Efficacy and Adverse Effects of Whitening Dentifrices Compared With Other Products: A Systematic Review and Meta-analysis

Whitening dentifrices (WDs) are widespread and accessible worldwide, claiming to whiten teeth. Therefore, this systematic review aimed to assess the extrinsic stain removal (ESR), the whitening potential, and the adverse effects of WDs. Randomized controlled trials comparing WDs with regular dentifrices (RDs) and other home-based whitening products were searched at NCBI-PubMed, Cochrane-CENTRAL, EBSCO-Host, and clinicaltrials.gov. The studies were screened and had data extracted by two independent researchers. Eligible studies presented outcomes of ESR, color change, and adverse effects, with no restriction of publication date. Data were meta-analyzed using RevMan 5.3, and the level of evidence was rated according to GRADE criteria. Eleven studies (n=1962) assessed reduction of stain area and intensity through Lobene Stain index, with a mean difference (MD) of -0.33 ([-0.41;-0.25]; p=0.00001) and -0.34 ([-0.44;-0.25]; p=0.00001), respectively. When the modified Lobene Stain index was used (six studies; n=2576), MD was -0.42 ([-0.58;-0.25]; p=0.00001) and -0.30 ([-0.39;-0.21]; p=0.00001), respectively. Mean color change through shade guide tabs (three studies; n=1322) was -1.80 ([-2.33;-1.26]; p=0.00001). All differences were in favor of the WDs, which also produced a risk of adverse effects (RR=1.74; [1.20, 2.52]; p=0.003; four studies; n=1322). The comparison of WDs with paint-on gel (two studies; n=58) yielded similar efficacy and adverse effects (p>0.05), whereas the comparison of WDs with white strips (two studies; n=87) yielded higher efficacy of the latter (p=0.00001) and similar adverse effects (p=0.52). The quality of evidence varied from low to moderate. WDs are more effective in reducing extrinsic stain and producing a whitening-like effect in teeth than RDs, although they also produce more adverse effects. Whitening efficacy of WDs is similar to paint-on gel and lower than white strips. Higher-quality evidence demands larger, well-conducted, independent studies.

Trends in First-Year Dental Students' Information Technology Knowledge and Use: Results from a U.S. Dental School in 2009, 2012, and 2017

Dental students must be skilled in the use and application of information technology (IT), but there are few studies of IT use and knowledge among U.S. dental students. The aim of this study was to retrospectively analyze survey data regarding IT use and knowledge collected from first-year dental students at one U.S. dental school in 2009, 2012, and 2017. Data were collected from an anonymous survey of these students as part of a D1 course called Informatics and Evaluation of Dental Literature. All students participated in the survey each year, for a response rate of 100%. Annual numbers of participants were 80 (2009), 90 (2012), and 97 (2017), for a total 267 respondents. The students reported that they frequently accessed Internet resources multiple times per day and that frequency of use had increased over time, principally from access via smartphones. These students reported feeling comfortable with higher education IT applications such as learning management systems and computerized testing. However, despite their frequent IT use, the students reported low levels of knowledge about IT security, and the three years of survey data showed that IT security knowledge had declined over time. These findings have implications for dental educators, including the need for methods for training students to protect their personal data and that of their patients.