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Teeth whitening products, study in Nature: "they produce extensive damage"

They sell a lot of them, even with high concentrations of the active ingredient: they are teeth whiteners, and a study says they do very badly.

Gianluca Ricciodi Gianluca Riccio
in Medicine
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Teeth whiteners
August 22 2021
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A study conducted by researchers at the University of Toronto highlights the enormous damage that can be caused by common teeth whitening agents.

Recently published in Nature Scientific Reports , the study evaluated the damage to dental cells caused by the use of carbamide peroxide teeth whitening treatments.

The study found that a recommended application of only 10% carbamide peroxide gel on teeth (formulations that also contain 35% carbamide peroxide gel are on sale online) reduces the protein content of the enamel by up to 50%.

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Whiteners literally wreak havoc on your teeth

“We have always been interested in the whitening effect of teeth based on peroxide. In particular, the effect on the tooth structure and its link with sensitivity, ”he says Laurent Bozec, author of the study and associate professor at the University of Toronto School of Dentistry.

In this research we wanted to further understand the impact on the enamel itself and deep within the pulp.

Laurent Bozec

Prior to this study, Bozec looked at the effect of using hydrogen peroxide in root canal treatment. On that occasion he found that it was causing collagen damage locally. This led him to investigate how the peroxide contained in tooth whiteners penetrates through the enamel and dentin before reaching the dental pulp. And he checked what damage it can cause along the way.

The study found that the loss of enamel protein content leads to greater penetration of the whitening agent into the tooth and can lead to increased dental pulp cell mortality.

The team used an internal dentin perfusion chamber to make the measurements. At carbamide peroxide concentrations around 35%, the researchers found that the dental pulp cells did not survive the exposure.

Teeth whiteners
The application of carbamide peroxide gel on the teeth in high concentrations can reduce the enamel protein content by up to 50%. 
Photo courtesy of the Bozec Lab

Teeth whiteners: extensive and still unknown damage

“Many home teeth whitening products have a really high concentration of peroxide gel, yet little is known about what it does inside our teeth,” says Bozec. “We believe this is the first study of its kind to show the extremely toxic effects of using a teeth whitening agent. Our hope is that people will opt for a lower concentration of peroxide if they really decide to use a teeth whitening product. "

Although using a lower peroxide concentration (e.g. 5%) would be less harmful to dental cells, consumers often opt for higher peroxide concentrations. Because? Obviously, to obtain an immediate whitening effect.

The researchers' recommendations

The study shows the need for a compromise between the peroxide concentrations used, the exposure time, the desired patient outcomes and the side effects encountered.

This mix should be tested in vivo before release to the market and patients should be made aware of the impact of these procedures on their oral health, the researchers recommend.

“There is the option of using a non-peroxide-based or controlled peroxide releasing agent that won't cause the same damage,” says Bozec. “I believe this is the future of teeth whiteners”.

tags: teeth
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