Efficacy of natural, peroxide‐free tooth‐bleaching agents: A systematic review, meta‐analysis, and technological prospecting

Ribeiro, Juliana Silva; Rosa, Wellington Luiz de Oliveira da; Silva, Adriana Fernandes da; Piva, Evandro; Lund, Rafael Guerra

doi:10.1002/ptr.6590

Cited by 16 publications

(10 citation statements)

References 30 publications

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“…Thus, we hypothesized that the development of new whitening agents based on natural products could provide similar aesthetic results and minor side effects 12 . Up to now, it seems that despite some papers relate the use of natural compounds as dental bleaching agents, these were not more effective than the traditional techniques 14 .…”

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confidence: 99%

Novel in-office peroxide-free tooth-whitening gels: bleaching effectiveness, enamel surface alterations, and cell viability

Ribeiro

Barboza

Cuevas‐Suárez

et al. 2020

Sci Rep

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To evaluate the bleaching ability, the effect on enamel surface and cytotoxicity of novel toothwhitening formulations containing papain, ficin, or bromelain. Forty bovine dental discs (6 cm ×4 cm) were pigmentated and randomly allocated into the following groups (n = 10): Group 1, 20 wt% carbamide peroxide (control); group 2, 1% papain-based whitening; group 3, 1% ficin-based whitening; and group 4, 1% bromelain-based whitening. The whitening gels were prepared and applied on the enamel three times per day once a week, for 4 weeks. Color measurement was obtained by CIEDE2000. Enamel Knoop microhardness and roughness were evaluated. The WST-1 assay was used to evaluate the cell viability of mouse fibroblast cells (L929). Data were statistically analyzed by one-way analysis of variance (ANOVA) and Student Newman Keuls's post hoc test at α = 0.05 significance level. Bromelain, ficin-based, and carbamide peroxide bleaching gels showed a similar color change (p < 0.001). Higher enamel hardness decrease and higher enamel roughness were caused by the carbamide peroxide (p < 0.05). The experimental whitening gels did not affect cell viability. Tooth bleaching gels containing bromelain, papain, or ficin have substantial clinical potential to be used in the development of peroxidefree tooth whitening gels. Tooth whitening has become one of the most performed and demanded cosmetic dental procedures. It is a non-invasive treatment that improves the appearance of a patient smile, positively affecting the quality of life 1,2. The two whitening techniques traditionally used are the at-home and the in-office whitening techniques. Both techniques involve the use of different concentrations of carbamide or hydrogen peroxide as active agents 3. Concentrations of such active agents commonly used for in-office whitening therapy vary from 20%, 35% or even 38% 4. Despite that, the efficiency of whitening systems is consolidated in the literature and dental practice, incorrect application in excessive quantities of time can cause side effects 5. The most common drawback caused by the use of high hydrogen peroxide concentrations is tooth sensitivity 6. A study demonstrated that 85% of patients treated using an in-office bleaching technique report tooth sensitivity 7,8. It was hypothesized that tooth sensitivity after dental bleaching is related to the degradation of the hydrogen peroxide into reactive oxygen species (ROS) which can diffuse to the pulp chamber through the dentinal tubules, inducing the release of inflammatory mediators, like IL-1β and RANK-L 9,10. Although the use of analgesics, anti-inflammatories, antioxidants, corticosteroids, and opioid drugs are used as a way to minimize this side-effect, the use of oral medications is not able to reduce the risk of tooth sensitivity 11. An alternative to reduce or solve this problem is the use of natural compounds. Given their natural origin, these types of products have a certain guarantee on their non-toxic biological behavior, resulting in little or no

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confidence: 99%

Novel in-office peroxide-free tooth-whitening gels: bleaching effectiveness, enamel surface alterations, and cell viability

Ribeiro

Barboza

Cuevas‐Suárez

et al. 2020

Sci Rep

Self Cite

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“…Cerca de um terço dos métodos de clareamento foi realizado sem supervisão de um cirurgião-dentista e foi apresentada também uma variedade de métodos de clareamento sem o uso de peróxidos. A literatura atual não suporta o uso de agentes caseiros ou naturais como clareamento dental 22 , ou alegações para o uso de dentifrícios à base de carvão vegetal, não havendo, assim, relatos de sua eficácia e segurança 23 . O mecanismo dos agentes naturais e das pastas clareadoras dá-se através de abrasivos e, observe-se, dentifrícios à base de carvão aumentam a rugosidade da superfície dental, com valores estatisticamente significativos após um mês de escovação usando creme dental contendo carvão 24 .…”

Section: Discussionunclassified

Seria o YouTube uma fonte confiável de informação sobre clareamento dental no Brasil?

Silva

Trevizan

Monteiro

2020

Rev. odontol. UNESP

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Resumo Introdução O clareamento dental é um procedimento amplamente realizado, levando a uma procura de informação pelos pacientes, sendo que uma dessas fontes são os vídeos do YouTube. Objetivo: Avaliar a qualidade das informações contidas nos vídeos do YouTube sobre clareamento dental no Brasil. Material e método Uma busca no YouTube foi realizada com a frase “clareamento dental”. Os primeiros 100 vídeos foram selecionados e visualizados na íntegra por dois examinadores, e parâmetros gerais foram registrados. Para avaliar a qualidade das informações, duas análises foram realizadas, avaliando a utilidade e a confiabilidade das informações. O teste de Mann-Whitney foi utilizado para avaliar e comparar a qualidade das informações. Resultado Dos 100 vídeos selecionados, 22 foram excluídos por não se adequarem aos critérios de seleção, restando 78 vídeos. Sobre a utilidade dos vídeos, 65,4% foram classificados como não úteis, 26,9% pouco úteis, 6,4% moderadamente úteis e apenas 1,3% muito útil. Sobre a confiabilidade dos vídeos, 94% não utilizaram fontes confiáveis de informação e 69% das informações não se apresentaram equilibradas e imparciais. Por outro lado, 60% dos vídeos exibiram informações claras e objetivas. Conclusão Atualmente, o YouTube não é uma fonte adequada de informações para pacientes sobre clareamento dental no Brasil. Sobre a qualidade dos vídeos, a maioria não se apresentou como satisfatória para os critérios de confiabilidade e utilidade. Os dentistas são a melhor fonte de conteúdo para clareamento dental. Entretanto os vídeos mais populares são de leigos e normalmente abordam receitas caseiras de clareamento dental.

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“…Some vegetablederived enzymes, such as papain and bromelain, have been tested in dentifrices, with an intention to help with the degradation of the acquired pellicle (34) and improve stain removal (99). A recent systematic review with a metanalysis evaluated several natural extracts, chlorine dioxide, sodium chloride, sodium bicarbonate, vinegar, etc., and their combination with peroxides, and concluded that, although they could be an alternative to tooth whitening, evidence is still scarce (29). Even so, the authors pointed out that there are a great number of patients with these products, indicating an interest of the industry in studying them and possibly developing new OTC options in the near future (29).…”

Section: Future Perspectives and General Findingsmentioning

confidence: 99%

Effectiveness and Adverse Effects of Over-the-Counter Whitening Products on Dental Tissues

et al. 2021

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The role of bleaching agents (e.g., hydrogen peroxide) in tooth bleaching is quite well-described in a few literature studies and considered as the option choice for those desiring brighter teeth, but alternative methods have emerged to fulfill the desire of patients in a faster, easier, and cheaper way. In this context, whitening over-the-counter (OTC) products are available in several vehicles, such as toothpaste, rinses, gums, paint-on varnishes, and strips, but their effectiveness in terms of bleaching is questioned. This review aimed to describe their mode of action, whitening effectiveness, and harmful effects associated with the indiscriminate use of these products. Dentifrices usually present a combination of abrasives that can induce damage to the tooth surface without evidence of promoting real bleaching. The same was found for rinses, which might present a low pH, with an erosive potential. Charcoal has been included in the composition of these products to improve their whitening effect but there is no evidence supporting it. Regarding strips, they present hydrogen peroxide in a variety of concentrations and are the only OTC products able to promote bleaching. Despite the vehicle, an indication for the use of these products should be made after a careful individual diagnosis of the etiology of the dental staining, considering that most of them seem to be effective only in removing extrinsic stains or preventing their formation over enamel. Also, their indiscriminate use might induce damage and deleterious effects over tooth tissues or gingival tissues. The dentist should be aware of the composition and mode of action of each individual product as they change according to the composition and the vehicle used to recommend the best mode of usage. Still, there is no sound evidence that any of the described OTC products promote a better bleaching effect than the products indicated for a professional.

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Efficacy of natural, peroxide‐free tooth‐bleaching agents: A systematic review, meta‐analysis, and technological prospecting

Cited by 16 publications

References 30 publications

Novel in-office peroxide-free tooth-whitening gels: bleaching effectiveness, enamel surface alterations, and cell viability

Novel in-office peroxide-free tooth-whitening gels: bleaching effectiveness, enamel surface alterations, and cell viability

Seria o YouTube uma fonte confiável de informação sobre clareamento dental no Brasil?

Effectiveness and Adverse Effects of Over-the-Counter Whitening Products on Dental Tissues

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