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. 2015 Oct;23(5):497-507.
doi: 10.1590/1678-775720150235.

Effects on gastric mucosa induced by dental bleaching--an experimental study with 6% hydrogen peroxide in rats

Anabela Baptista Paula  1 , Maria Isabel Dias  2 , Manuel Marques Ferreira  1 , Teresa Carrilho  1 , Carlos Miguel Marto  1 , João Casalta  1 , António Silvério Cabrita  1 , Eunice Carrilho  1
Affiliations

Effects on gastric mucosa induced by dental bleaching--an experimental study with 6% hydrogen peroxide in rats

Anabela Baptista Paula et al. J Appl Oral Sci. 2015 Oct.

Abstract

The value of aesthetic dentistry has precipitated several developments in the investigation of dental materials related to this field. The free marketing of these products is a problem and it is subject to various interpretations regarding its legality. There are several techniques for tooth whitening, the most used one being the external bleaching. It is the later version of such technique that poses the greatest danger of ingesting the product. The present study analysed the systemic effect of these products when they are swallowed.

Objective: This experimental study aimed to observe the effects of a tooth whitening product, whose active agent is 6% hydrogen peroxide, on the gastric mucosa of healthy and non-tumour gastric pathology animals.

Material and methods: Fifty Wistar-Han rats were used and then distributed into 5 groups, one for control and four test groups in which the bleaching product was administered in animals with and without non-tumour gastric pathology (induced by the administration of 1 sample of 50% ethanol and 5% of drinking water during 6 days) at different times of study by gavage. There was a decrease in body weight in animals of groups handled during the study period, which was most pronounced in IV and VA groups. Changes in spleen weight relative to body weight revealed no statistically significant changes. An analysis of the frequency was performed on the results of macroscopic observation of the gastric mucosa.

Results: The gastric mucosa revealed lesions in all manipulated groups, being more frequent in groups III and IV. It appears that there is a synergism when using hydrogen peroxide and 50% ethanol in the same group.

Conclusion: Therefore, it seems that there are some signs of toxicity 3 to 4 days after administration of 6% hydrogen peroxide. The prescription of these therapies must be controlled by the clinician and the risks must be minimized.

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Figures

Figure 1
Figure 1. Experimental procedure performed in the various groups. (Q - quarantine, P - hydrogen peroxide administration; G - non-tumoral gastric pathology induced)
Figure 2
Figure 2. Results of the analysis of variance of animal weight in all experimental groups over study time. The results are presented as mean±standard error (SE) for all conditions tested
Figure 3
Figure 3. Results of the analysis of evolution of animal weights in percentage, which is the fraction of weight change from the beginning to the end of study. The results are presented as mean±standard error (SE) with a level of significance of (*) <0.05; (**) <0.01; (***) <0.001
Figure 4
Figure 4. Results of the comparison as a percentage of the ratio of animal and spleen weight. The results are presented as mean with a level of significance of (*) <0.001
Figure 5
Figure 5. Histological observation. A– Group II, mucosal changes with foci of necrosis and sloughing can be observed; B– Group III, loss of the surface layer of the mucosal epithelium can be observed; C– Group IV, the presence of inflammatory infiltrate and edema may be observed; D– Group V, loss of superficial epithelial layer of the mucosa may be observed
Figure 6
Figure 6. Macroscopic observation of the gastric mucosa in relation to parameter - Normal appearance of the mucosa in its entire length
Figure 7
Figure 7. Macroscopic observation of the gastric mucosa in relation to parameter - Macroscopically corresponding to inflammation areas
Figure 8
Figure 8. Macroscopic observation of the gastric mucosa in relation to parameter - Erasing of the mucosa folds
Figure 9
Figure 9. Macroscopic observation of the gastric mucosa in relation to parameter – Macroscopically corresponding to bleeding areas
Figure 10
Figure 10. Macroscopic observation of the gastric mucosa in relation to parameter – Macroscopically corresponding to necrosis/ulcers
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