Description: Many dental practices offer chairside bleaching options for patients. Typically, in-surgery bleaching is performed with a 6% HP.7 This procedure is monitored by a dental professional and precautions are taken to minimize sensitivity and gingival irritation by protecting the soft tissues with isolation techniques.3,7 Whitening may occur after one treatment, however the desired results may take several visits. After initial in-surgery bleaching there may be some rebound of the color, which explains why multiple visits may be necessary and why some dentists may fabricate take-home trays for patients to use to lock in the shade.3
Light sources, including lasers, light emitting diodes (LEDs), plasma arc lamps (PACs) and halogen lamps are used with some in-office techniques and products in combination with in-surgery HP whitening procedures.17 The theory behind using a light source is that by heating the HP gel, the free radicals are made available faster, thus resulting in more effective whitening. However, results of a recent meta-analysis did not confirm this outcome for in-surgery bleaching gels with either high or low levels of HP, and the authors stated that it allowed them to “…determine that light-activated bleaching (regardless of light source and protocol) is similar to the use of HP alone (regardless of protocol) in terms of color change.”17 In addition, they found that the risk of tooth sensitivity was not influenced by light sources. When comparing in-surgery to at-home bleaching, there is no conclusive evidence of increased risk or intensity of tooth sensitivity or better efficacy for in-surgery bleaching.14
Pros: Initial assessment to determine causes of discoloration and clinical concerns; professional supervision and soft tissue protection; and, quickest results.
Cons: Most expensive option; may result in more sensitivity when 6% concentration of HP is used;7,14 the clinician (not patient) controls the outcome when bleaching is completed in the office; and, may need multiple sessions and supplemental take-home trays to accomplish desired results.3,7