Effect of various tooth-whitening products on enamel microhardness.

Objectives: The purpose of this in vitro study was to evaluate the effect of various tooth-whitening products containing carbamide peroxide (CP) or hydrogen peroxide (HP), on enamel microhardness.

Methods: Enamel blocks were exposed to: Nite White ACP 10% CP (Group 2, n=10); Yotuel Patient 10% CP (Group 3, n=10); Opalescence PF 10% CP (Group 4, n=10); Opalescence PF 20% CP (Group 5, n=10); Opalescence Treswhite Supreme 10% HP (Group 6, n=10); Yotuel 10 Minutes 30% CP (Group 7, n=10); Opalescence Quick 45% CP (Group 8, n=10), Yotuel Special 35% HP (Group 9, n=10), Opalescence Boost 38% HP (Group 10, n=10) according to the instructions of the manufacturers. The control (Group 1, n=10) was enamel blocks kept in artificial saliva at 37 degrees C without any treatment. The microhardness values were obtained before exposure and after a 14-day treatment period. Specimens were kept in artificial saliva at 37 degrees C between treatments. Data were analysed using Kruskal-Wallis one-way ANOVA and Tukey-Kramer Multiple Comparison Test. Indent marks on the enamel blocks were also examined under the Scanning Electron Microscope.

Results: All whitening products decreased enamel microhardness except group 10 but only Groups 2, 3, 4, 5 and 7 showed significant decrease in enamel microhardness as compared to the control group (p < 0.05). Groups 2, 3 and 7 differed significantly from all the other groups (p < 0.05). The highest damage was recorded for Group 2 (Nite White ACP 10% CP), which differed significantly from Groups 3 and 7. SEM images also showed damage to enamel.

Conclusions: All products tested in this study decreased enamel microhardness except Opalescence Boost 38% HP. The products containing carbamide peroxide were more damaging to enamel because of the longer application times. Nite White ACP 10% CP showed the highest reduction in enamel microhardness as compared to other products tested.