Adverse effects of tooth bleaching: A review

Abstract

Current bleaching methods mainly use hydrogen peroxide as the active agents. Tooth whitening is achieved either by in-office bleaching technique or self-applied or home bleach method. This review focused mainly on the adverse outcomes of tooth bleaching such as cervical root resorption, crown fracture, tooth sensitivity, mucosal reaction, and enamel surface alterations produced during the treatment and the management of vital and non-vital teeth-bleaching procedures. Cervical root resorption is one of the unwanted effects observed with the internal bleaching, especially seen with thermo-catalytic procedures. There is a possibility of crown fracture after intracoronal bleaching most likely due to the extensive removal of the intracoronal dentin. One of the common side effects of external tooth bleaching is the tooth sensitivity that ranged between 15% and 65%. Another important adverse effect of high concentration of hydrogen peroxide bleaching is the mucosal irritation ranged between 30% and 35%. Morphologic changes of enamel were also observed with the use of higher concentration of bleaching agents. In view of this review, it is highly desirable to take all the necessary precautions and considerations while performing tooth-bleaching treatment.