Tooth bleaching using peroxide-containing agents: current status of safety issues.

During the last 10 years, at-home tooth bleaching using peroxide-containing agents has quickly become well accepted. It is one of the most popular cosmetic dental procedures for whitening teeth. Although there are few disputes regarding their efficacy, concerns and debates have continued regarding the safety of peroxide-containing tooth bleaching agents. Potential carcinogenicity and genotoxicity of the peroxides used in bleaching agents are the two most persistent and controversial issues. This article reviews and discusses available information on carcinogenicity and genotoxicity of hydrogen peroxide and the potential risks associated with the use of peroxide-containing bleaching agents. Clinical studies reported after the 1996 international symposium on responses of oral tissues to peroxide-containing bleaching agents are also reviewed. Overall evidence supports the conclusion that the proper use of peroxide-containing at-home tooth bleaching agents is safe. However, potential adverse effects may occur in inappropriate applications, abuses, or the use of inappropriate products. At-home tooth bleaching should be monitored by dental professionals to maximize the benefits while minimizing potential risks.