Many studies show the safety and efficacy of these products; however, have you considered other potential benefits besides whiter teeth? In a systematic review published in the International Journal of Dental Hygiene in 2019, the effect of bleaching products on plaque and gingivitis indices was evaluated.
Most of the studies included in the systematic review were funded by manufacturers with a high risk of bias. It has been hypothesized that bleaching products may modify the enamel leaving it more susceptible to plaque accumulation. Other studies have determined the pH level in different products ranges from 4.5 to 10.8. This lower pH level, which causes erosion, seems to be the culprit in enamel modification rather than hydrogen peroxide. Further studies are needed to determine the long-term effects on enamel.
The consensus of this systematic review is that plaque index is lowered during the whitening treatment. It has even been suggested that these products be used as an anti-caries treatment. Most short-term studies indicate a change in the microbiota indicative of reduced caries, however long-term studies determined the opposite to be true with an increase in S. mutans and S. sanguis or no change at all. Whitening products have not been studied for the use of caries control and further studies would be needed to confidently recommend the products be used in that capacity.
Short-term studies indicate a statistically significant reduction in plaque and gingivitis during whitening treatment. No data is available for long term use and further studies are needed to support the relevance of these findings.
Have you ever considered the possibility of added benefits to patients that use whitening products? We would love to hear your feedback on this review. Please take a few moments to read the study in its entirety and share your thoughts and experiences with whitening products.
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