Bright Smiles, Hidden Dangers: A Literature Review on the Potential Side Effects of Peroxide Based Over-The-Counter Teeth Whitening Treatments

Abstract

Background: Adults' dissatisfaction with their smile and tooth color has led to an increased demand for teeth whitening products, particularly over-the-counter (OTC) systems, which utilize peroxides like hydrogen peroxide and carbamide peroxide. While generally safe, these products can temporarily increase tooth sensitivity due to enamel surface damage. Method: An analytical review was conducted using databases like PubMed, Web of Science, and ScienceDirect, focusing on publications from the past 10 years. Initial findings totaled 35, which were narrowed down to 12 after applying selection criteria, with 5 manuscripts ultimately included. Each paper independently assessed by the authors covered the risks and side effects of hydrogen peroxide and carbamide peroxide in whitening products. Discussion: Studies highlighted the oxidizing mechanisms of hydrogen peroxide and carbamide peroxide, resulting in a lighter tooth appearance. Additionally, they revealed risks associated with prolonged use, including enamel microhardness and ultrastructural changes, and increased tooth sensitivity due to peroxide penetration and release of inflammatory mediators. Conclusion: While peroxide-based whitening products effectively enhance tooth color, their use necessitates caution due to potential adverse effects on enamel integrity and tooth sensitivity. As demand for at-home whitening rises, balancing efficacy with safety is crucial. Future research should refine whitening protocols, optimize safety parameters, and comprehensively evaluate adverse effects to advance dental whitening practices. Keywords: Hydrogen peroxide, carbamide peroxide, teeth whitener, teeth bleaching, side effects, Over-the-counter products