Over-the-counter whitening agents: a concise review

Abstract

Tooth discoloration is commonly found in the dental clinic and tooth bleaching has been considered the preferred esthetic alternative, being more conservative, safe and with predictable results. Supervised home-use of 10% Carbamide Peroxide (CP) bleaching with custom-trays is the most common bleaching procedure dispensed by dentists to their patients. The good results obtained with this technique stimulated the flourishing of new products and techniques. Over-the-counter (OTC) bleaching products appeared as a low-cost alternative to bleach discolored teeth without dentist supervision. Different OTC products are available in supermarkets, drug stores or on the Internet, including rinses, paint-on brushes, toothpastes, chewing guns, dental floss, and whitening strips. There is lack of clinical evidence regarding the safety and effectiveness of these products, being most of the studies supported by the manufacturers'. Basically, toothpastes, chewing gums, and dental floss are removal agents of superficial stains. Rinses and paint-on brushes with low levels of hydrogen peroxide have some whitening effect, but without clinical relevance. Strips present similar esthetic results and side-effects, compared to bleaching with 10% CP using trays; however, the studies have financial support from the manufacturers and were based on short term evaluations. Legislation varies widely in different countries regarding OTC dental bleaching. Concerns have appeared due to the potential abusive use of these self-medication agents, especially in young patients, with potential harmful results. Dentists should be acquainted with this kind of products to be able to inform their patients. In conclusion, there is a need for independent clinical trials to provide sufficient evidence regarding the use of OTC bleaching products.

Physical-chemical characteristics of whitening toothpaste and evaluation of its effects on enamel roughness

“…[3][4][5] The color of teeth is influenced by a combination of their intrinsic color and the presence of any extrinsic stains that may form on the tooth surface. 6 The active components of the whitening toothpastes include surfactants, polyphosphates and enzymes. Some of them also contain low peroxide concentrations.…”

“…However, the evidence to date suggests that the primary stain removal ingredient in these toothpastes is the abrasive agents. 4,6 The abrasive agents are present in the toothpastes' formulation, which play an important role in cleaning teeth. However, their abrasiveness, which is influenced by particle hardness, size and shape, and also by the pH of the toothpaste, must be controlled.…”

Produtos de autocuidado para clareamento dental

“…Dentre os métodos utilizados para a recuperação da descoloração dentária, o clareamento dental é o mais conservador. O clareamento pode ser realizado no consultório odontológico ou em casa, sob a supervisão do dentista, com agentes clareadores colocados em moldeiras ou com produtos clareadores usados pelo paciente, sem supervisão profissional 2 . O clareamento caseiro com peróxido de carbamida (PC) a 10% tem sido um dos procedimentos mais requisitados em odontologia e é considerado o gold standard em termos de efeito clareador e baixo ní-vel de efeitos adversos para clareamento de dentes vitais 3 .…”

“…Tendo em vista a popularidade e os resultados estéticos favoráveis do tratamento clareador caseiro com PC 10%, ocorreu um aparecimento de novos produtos no mercado, os quais apresentam diferentes formas de uso, contendo ou não agentes clareadores, e que podem ser comprados livremente em farmácias, supermercados ou pela internet, sendo utilizados sem a supervisão do odontólogo. Esses produtos, chamados de autocuidado ou OTC (do in- glês over-the-counter), foram introduzidos nos Estados Unidos por volta do ano 2000, como alternativa mais econômica em relação ao tratamento realizado pelos dentistas no consultório ou com o uso de moldeiras 2,4 . O presente trabalho tem como objetivo realizar uma revisão de literatura sobre os diferentes produtos de autocuidado para clareamento dental, procurando discutir sua efetividade e os potenciais problemas relacionados com o seu uso.…”

Genotoxic potential of 10% and 16% Carbamide Peroxide in dental bleaching

“…Intrinsic stains are related to the properties of enamel and dentin, whereas extrinsic stains are associated with deposition of food and beverages onto the tooth surface. 1 Tooth bleaching with custom trays for home use is considered the most common bleaching procedure recommended by dentists to patients. 2 The procedure usually involves the use of 10% carbamide peroxide (CP) applied in a tray and worn by the patient overnight for at least 2 weeks.…”