Hydrogen peroxide tooth-whitening (bleaching) products: Review of adverse effects and safety issues

Tredwin, Christopher; Naik, Supritha; Lewis, Nicholas; Scully, Crispian

doi:10.1038/sj.bdj.4813423

Cited by 272 publications

(235 citation statements)

References 64 publications

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“…It should be highlighted that the exact mechanism by which the bleaching agents act on dentin is not yet clearly understood (15). It has been speculated that the adverse effects of these substances on dental tissues are related to their pH rather than to the chemical agents themselves (1).…”

Section: Discussionmentioning

confidence: 99%

“…In contact with the dental tissues, the CP dissociates in urea and HP. Urea is decomposed in carbon dioxide and ammonia, and HP is decomposed in water and nascent oxygen, with release of energy (1,15). The reactive and instable oxygen molecules attack the longchained, dark-colored chromophore molecules split them into smaller, less colored molecules (15).…”

Section: Discussionmentioning

confidence: 99%

“…The analysis should thus be limited to the chemical effects of the bleaching substances (HP and CP) on the dental tissues (1,15).…”

Section: Discussionmentioning

confidence: 99%

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Ex-vivo evaluation of the intrapulpal temperature variation and fracture strength in teeth subjected to different external bleaching protocols

et al. 2011

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This study evaluated the influence of bleaching protocols on intrapulpal temperature and fracture strength of the bleached teeth. Ninety maxillary incisors were assigned to 9 groups (n=10): G1: 35% carbamide peroxide (35% CP), G2: 38% hydrogen peroxide (38% HP), G3: halogen light, G4: LED-laser, G5: 35% CP + halogen light, G6: 38% HP + halogen light, G7: 35% CP + LED-laser, G8: 38% HP + LED-laser, and G9: no treatment (control). Pulp space was widened, a thermocouple was introduced through the apex up to the pulp chamber and the temperature was recorded (°C). The fracture strength (kN) was determined using an Instron machine. Data were analyzed by ANOVA and Tukey's test (p<0.05). The halogen light alone (1.10 ± 0.24) (G3) and associated with 38% HP (1.15 ± 0.30) (G6) produced the highest temperature increase, statistically different (p<0.05) from the other groups. G1 (0.15 ± 0.06) and G6 (0.19 ± 0.07) produced the lowest values, statistically different (p<0.05) from G5 (0.65 ± 0.49). The bleaching protocols increased the temperature, but no increment exceeded the critical value of 5.6°C. Neither 35% CP nor 38% HP or the light sources alone altered the fracture strength of the teeth.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ex-vivo evaluation of the intrapulpal temperature variation and fracture strength in teeth subjected to different external bleaching protocols

et al. 2011

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“…6 Concerns have also been raised about the potential of bleaching treatments to cause premalignant oral lesions. 7 Hydrogen peroxide (H 2 0 2 ) has been found to enhance the carcinogenic effects of potent DNA reactive carcinogens in experimental animals, but these experimental conditions are artificial; they involve high levels of exposure and are of no relevance to potential human exposure to low quantities of H 2 0 2 from tooth whitening products. 8 However, during the bleaching process, CP breaks down into H 2 0 2 and urea, which are then dissociated into oxygen, water, ammonia, carbon dioxide, 9 and reactive oxygen species (ROS) that are considered potentially carcinogenic agents able to cause damage to proteins and changes in the cell nucleus.…”

Section: Introductionmentioning

confidence: 99%

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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“…Nowadays, bleaching agents with hydrogen peroxide, as their active substance, have been chosen in clinical field because their action mechanism consists of a strong oxidation reaction through the formation of free radicals, reactive oxygen molecules and peroxide anions of hydrogen (CHNG, 2002;EIMAR, 2012;XU, 2011). These reactive molecules attack the long-chained, dark-colored chromophore molecules of the tooth and split them into smaller, less colored and more diffusible molecules (TREDWIN, 2006). Carbamide peroxide, a material hitherto used for extern bleaching, has been indicated for inner bleaching and has obtained satisfactory results.…”

Section: Introductionmentioning

confidence: 99%

Influence of Post-Bleaching Time Intervals Using 37% Carbamide Peroxide on Dental Substrate Adhesion

Yamakami

Faraoni

Caslini

et al. 2017

Iniciac cient Cesumar

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ABSTRACT:The aim of this study was to evaluate the influence of post-bleaching time intervals using 37% carbamide peroxide on dental substrate adhesion. Fifty bovine incisors were sectioned in two groups of 4X4 mm standard blocks to obtain 50 specimens in each group (n=50). In fifty blocks, the dentin (D) was analyzed and in the other 50 the enamel (E). Blocks were subjected to bleaching treatment and restored with Single Bond/ z250 according to post-bleaching time intervals (0, 7, 14 and 21 days : 8.40 (0.87). Data were submitted to ANOVA and Tukey (p< 0.05) tests. The bond strength value for the enamel was statistically higher than the dentin, and both were lower than the control group that had similar results after 21 days post-bleaching. In dentin group, the control showed superior bond strength and was statistically different in relation to other times. It was concluded that bleaching had negative influence on adhesion. Therefore it is necessary to wait, at least, 21 days after bleaching to restore the enamel. KEYWORDS:Bleaching Agents; Peroxides; Dentin; Enamel. AVALIAÇÃO IN VITRO DA INFLUÊNCIA DE DIFERENTES INTERVALOS DE TEMPO PÓS-CLAREAMENTO COM PERÓXIDO DE CARBAMIDA 37% NA ADESÃO AO SUBSTRATO DENTALABSTRACT: O objetivo deste estudo foi avaliar a influência do peróxido de carbamida a 37% sobre a adesão dos substratos dentários em diferentes intervalos de tempo pós-clareamento. Cinquenta incisivos bovinos foram divididos em dois grupos de blocos padrão 4 x 4 mm para obter 50 espécimes de cada grupo (n = 50). Em cinquenta blocos, a dentina (D) foi analisada e nos outros 50 o esmalte (E). Os blocos foram submetidos ao tratamento de clareamento e restaurados com Single Bond/z250 de acordo com os intervalos de tempo pós-clareamento (0, 7, 14 e 21 dias). Após vinte e quatro horas os corpos de prova preparados com adesivo/resina foram submetidos ao teste de resistência ao cisalhamento (SBS) em uma máquina universal de ensaio. As médias (Mpa) e seus respectivos desvios padrão foram: E -controle: 31,89 (2,39); T0: 19,07 (2,00); T7: 24,97 (4,89); T14: 29,71 (4,89); T21: 40,91 (4,75) e D -controle: 18,90 (3,64); T0: 2,22 (0,41); T7: 3,79 (0,75); T14: 5,95 (0,79); T21: 8,40 (0,87). Os dados foram submetidos à ANOVA e ao teste de Turkey (p <0,05). O valor da resistência de união para o esmalte foi estatisticamente superior a dentina e ambos foram inferiores ao grupo controle que apresentou resultados semelhantes após 21 dias pós-branqueamento. O grupo controle (D) apresentou valores de resistência de união superior e estatisticamente diferente em relação aos outros tempos. Concluiu-se que o clareamento teve influência negativa sobre a adesão. Portanto, tornar-se-á necessário aguardar, pelo menos, 21 dias após o clareamento para restaurar o esmalte.

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Hydrogen peroxide tooth-whitening (bleaching) products: Review of adverse effects and safety issues

Cited by 272 publications

References 64 publications

Ex-vivo evaluation of the intrapulpal temperature variation and fracture strength in teeth subjected to different external bleaching protocols

Ex-vivo evaluation of the intrapulpal temperature variation and fracture strength in teeth subjected to different external bleaching protocols

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

Influence of Post-Bleaching Time Intervals Using 37% Carbamide Peroxide on Dental Substrate Adhesion

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