ABSTRACT Introduction Adhesion of bacteria, especially Streptococcus mutans (S. mutans), to the surface of tooth restorations is a factor in the etiology of secondary caries. Given the ever-increasing popularity of bleaching procedures, the aim of the present study was to evaluate adhesion of S. mutans and surface roughness (SR) of microhybrid composite resin and giomer subsequent to the application of 15% carbamide peroxide. Materials and methods Twenty disk-shaped samples were prepared from each material, measuring 8 mm in diameter and 2 mm in thickness. Then, the samples of each material were divided into two groups (n = 10): (a) microhybrid without bleaching; (b) microhybrid with bleaching; and (c) giomer without bleaching; and (d) giomer with bleaching. The samples in groups I and III were immersed in artificial saliva for 14 days without any bleaching procedure; the samples in groups II and IV underwent a bleaching procedure on their polished surfaces with 15% carbamide peroxide for 14 days (4 hours of bleaching and 20 hours of immersion in artificial saliva). The SR of all the samples was determined with the use of a profilometer. The samples were added to the culture medium after 4 hours of placement in a microbial suspension at 37°C; after 24 hours of incubation at 37°C, the bacterial counts, indicating the number of bacteria adhering to the surface, were determined by counting them in the plates containing the solid culture medium. Results The type of the restorative material had a significant effect on SR, with greater SR in giomer (p = 0.03). However, bleaching had no significant effect on SR (p = 0.099). In relation to the rate of bacterial adhesion (BA), both the types of the restorative materials and bleaching procedures were significantly effective; in this context, there was more BA in microhybrid composite resin samples that did not undergo bleaching (p < 0.001). Bleaching resulted in the adhesion of S. mutans to the surface of both materials decrease. Pearson's correlation coefficient did not reveal any correlation between BA and SR (p = 0.42). Conclusion The BA was higher in microhybrid composite resin, and SR was higher in giomer. The BA was higher in samples that did not undergo a bleaching procedure. Clinical significance There is no change in the SR of microhybrid composite resin and giomer after application of 15% carbamide peroxide; therefore, it is not necessary to polish or replace these restorative materials after bleaching. In addition, use of 15% carbamide peroxide does not increase caries risk. How to cite this article Mohammadi N, Mowlaie S, Savadi- Oskoee S, Ebrahimi ME, Rikhtegaran S, Rahbar M, Pirzadeh T. Effect of 15% Carbamide Peroxide on the Surface Roughness and Adhesion of Streptococcus mutans to Microhybrid Composite Resin and Giomer. World J Dent 2017;8(4):288-295.