Tooth whitening: esthetic benefits and clinical challenges

Introduction: Tooth whitening has been widely used as an esthetic procedure, growing in demand since its initial description in 1864. This process uses chemical agents such as hydrogen peroxide, capable of oxidizing chromogens present in tooth enamel, lightening the teeth. However, its continued use can have side effects, including demineralization of the enamel and alterations in the oral microbiota, such as the growth of Candida albicans. Development: Several studies have analyzed the effects of hydrogen peroxide at different concentrations. At high concentrations, such as 35%, its capacity to alter the morphology and mineral content of dental enamel, increasing its roughness and favoring the adhesion of microorganisms has been demonstrated. The formation of biofilms by bacteria and fungi, such as Streptococcus mutans and Candida albicans, has been the subject of debate, with contradictory results regarding their prevalence on surfaces treated with bleaching agents. This study found that the control group, without peroxide treatment, presented greater adhesion of C. albicans, which could be attributed to an antimicrobial effect of the oxidizing agent. Conclusion: Tooth whitening, although effective as an esthetic procedure, presents clinical challenges due to its potential adverse effects. The findings highlight the need for further research to fully understand the impact of these agents on the oral microbiota and enamel. Future studies should include larger samples and employ advanced techniques to improve the validity of the results and optimize the safety of the procedures.