randomized clinical trial comparing efficacy and tooth sensitivity of in-office and at-home bleaching techniques.

Objective Our study aims to compare the efficacy and tooth sensitivity following in-office (35% hydrogen peroxide) or at-home (10% carbamide peroxide) bleaching treatments both preceded by 2% potassium nitrate (2%KF) desensitizing gel.Methodology 130 volunteers were randomly allocated to a) in-office bleaching and a placebo at-home protocol; or b) in-office placebo and at-home bleaching treatment. 2% KF was applied for 10 min before both treatments.Objective color evaluation was performed (spectrophotometer CIEL*a*b* system and CIEDE2000) to calculate the color change (ΔE00). Subjective evaluation was performed using the VITA classical shade guide followed by shade variation (ΔSGU) at the beginning and end of bleaching treatment and 2 weeks post-bleaching. Tooth sensitivity was daily recorded using a Likert scale varying from 1 (no sensitivity) to 5 (severe sensitivity). Analysis was carried out using non-parametric tests.Results Regarding the color change, at-home bleaching resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.003) and Δa* (p=0.014). Two weeks post-bleaching, the at-home treatment resulted in significant color improvement compared to in-office treatment for the parameters Δb* (p=0.037) and ΔE00 (p=0.033). No differences were observed in either ΔSGU parameters. Concerning sensitivity, patients treated with in-office bleaching reported more tooth sensitivity than the at-home group only on the first day after bleaching started, without significant differences in the other periods evaluated (p>0.05).Conclusions At-home and in-office bleaching, preceded by a desensitizing agent, were effective for vital teeth bleaching and 10% carbamide peroxide produced a higher whitening effect than 35% hydrogen peroxide in the short time evaluation. Tooth sensitivity rates were similar for the two techniques tested.

“CRITICAL EVALUATIION OF EFFIICACY, REBOUND EFFECT AND SENSIITIIVIITY OF IN--OFFIICE VS AT--HOME BLEACHIING TECHNIIQUES: AN IN VIIVO STUDY”

Materials and method: 20 patients were selected. All patients were enrolled in split arch study design in which first quadrant bleaching was done by in-office bleaching technique and second quadrant bleaching was done by at-home bleaching technique using Polaoffice and Polanight bleaching products By SDI. Shade selection was done using 3D-MASTER within the standardized light. The shades were visually assessed by two expert examiners independently with reference to value ordered shade guide. The tooth sensitivity of patient in both first and second quadrant was evaluated using visual analog scale. At-home bleaching was done for 45 minutes on first day, third day and fifth day. On fifth day in-office bleaching was done for eight minutes of 3 cycles. Result In office bleaching technique performed with respect to tooth whitening, color regression and sensitivity. Conclusion: The bleaching efficacy, longevity can be improved with increased hydrogen peroxide concentration in certain amount but with minimum application of time. The newer product with neutral pH enhances the bleaching efficacy but also helps in reducing the sensitivity and relapse. The effectiveness and risk of sensitivity after the tooth bleaching depends on the techniques.

Effectiveness of Different Laser-Assisted In-Office Bleaching Techniques: 1-Year Follow-Up.

Objective: The aim of this study was to evaluate color longevity after different bleaching techniques. Background: Laser-activated bleaching methods are gaining popularity due to decreased chair time and increased patient compliance. However, the longevity of such methods has not been stated clearly. Methods: Sixty patients were divided into the following three groups (n = 20); group 1: chemical bleaching with 35% hydrogen peroxide (HP) gel, group 2: bleaching with 35% HP gel with diode laser activation, and group 3: bleaching with 35% HP gel with Er,Cr:YSGG laser activation. Color changes (ΔE*) were calculated by using two different formulas: (i) CIELAB (ΔEab) and (ii) CIEDE2000 (ΔE00) with a spectrophotometer before treatment, 24 h after treatment 3, 6, and 12 months after treatment. Evaluation of postoperative sensitivity was performed before and immediately after treatment, followed by re-evaluation 24 h and 1 week after treatment. Results: For ΔEab calculation, no significant difference was observed during both intra- and inter-group evaluations (p > 0.05). For ΔE00 calculation, no significant intergroup difference was observed (p > 0.05), whereas significant intragroup differences between the values of after treatment, 6-12 months. In the chemical bleaching group, increased postoperative sensitivity was observed after 24 h (p < 0.001). In the diode-laser-activated group, postoperative hypersensitivity was detected at 24 h and 1 week. No significant hypersensitivity was observed in the Er,Cr:YSGG-laser-activated group (p > 0.05). Conclusions: All three techniques provided efficient bleaching. Chemical and diode-activated bleaching methods resulted in slight sensitivity after application, whereas Er,Cr:YSGG-laser-activated bleaching did not cause sensitivity.

Effect of In-Office Bleaching Techniques and Topical Fluoride Application on Color and Surface Roughness of Two Types of Dental Ceramics (In-Vitro Study)

Objective: This in-Vitro study was to assess the effect of 2 bleaching techniques & topical Fl application on color & Ra of 2 types of CAD/CAM ceramics. Materials&methods:40 discs of 2 CAD/CAM ceramics were used IPS e.max(E)&Suprinity(S). Baseline measurements for color & Ra were taken using spectrophotometer &AFM. The specimens were divided into 2subgroups according to the bleaching agent used Zoom(Z) & Opalescence Boost 40%(O). 2 measurements of color & Ra were done: immediately after bleaching (I)& after 1week from the last bleaching session(D). Specimens were exposed to APF application & final measurements of color & Ra values were done. Results: Bleaching had a statistically significant effect on mean ∆E of all groups. No significant difference on mean ∆E of the 2ceramic materials. O showed higher statistically significant difference in ∆E than Z. S showed higher statistically significant difference in ∆E than E. Ceramic type & bleaching agents had a statistically significant effect on mean Ra. In I, SZ showed the highest mean Ra value while in D&F,EO showed the highest mean Ra. After F, Ra of ceramic materials demonstrated higher values than bleaching only. There was a +ve correlation between ∆E&Ra. Conclusions: The influence of in-office bleaching agents on color was material dependent. The changes in color & Ra were time dependent. Fl application following bleaching of ceramic materials showed higher color & Ra changes than bleaching only in groups. Recommendation: The ceramic restoration should be protected before bleaching&/or Fl application to avoid esthetic deterioration.

Microstructural effect of a laser-activated bleaching agent containing titanium dioxide on human enamel.

Aim:This study aimed to evaluate the effect of a laser-activated bleaching agent containing titanium dioxide (TiO2) nanoparticles on enamel roughness and hardness.Materials and Methods:Twenty human premolars were randomized into two groups according to the bleaching treatments performed: HP – 35% hydrogen peroxide and HP + TiO2 – 30% hydrogen peroxide containing TiO2 light-activated by diode laser (980 nm). It was performed two bleaching sessions with an interval of 7 days. Microhardness and roughness of the enamel were assessed at three times: T0 – Before 1st appointment, T1 – after 2nd appointment, and T2–7 days after 2nd appointment.Results:The HP + TiO2 did not cause changes on enamel roughness and hardness and presented the same effects of the HP.Conclusions:Both bleaching agents showed no difference between them. Then, it is possible to conclude that both are viable for clinical use during in-office dental bleaching technique regarding the microstructural changes that they might cause.

Adverse effects of tooth bleaching: A review

Current bleaching methods mainly use hydrogen peroxide as the active agents. Tooth whitening is achieved either by in-office bleaching technique or self-applied or home bleach method. This review focused mainly on the adverse outcomes of tooth bleaching such as cervical root resorption, crown fracture, tooth sensitivity, mucosal reaction, and enamel surface alterations produced during the treatment and the management of vital and non-vital teeth-bleaching procedures. Cervical root resorption is one of the unwanted effects observed with the internal bleaching, especially seen with thermo-catalytic procedures. There is a possibility of crown fracture after intracoronal bleaching most likely due to the extensive removal of the intracoronal dentin. One of the common side effects of external tooth bleaching is the tooth sensitivity that ranged between 15% and 65%. Another important adverse effect of high concentration of hydrogen peroxide bleaching is the mucosal irritation ranged between 30% and 35%. Morphologic changes of enamel were also observed with the use of higher concentration of bleaching agents. In view of this review, it is highly desirable to take all the necessary precautions and considerations while performing tooth-bleaching treatment.