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Tooth whit”EU”ning

-

Effects and risks of tooth whitening with hydrogen peroxide in

individuals under 18 years of age - a systematic literature review.

Authors:

Fredrik Bengtsson

Martin Svanberg

Supervisor: Gunilla Klingberg Malmö Högskola

Master of Odontology, 15hp Odontologiska fakulteten Programme in Dentistry, St 2014 – St 2016 205 06 Malmö

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Abstract

Aim

To investigate the effects and adverse events of tooth whitening performed on children with permanent teeth by the use of products containing or releasing hydrogen peroxide. This was made considering children affected by objectively and subjectively observed tooth

discolorations in purpose to consolidate existing research and compare it to the EU directives established 2012.

Search strategies

A systematic search of the literature was conducted using the databases Medline, Cochrane, Embase and Scopus. Only studies published in English, Swedish, Danish and Norwegian were included.

Selection criteria

The selection criteria aimed to include studies performed on patients under the age of 18, using whitening products containing or releasing hydrogen peroxide. The bleaching process had to be performed in vivo on permanent teeth. Case reports were included only to be separately reviewed looking for severe side effects and adverse events.

Results

A total of 214 articles were identified and 13 met the inclusion criteria. Four papers were judged to have a low risk of bias, eight a moderate risk and one a high risk of bias. Most studies were performed on mild discolorations while they lacked in necessary follow-up times.

Conclusion

There are not enough studies evaluating the effect of using hydrogen peroxide to bleach more severe discolorations on individuals under 18 years old. A limited number of studies showed some support for bleaching with hydrogen peroxide on mild tooth discolorations. Parallel to this, the included studies demonstrated a high number of mild and transient adverse events. Until proven otherwise, the lack of studies gives some ethical support to the EU-directives established 2012.

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Tandbl”EU”kning

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Risker och effekter av tandblekning med väteperoxid på individer

under 18 år – en systematisk litteraturöversikt

Författare:

Fredrik Bengtsson

Martin Svanberg

Handledare: Gunilla Klingberg Malmö Högskola

Master i odontologi, 15hp Odontologiska fakulteten Tandläkarprogrammet Vt 2014 – Vt 2016 205 06 Malmö

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Sammanfattning

Syfte

Att utvärdera effekterna och bieffekterna av tandblekningsprodukter innehållande eller utsöndrande av väteperoxid på permanenta tänder hos personer under 18 år. Studien gjordes med tanke på barn som drabbats av missfärgade tänder med ett objektivt och subjektivt behandlingsbehov. Detta i syfte att insamla all nuvarande forskning på området samt ställa detta mot EU-direktiven utfärdade 2012.

Sökstrategier

En systematisk sökning av litteraturen gjordes i databaserna Medline, Cochrane, Embase och Scopus. Inkluderade artiklar skulle vara på antingen Engelska, Svenska, Danska eller Norska.

Selektionskriterier

Studierna skulle vara gjorda på personer under 18 år med produkter som innehöll eller utsöndrande väteperoxid. Enbart studier på permanenta tänder inkluderades. Studierna var tvungna att utvärdera positiva och/eller negativa effekter av behandlingen. Blekningen skulle utföras in vivo. Fallrapporter inkluderades enbart i syfte att finna eventuella allvarliga

bieffekter.

Resultat

Totalt identifierades 214 artiklar varav 13 stycken uppfyllde inkluderings- och exkluderings-kriterierna. Fyra studier bedömdes ha låg risk av bias, åtta av medelhög samt en som hög risk av bias. Syftet och studiedesignen varierade mellan de inkluderade studierna. De flesta studierna var utförda på mildare missfärgningar samtidigt som de saknade erforderliga uppföljningstider.

Slutsats

Det finns inte tillräckligt med studier gjorda på personer under 18 år som utvärderar effekterna av bleking med väteperoxid på fall med mer omfattande missfärgningar. Ett begränsat antal studier med medelhög risk av bias ger ett visst stöd för blekning med väteperoxid på mildare fall av missfärgningar. Samtidigt rapporterades ett stort antal milda, övergående bieffekter. Tills motsatsen bevisats finns ett etiskt stöd för EU-direktiven etablerade 2012.

References

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