Clinical strategies to reduce sensitivity caused by the bleaching treatment: integrative review




Tooth Bleaching; Health teaching; Dentin desensitizing agents; Dentin sensitivity.


Dentin sensitivity is the main side effect in cases of tooth whitening, and although there are a variety of products formulated for its management, with different degrees of effectiveness, there is still no universally accepted therapy to alleviate the symptoms of this sensitivity. Thus, the objective of this work is to present the clinical strategies used to reduce sensitivity in cases of tooth whitening. This is a descriptive study of the integrative literature review type, carried out through the following databases: PubMed, SciELO and VHL. For this review, articles available in full in Portuguese and English were included, and theses, monographs, course conclusion works, books and other literature reviews were excluded. The descriptors used were: Tooth Bleaching; Dentin Sensitivity; Dentin Desensitizing Agents, organized into a search key combination using the Boolean operator “AND”. A total of 114 articles were found, of which, after excluding those that did not meet the inclusion criteria and were not relevant to the theme, 7 articles were selected for the construction of the review. Despite the divergent opinions present in the literature, it is noted that the use of fluorides associated with products containing bioactives, such as argine, potassium nitrate and calcium phosphate, have better results in the control of dentin sensitivity due to their natural actions of tubular occlusion and formation of a protective layer on tooth enamel, hus being a safer and more used option.


Achachao Almerco, K., & Tay Chu Jon, L. Y. (2019). Terapias para disminuir la sensibilidad por blanqueamiento dental. Revista Estomatológica Herediana, 29(4), 297-305.

Alexandrino, L. D., Alencar, C. de M., Silveira, A. D. S., Alves, E. B., & Silva, C. M. (2017). Randomized clinical trial of the effect of NovaMin and CPP-ACPF in combination with dental bleaching. Journal of Applied Oral Science: Revista FOB, 25(3), 335–340.

Basting, R. T., Amaral, F. L., França, F. M., & Flório, F. M. (2012). Clinical comparative study of the effectiveness of and tooth sensitivity to 10% and 20% carbamide peroxide home-use and 35% and 38% hydrogen peroxide in-office bleaching materials containing desensitizing agents. Operative Dentistry, 37(5), 464-473.

Bernardon, J. K., Sartori, N., Ballarin, A., Perdigão, J., Lopes, G. C., & Baratieri, L. N. (2010). Clinical performance of vital bleaching techniques. Operative Dentistry, 35(1), 3-10.

Briso, A. L. F., Rahal, V., Azevedo, F. A., Gallinari, M. O., Gonçalves, R. S., Frascino, S. M. B., Santos, P. H. D., & Cintra, L. T. A. (2018). Neurosensory analysis of tooth sensitivity during at-home dental bleaching: a randomized clinical trial. Journal of Applied Oral Science, 26, e20170284.

Browning, W. D., Blalock, J. S., Frazier, K. B., Downey, M. C., & Myers, M. L. (2007). Duration and timing of sensitivity related to bleaching. Journal of Esthetic and Restorative Dentistry, 19(5), 256-264.

Carey, C. M. (2014). Tooth whitening: what we now know. The Journal of Evidence-Based Dental Practice, 14 Suppl, 70–76.

Cartagena, A. F., Parreiras, S. O., Loguercio, A. D., Reis, A., & Campanha, N. H. (2015). In-office bleaching effects on the pulp flow and tooth sensitivity – case series. Brazilian Oral Research, 29(1).

Cavalli, V., Azevedo Rodrigues, L. K., Paes-Leme, A. F., Brancalion, M. L., Arruda, M. A. Z., Bittencourt Berger, S., & Giannini, M. (2010). Effects of bleaching agents containing fluoride and calcium on human enamel. Quintessence International, 41(8), 157-165.

Diniz, A. C. S., Lima, S. N. L., Tavarez, Rr., Borges, A. H., Pinto, S. C. S., Tonetto, M. R., Loguercio, A. D., & Bandéca, M. C. (2018). Preventive Use of a Resin-based Desensitizer Containing Glutaraldehyde on Tooth Sensitivity Caused by In-office Bleaching: A Randomized, Single-blind Clinical Trial. Operative Dentistry, 43(5), 472–481.

Faria-e-Silva, A. L., Nahsan, F. P., Fernandes, M. T., & Martins-Filho, P. R. (2015). Effect of preventive use of nonsteroidal anti-inflammatory drugs on sensitivity after dental bleaching: a systematic review and meta-analysis. Journal of the American Dental Association, 146(2), 87-93.

Fioriljo, L., Laino, L., De Stefano, R., D'Amico, C., Bocchieri, S., Amoroso, G., Isola, G., & Cervino, G. (2019). Dental Whitening Gels: Strengths and Weaknesses of an Increasingly Used Method. Gels, 5(3).

Gillam, D. G., Newman, H. N., Davies, E. H., Bulman, J. S., Troullos, E. S., & Curro, F. A. (2004) Clinical evaluation of ferric oxalate in relieving dentine hypersensitivity. Journal of Oral Rehabilitation, 31(3), 245-250.

Greenwall, L. (2001). Bleaching materials. Bleaching Techniques in Restorative Dentistry. (1st ed.). Thomson; p. 31-60.

Ito, S., et al. Etodolac, um inibidor da ciclooxigenase-2, atenua a neuropatia periférica induzida por paclitaxel em um modelo de camundongo de alodinia mecânica. Journal of Pharmacology and Experimental Therapeutics. 342(1), 53-60. 2012.

Khoroushi, M., Mazaheri, H., & Manoochehri, A. (2011). Effect of CPP-ACP application on flexural strength of bleached enamel and dentin complex. Operative Dentistry, 36(4), 372-379.

Kose, C., Reis, A., Baratieri, L. N., & Loguercio, A. D. (2011). Clinical effects of at-home bleaching along with desensitizing agent application. American Journal of Dentistry, 24(6), 379-782.

Kwon, S. R., & Wertz, P. W. (2015). Review of the Mechanism of Tooth Whitening. Journal of Esthetic and Restorative Dentistry, 27(5), 240–257.

Loguercio, A. D., Tay, L. Y., Herrera, D. R., Bauer, J., & Reis, A. (2015). Effectiveness of nano-calcium phosphate paste on sensitivity during and after bleaching: a randomized clinical trial. Brazilian Oral Research, 29, 1-7.

Maran, B. M. Vochikovski, L., Hortkoff, D. R. A., Stanislawczuk, R., Loguercio, A. D., & Reis A. (2018). Tooth sensitivity with a desensitizing-containing at-home bleaching gel—a randomized triple-blind clinical trial. Journal of Dentistry, 72, 64-70.

Marquillas, C. B. Procaccini, R., Malmagro, M. V., & Sánchez-Martín MJ. (2020). Breaking the rules: tooth bleaching by means of a reducing agent. Clinical Oral Investigations, 4(8), 2773-2279.

Mehta, D., Venkata, S., Naganath, M., Linga, U. R., Ishihata, H., & Finger, W. J. (2013). Clinical trial of tooth desensitization prior to in-office bleaching. European Journal of Oral Sciences, 121(5), 477-482.

Moura, G. F., Teixeira, D. N. R., Machado, A. C., Spini, P. H., & Soares, P. V. (2016). Analysis of bleaching products associated with desensitizing agents in experimental whitening gel -randomized clinical trial. Bioscience Journal, 32 (1).

Navarra, C. O., Reda, B., Diolosà, M., Casula, I., Di Lenarda, R., Breschi, L., & Cadenaro, M. (2014). The effects of two 10% carbamide peroxide nightguard bleaching agents, with and without desensitizer, on enamel and sensitivity: an in vivo study. International Journal of Dental Hygiene, v. 12(2), 115-120.

Paula, E., Kossatz, S., Fernandes, D., Loguercio, A., & Reis, A. (2013). The effect of preoperative ibuprofen use on tooth sensitivity caused by in-office bleaching. Operative Dentistry, 38(6), 601-608.

Perete-De-Freitas, C. E., Silva, P. D., & Faria-E-Silva, A. L. (2017). Impact of Microabrasion on the Effectiveness of Tooth Bleaching. Revista Brasileira de Odontologia, 28(5), 612-617.

Pierote, J. J. A., Prieto, L. T., Dias, C. T. D. S., CÂmara, J. V. F., Lima, D. A. N. L., Aguiar, F. H. B., & Paulillo, L. A. M. S. (2020). Effects of desensitizing products on the reduction of pain sensitivity caused by in-office tooth bleaching: a 24-week follow-up. Journal of Applied Oral Science : Revista FOB, 28, e20190755

Piknjač, A., & Zlatarić, D. K. (2021). Clinical Evaluation of 6-Month Efficacy of 40% in-Office Whitening Treatment. Pesquisa Brasileira em Odontopediatria e Clínica Integrada, 21.

Pintado-Palomino, K., & Tirapelli, C. (2015). The effect of home-use and in-office bleaching treatments combined with experimental desensitizing agents on enamel and dentin. European Journal of Dentistry, 9(1), 66-73. 2015.

Po, L. H., & Wilson, N. W. (2014). Effects of different desensiti-zing agents on bleaching treatments. European Journal of General Dentistry, 3(2), 93-99.

Reis, A., Dalanhol, A. P., Cunha, T. S., Kossatz, S., & Loguercio, A. D. (2011). Assessment of tooth sensitivity using a desensitizer before light-activated bleaching. Operative Dentistry, 36(1), 12–17.

Ribeiro, J. S., Barboza, A. S., Cuevas-Suárez, C. E., Silva, A. F., Piva, E., & Lund, R. G. (2020). Novel in-office peroxide-free tooth-whitening gels: bleaching effectiveness, enamel surface alterations, and cell viability. Scientific Reports, 10, 10016. 2020.

Roberto, A. R., Jassé, F. F., Boaventura, J. M. C., Martinez, T. C., Rastelli, A. N. S., Júnior, O. B. O., & Saad, J. R. C. (2011). Evaluation of tooth color after bleaching with and without light-activation. Revista Odonto Ciência, 26(3), 247-252.

Vaez, S. C., Faria-e-Silva, A. L., Loguércio, A. D., Fernandes, M. T. G., & Nahsan, F. P. S. (2018). Preemptive use of etodolac on tooth sensitivity after in-office bleaching: A randomized clinical trial. Journal of Applied Oral Science, 26, e20160473.

Vilela, A. P., Rezende, M., Terra, R. M. O., da Silva, K. L., Sutil, E., Calixto, A. L., Reis, A., D Loguercio, A., & Farago, P. V. (2021). Effect of topical application of nanoencapsulated eugenol on dental sensitivity reduction after in-office dental bleaching: a randomized, triple-blind clinical trial. Journal of Esthetic and Restorative Dentistry, 33(4), 660–667.

Seghi, R. R., & Denry, I. (1992). Effects of external bleaching on indentation and abrasion characteristics of human enamel in vitro. Journal of Dental Research. 71, 1340–1344.

Souza, M. T., Silva, M. D., & Carvalho, R. (2010). Revisão integrativa: o que é e como fazer. einstein (São Paulo), 8(1), 102-106.

Torres, C. R., Wiegand, A., Sener, B., & Attin, T. (2010). Influence of chemical activation of a 35% hydrogen peroxide bleaching gel on its penetration and efficacy – In vitro study. Journal of Dentistry, 38(10), 838-846.

Wefel, J. S. (2009). NovaMin: likely clinical success. Advances in Dental Research, v. 21(1), 40-43.

Woo, J. M., Ho, S., & Tam, L. E. (2010). The effects of bleaching time on dentin fracture toughness in vitro. Journal of Esthetic and Restorative Dentistry, 22 (3), 179-184.



How to Cite

OLIVEIRA, V. G. de .; CAROLINO, R. de A. .; RIBEIRO, P. J. T. .; FIGUEIREDO, T. R. M. de .; SILVA, R. E. de M. P. da .; PIRES, L. P. B. . Clinical strategies to reduce sensitivity caused by the bleaching treatment: integrative review. Research, Society and Development, [S. l.], v. 11, n. 7, p. e44111730136, 2022. DOI: 10.33448/rsd-v11i7.30136. Disponível em: Acesso em: 6 jul. 2022.



Health Sciences