---

Tooth whitening has become an increasingly popular esthetic service for patients and is well-integrated in dental practices. At-home whitening with carbamide peroxide and hydrogen peroxide (H2O2) was originally part of a complete dental procedure which included the dentist examining the patient to ensure there were no contraindications to treatment with the bleaching agent. However, it has seen rapid growth as an over-the-counter product. The latter products typically have higher concentrations of H202 that are used for shorter time periods.

Safety Concerns of H2O2 Bleaching Products

The safety concerns regarding potential systemic effects are no longer a primary issue given the H2O2 is limited to the oral cavity and does not reach levels which would induce systemic toxicity. However, patients should be advised not to smoke or drink alcohol while undergoing bleaching treatment as H2O2 can promote tumour growth in the presence of DMBA (tobacco carcinogen) in vitro.

There are documented local adverse effects of bleaching products like tissue burns, tooth sensitivity which is transient,gingival irritation.

Mineral loss occurs during bleaching but, is not significant as there are remineralization capabilities within the oral cavity.

Chlorine dioxide bleaching agents are also available and are used mainly in beauty spas and cruise ships. These agents make teeth more susceptible to re-staining, strip enamel from tooth surfaces irreversibly while reducing the enamel's natural lustre and cause sensitivity.

---

Tooth whitening