Whitening toothpaste containing activated charcoal, blue covarine, hydrogen peroxide or microbeads: which one is the most effective?

Abstract

The efficacy of whitening toothpastes is questionable and controversial. Clinicians, patients and researchers have expressed concern with whitening toothpastes due to the risk of wearing the dental structure and the potential for disappointment if the advertised cosmetic results are not achieved. Objective: This study compared the whitening performance of toothpastes with different whitening technologies after initial and continued use. Material and Methods: Ninety bovine incisors were stained using a concentrated solution of black tea. They were randomly distributed into 6 groups, according to the toothpaste whitening technology: activated charcoal (B&W), blue covarine (WAD), hydrogen peroxide (LWA), microbeads (Oral B 3D White Perfection – 3DW) and optimized abrasives (XW4D). They were compared to a traditional toothpaste without a whitening agent (TA – control). Specimens underwent a brushing machine with controlled pressure, time and temperature. A calibrated examiner measured the color using a VITA-Classical scale before the first brushing cycle (T0), after the first brushing cycle (TI), and after a brushing cycle that simulates continuous use (TCU). Whitening performance was evaluated by the difference of shades (ΔSGU) between T0–TI and T0–TCU timepoints, using the Kruskal-Wallis and Dunn's non-parametric test. The Wilcoxon test was used to evaluate the cumulative effect (α=0.05). Results: Statistically significant differences were observed between toothpastes in both TI and TCU (p<0.05). The time of use also had a significant effect (p<0.05). Conclusion: Only WAD and 3DW showed whitening performance after the first use (TI). The greatest whitening performance after continuous use was obtained by WAD, followed by LWA and 3DW. The use of conventional toothpaste (TA) promotes no tooth whitening. Clinical relevance: Microbead abrasives (3DW) and blue covarine (WAD) were the active technology tested that presented the best global tooth whitening performance.

Whitening Dentifrices Effect on Enamel with Orthodontic Braces after Simulated Brushing

“…The best whitening performance was obtained in microsphere dentifrices, followed by those with hydrogen peroxide and blue covarine dye (CI74160). 4,12 These results corroborate the present study, in which groups containing abrasive agents such as activated charcoal or bleaching agents such as hydrogen peroxide showed significant color change over the initial 6 months and progressive change over the final 6 months. H 2 O 2 showed a higher perception of whiteness compared with the other groups.…”

“…25 Patients should be directed to use these formulations properly, as there may be potential for increased abrasiveness and damage to enamel. 4,22 Whitening dentifrices can be more effective in altering the color of teeth than the conventional dentifrices. The best whitening performance was obtained in microsphere dentifrices, followed by those with hydrogen peroxide and blue covarine dye (CI74160).…”

“…2,3 The use of different types and concentrations of abrasives does not promote tooth whitening but is based on the mechanical or abrasive activity of removing biofilms and pigments adhered to the surface of tooth enamel, thus improving aesthetics and restoring the natural dental color. 4 Whitening dentifrices containing hydrated silica, calcium carbonate, dicalcium dihydrate phosphate, calcium pyrophosphate, alumina, perlite, or sodium bicarbonate mechanically remove biofilm stains on the surface of tooth enamel. In addition, daily use of these abrasives modifies the surface of the enamel by reducing biofilm adhesion, decreasing dental stains, and altering its color.…”

Charcoal-based mouthwashes: a literature review

“…The conducted literary search yielded ten potentially qualified articles on charcoal as an ingredient in mouthwash or rinse for oral hygiene purposes; however, none of the publications met the inclusion criteria. 4,5,6,7,8,9,10,11,12,13 Product information The inclusion of charcoal was the sine qua non for this investigation. With respect to therapeutic agents, fluoride was found in 13.9% (5/36) of the products, and 8.3% (3/36) of the brands contained cetylpyridinium chloride or chlorhexidine.…”

“…Although there are no investigations to substantiate that charcoal mouthwash may whiten teeth, an in vitro study involving bovine incisors found one brand of charcoal-based toothpaste resulted in some degree of loss of surface pigmentation. 13 However, Greenwall et al 24 suggested that charcoal particles may lead to marginal staining along the cavosurfaces of defective composite restorations. Only one brand of charcoal mouthwash contained hydrogen peroxide as an apparent chemical bleaching method to whiten teeth; none listed carbamide peroxide.…”