Acute Toxicological Effects of Ingested Tooth Whiteners in Female Rats

Cherry, D.V.; Bowers, Daniel E.; Thomas, Lothar; Redmond, A.F.

doi:10.1177/00220345930720090701

Cited by 24 publications

(13 citation statements)

References 21 publications

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“…For hydrogen peroxide, the oral LD 50 value was found to be approximately 1600 mg/kg (Ito et al, 1976), but no other studies have confirmed the above findings. In rats, a single oral dose of 5 g/kg BW of proprietary solutions of 10%, 15%, and 35% carbamide peroxide induced a concentration-dependent acute toxicity, and the rats showed respiratory depression, reduced weight gain and water consumption, changes in estrous cycle, and, at necropsy, histological abnormalities of the stomach, including necrotic mucosa and disrupted gastric glands (Cherry et al, 1993). In the highest-concentration group, 3 animals died of gastric hemorrhage and bloating.…”

Section: Animal Studiesmentioning

confidence: 99%

Tooth Bleaching—a Critical Review of the Biological Aspects

Dahl

Pallesen

2003

Critical Reviews in Oral Biology & Medicine

469

370

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Present tooth-bleaching techniques are based upon hydrogen peroxide as the active agent. It is applied directly, or produced in a chemical reaction from sodium perborate or carbamide peroxide. More than 90% immediate success has been reported for intracoronal bleaching of non-vital teeth, and in the period of 1-8 years' observation time, from 10 to 40% of the initially successfully treated teeth needed re-treatment. Cervical root resorption is a possible consequence of internal bleaching and is more frequently observed in teeth treated with the thermo-catalytic procedure. When the external tooth-bleaching technique is used, the first subjective change in tooth color may be observed after 2-4 nights of tooth bleaching, and more than 90% satisfactory results have been reported. Tooth sensitivity is a common side-effect of external tooth bleaching observed in 15%-78% of the patients, but clinical studies addressing the risk of other adverse effects are lacking. Direct contact with hydrogen peroxide induced genotoxic effects in bacteria and cultured cells, whereas the effect was reduced or abolished in the presence of metabolizing enzymes. Several tumor-promoting studies, including the hamster cheek pouch model, indicated that hydrogen peroxide might act as a promoter. Multiple exposures of hydrogen peroxide have resulted in localized effects on the gastric mucosa, decreased food consumption, reduced weight gain, and blood chemistry changes in mice and rats. Our risk assessment revealed that a sufficient safety level was not reached in certain clinical situations of external tooth bleaching, such as bleaching one tooth arch with 35% carbamide peroxide, using several applications per day of 22% carbamide peroxide, and bleaching both arches simultaneously with 22% carbamide peroxide. The recommendation is to avoid using concentrations higher than 10% carbamide peroxide when one performs external bleaching. We advocate a selective use of external tooth bleaching based on high ethical standards and professional judgment.

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Section: Animal Studiesmentioning

confidence: 99%

Tooth Bleaching—a Critical Review of the Biological Aspects

Dahl

Pallesen

2003

Critical Reviews in Oral Biology & Medicine

469

370

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“…Many of the systems available today use 10, 15–16 or 35% carbamide peroxide as the active bleaching agent ( Yarborough, 1991; Cherry et al , 1993 ). Vital bleaching using carbamide peroxide has been suggested as a safe alternative to vital bleaching with hydrogen peroxide ( Haywood & Heymann, 1991).…”

Section: Introductionmentioning

confidence: 99%

Effects of three concentrations of carbamide peroxide on the structure of enamel

Oltu

Gürgan

2000

J of Oral Rehabilitation

155

113

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Carbamide peroxide bleaching agents have raised important questions on their potential adverse effects on the structure of enamel. The purpose of this study was to examine the effects of three carbamide peroxide bleaching agents in different concentrations (10, 16 and 35%) on the structure of enamel. Forty enamel slabs prepared from human third molars were divided equally among four groups. The specimens in the first and second group were subjected to 10% or 16% carbamide peroxide for 8 h per day for 6 weeks. Thirty-five percent carbamide peroxide was applied to the third group for 30 min a day for a 4 day period according to the manufacturers recommendation. The fourth group served as the control and was kept in artificial saliva during the test period. At the completion of the treatment, all the specimens were examined by infrared absorbtion spectroscopy and X-ray diffraction analysis. The results revealed that 10% or 16% carbamide peroxide did not seem to effect the structure of enamel, whereas 35% carbamide did affect the structure. The use of lower concentrations of carbamide peroxide (10-16%) is recommended over higher concentrations (35%) to avoid changes to the enamel.

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“…8 Animal models can also be used to characterize the toxic effects of bleaching substances. 24 These studies show the genotoxic effect caused by oxidative stress to the DNA, due to the action of peroxide, but the effects are smaller than those found in in vitro studies. This is probably related to the quick detoxification of H 2 0 2 and the elimination of free radicals before any interaction with the DNA.…”

Section: Discussionmentioning

confidence: 93%

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

et al. 2015

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Dental bleaching has become one of the most frequently requested esthetic treatments in dental offices. Despite the high clinical success observed with this procedure, some adverse effects have been reported, including a potential for developing premalignant lesions, root resorption and tooth sensitivity, especially when misused. The aim of this study was to evaluate the genotoxic response using a micronucleus (MN) assay, after the application of two concentrations of carbamide peroxide. Thirty-seven patients were divided into two groups and randomly received either a 10% carbamide peroxide (CP) (19) or a 16% carbamide peroxide (18) concentration for 21 days in individual dental trays. Gingival margin cells were collected immediately before the first use (baseline), and then 15 and 45 days after baseline. The cells were placed on a histological slide, stained by the Feulgen technique, and evaluated by an experienced blinded examiner. One thousand cells per slide were counted, and the MN rate was determined. The two groups were analyzed by the Wilcoxon rank-sum test and the Kruskal-Wallis equality-of-populations rank test. A slight increase in MN was observed for both groups, in comparison with the baseline, at 15 days. However, no difference was observed between the two groups (10% and 16%), at either 15 or 45 days (p = 0.90). When bleaching is not prolonged or not performed very frequently, bleaching agents containing carbamide peroxide alone will not cause mutagenic stress on gingival epithelial cells.

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Acute Toxicological Effects of Ingested Tooth Whiteners in Female Rats

Cited by 24 publications

References 21 publications

Tooth Bleaching—a Critical Review of the Biological Aspects

Tooth Bleaching—a Critical Review of the Biological Aspects

Effects of three concentrations of carbamide peroxide on the structure of enamel

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

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