Teeth whitening is the most popular cosmetic dentistry procedure. It’s estimated that 39.3 million Americans used at-home or in-office teeth whitening products in 2019. However, the side effects of teeth whitening, most notably tooth sensitivity and gingival inflammation, still prevent many patients from seeking out this treatment. Since the inflammation process contributes to post-bleaching tooth sensitivity, some dental professionals have tried administering anti- inflammatory or analgesic drugs to their patients before whitening their teeth. However, a recent systematic review and meta-analysis published in the Journal of the American Dental Association questioned the effectiveness of this approach. To evaluate the effectiveness of administering anti-inflammatory or analgesic drugs, the authors searched the databases Medline via PubMed, Scopus, Web of Science, and Cochrane Library for clinical trials. They also searched ClinicalTrials. gov for unpublished trials. Only randomized clinical trials comparing anti-inflammatory and analgesic drugs with a placebo and evaluating tooth sensitivity after in-office bleaching where included. Of the 5,050 studies identified, nine were analyzed after showing low risk of bias. Authors evaluated studies that administered the drugs prior to bleaching, as well as studies that administered drugs for a period of time after the teeth whitening was complete.
The drugs used in the studies being evaluated included ibuprofen (evaluated in three studies), dexamethasone (evaluated in two studies), and acetaminophen and codeine (evaluated in two studies). The other drugs evaluated were etoricoxib, naproxen, etodolac, piroxicam, acetaminophen, and ketorolac tromethamine. Other studies administered a steroidal anti- inflammatory drug prior to in-office bleaching, as well as administering posts at intervals for 48 hours following the procedure. After the analysis, the authors concluded that neither anti-inflammatory nor analgesic drugs were of any help in addressing the side effects of teeth whitening. They stated, “On the basis of the great variety of drug types evaluated in the primary studies, we are confident that the approach of using drugs for the prevention or reduction of the risk and intensity of tooth sensitivity is not efficacious for in-office bleaching, and some of the drugs may be associated with adverse effects such as nausea, vomiting, malaise, and allergic reaction.” For most patients, the side effects of teeth whitening are mild and temporary. Dental professionals should educate their patients about possible tooth sensitivity and gingival inflammation before teeth whitening and provide useful tools for addressing these side effects when possible.
Are Anti-Inflammatory and Analgesic
Drugs Effective for Preventing Tooth Sensitivity When Whitening?
Have a Laugh
Potato Latkes
INGREDIENTS
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2 large russet potatoes, scrubbed
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2 tsp kosher salt
1 large onion, peeled and cut into quarters
1 tsp baking powder 1/2 tsp black pepper
2 large eggs
1/2 cup all-purpose flour
Safflower or vegetable oil, for frying
DIRECTIONS
1. Using either a food processor with a coarse grating disc or the coarse side of a box grater, grate potatoes and onion. (If using a food processor, halve or quarter potatoes.) Once grated, wrap in a clean dish towel or cheesecloth to wring out as much moisture as possible. 2. Transfer to a mixing bowl and mix in eggs, flour, salt, baking powder, and pepper. 3. Heat a heavy-bottomed pan containing 1/4-inch of oil over medium-high heat. Use a heaping tablespoon to drop batter into the hot pan, working in batches. Use a spatula or spoon to form them into discs. Fry about 5 minutes per side, until deeply browned. 4. Transfer to a paper towel-lined wire rack to drain, and serve alongside applesauce and sour cream.
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