Effects of prolonged use of over-the-counter bleaching agents on enamel: An in vitro study

This study evaluated the effects of four over-the-counter (OTC) bleaching products on the properties of enamel. Extracted human molars were randomly assigned into four groups (n = 5): PD: Poladay (SDI), WG: White Teeth Global (White Teeth Global), CW: Crest3DWhite (Procter & Gamble), and HS: HiSmile (HiSmile). The hydrogen peroxide (H2O2) content in each product was analyzed via titration. Twenty teeth were sectioned into quarters, embedded in epoxy resin, and polished. Each quarter-tooth surface was treated with one of the four beaching times: T0: control/no-bleaching, T14: 14 days, T28: 28 days, and T56: 56 days. Materials were applied to enamel surfaces as recommended. Enamel surfaces were examined for ultramicrohardness (UMH), elastic modulus (EM), superficial roughness (Sa), and scanning electron microscopy (SEM). Ten additional teeth were used to evaluate color and degree of demineralization (DD) (n = 5). Data were statistically tested by two-way ANOVA and Tukey's tests (alpha = 5%). Enamel surfaces treated with PD and WG presented UMH values significantly lower than the controls (p < .05). Elastic modulus (E) was significantly reduced at T14 and T28 for PD, and at T14 for HS (p < .05). A significant increase in Sa was observed for CW at T14 (p < .05). Color changes were observed in the PD and WG groups. Additionally, DD analysis showed significant demineralization at T56 for CW. Overall, more evident morphological alterations were observed for bleaching products with higher concentrations of H2O2 (p < .05), PD, and WG. Over-the-counter bleaching products containing H2O2 can significantly alter enamel properties, especially when application time is extended.