A review of the effect of vital teeth bleaching on the mechanical properties of tooth enamel.

Tooth whitening is considered the easiest and most cost-effective procedure for treating tooth discoloration. Contemporary bleaching agents contain hydrogen peroxide as the active ingredient. It is either applied directly or produced from its precursor, carbamide peroxide. A review of the published literature was undertaken to investigate the potential adverse effects of whitening products on dental enamel, with a focus on its mechanical properties and the influence of various parameters on study outcomes. There appear to be considerable differences in opinion as to whether changes in mechanical properties occur as a result of tooth whitening. However, the mechanical property findings of those studies appear to be related to the load applied during the indentation tests. Most studies which used loads higher than 500mN to determine enamel hardness showed no effect of bleaching, whereas those using lower loads were able to detect hardness reduction in the surface layer of enamel. In conclusion, bleaching reduces the hardness of the enamel surface of enamel, and that is more readily detected with instrumented low load testing systems. This hardness reduction may arise due to degradation or denaturation of enamel matrix proteins by the peroxide oxidation.