Dental aesthetic perception of patients submitted to violet LED bleaching: Randomized controlled trial

Abstract

Objective

To evaluate the effects of violet LED compared to 35 % hydrogen peroxide (HP) and the combination of treatments, on aesthetic perception and psychosocial impact before and after treatment.

Methods

Eighty-four participants were randomly assigned to three bleaching groups (n = 28): HP only, violet LED only (VLED), and HP combined with violet LED (HP+VLED). Treatments were applied in three sessions at seven-day intervals. The following questionnaires were applied before and 30 days after treatment: Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ), Oral Health Impact Profile specific to Aesthetics (OHIP-Aesthetics), and Orofacial Esthetics Scale (OES). Data were analyzed using descriptive statistics, linear mixed models for repeated measures, and nonparametric tests (α = 0.05).

Results

For PIDAQ, the HP and HP+VLED groups showed significant increases in dental self-confidence and reductions in social and psychological impacts, as well as in aesthetic concern (p < 0.05). The VLED group demonstrated improvement only in social impact and aesthetic concern. For OHIP-Aesthetics, only the HP+VLED group presented significant reductions in functional limitation, psychological discomfort, physical and psychological disability, and total score (p < 0.05). The OES scores increased significantly in the HP and HP+VLED groups, but not in the VLED group.

Conclusion

Violet LED alone produced limited benefits for aesthetic perception and quality of life. Treatments with 35 % HP, alone or combined with violet LED, led to greater improvements in self-perception and reduced psychosocial impact.

Clinical relevance

The current study demonstrates that while violet LED alone offers limited benefits, 35 % hydrogen peroxide protocols generate meaningful improvements in dental self-confidence, reduced psychosocial impact, and enhanced aesthetic satisfaction. These effects were evident in both the HP-only and HP+VLED groups. The findings highlight that beyond achieving a whiter smile, bleaching treatments can positively influence patient-reported outcomes related to quality of life, reinforcing the importance of including psychosocial measures when evaluating aesthetic dental interventions. This study contributes valuable data to support patient-centered care in clinical practice.