Erosion and abrasion on dental structures undergoing at-home bleaching

Abstract

This review investigates erosion and abrasion in dental structures undergoing at- home bleaching. Dental erosion is a multifactorial condition that may be idiopathic or caused by a known acid source. Some bleaching agents have a pH lower than the critical level, which can cause changes in the enamel mineral content. Investigations have shown that at-home tooth bleaching with low concentrations of hydrogen or carbamide peroxide have no significant damaging effects on enamel and dentin surface properties. Most studies where erosion was observed were in vitro. Even though the treatment may cause side effects like sensitivity and gingival irritation, these usually disappear at the end of treatment. Considering the literature reviewed, we conclude that tooth bleaching agents based on hydrogen or carbamide peroxide have no clinically significant influence on enamel/dentin mineral loss caused by erosion or abrasion. Furthermore, the treatment is tolerable and safe, and any adverse effects can be easily reversed and controlled.

Keywords: abrasion; dentin; enamel; erosion; peroxide; tooth bleaching.

Figure 1

Scanning electron microscopic analysis of unbleached human enamel and bleached enamel under in vitro or in situ conditions. (A and B) lower and higher magnification of unbleached enamel, with no signs of eroded structure. (C and D) lower and higher magnification of 10% carbamide peroxide-treated enamel, using in vitro methodology. The enamel has altered surface topography, showing loss of mineral structure and an eroded surface. (E and F) lower and higher magnification of 10% CP treated enamel under in situ condition. The enamel has some altered surface, with localized mineral loss, which is lower than the mineral loss observed for bleached enamel in vitro. Pictures courtesy of Dr Lidia M Justino, Univali, Brazil.