Evaluation of a 6% hydrogen peroxide tooth-whitening gel on enamel microhardness after extended use

Objectives: To evaluate the effects of a 6% hydrogen peroxide tooth whitener, Xtra White, on sound human enamel microhardness in vitro after an extended and exaggerated simulated 8 weeks of product use. Method and Materials: Polished human enamel specimens were prepared and baseline microhardness and color measurements determined. The enamel specimens were exposed to a fluoride-containing toothpaste for 30 seconds and then exposed to water, Xtra White, a control carbopol gel containing no hydrogen peroxide, or a carbonated beverage (each group, n = 8) for 20 minutes. Specimens were exposed to whole saliva at all other times. In order to simulate 8 weeks of extended product use, quadruple the length of the manufacturer's instructions, 112 treatments, were conducted. Microhardness measurements were taken after 2, 4, 6, and 8 weeks of simulated treatments, and color was measured after 2 and 8 weeks. Results: The Xtra White-treated specimens showed a statistically significant (P .0001) increase in L* and decrease in b* compared to the water-treated specimens after 2 weeks simulated use, indicating bleaching had occurred. The carbonated beverage-treated specimens were significantly softened (P = .0009) compared to baseline after only 1 treatment. The carbopol gel-treated specimens were significantly softened (P = .0028) after 2 weeks of simulated treatments compared to baseline. There were no statistically significant differences in enamel microhardness between baseline and all treatment times for XW and water groups. Conclusion: Xtra White does not have any deleterious effects on sound human enamel microhardness after an extended and exaggerated simulated 8 weeks of product use. Keywords: color measurement, colorimeter, esthetics, peroxide, tooth bleaching, tooth color, tooth whitening