Efficacy of hydrogen-peroxide-based mouthwash in altering enamel color

Am J Dent. 2014 Feb;27(1):47-50.


Purpose: To analyze the efficacy of Colgate Plax Whitening mouthwash containing 1.5% hydrogen peroxide.

Methods: 30 enamel fragments, obtained from the proximal surfaces of human third molars were darkened with Orange II methyl orange. The fragments were divided into three groups according to the type of bleaching agent applied (n = 10): (1) 10% carbamide peroxide gel (positive control, PC) was applied for 2 hours/day for 28 days; (2) a solution containing 1.5% hydrogen peroxide (Plax) was applied for 4 minutes once a day for 28 days, and (3) no bleaching agent, kept in artificial saliva (negative control, AS). The specimens were kept in artificial saliva between treatment intervals. The specimens were photographed before darkening (baseline), after darkening and before lightening and on the 28th day of whitening. Afterwards, they were analyzed with color measurement software using the CIELab system. The data for the L*, a* and b* parameters were submitted to two-way ANOVA with repeated measures. The values of deltaL *, deltaa *, deltab * and deltaE* were calculated using two procedures: (1) darkened versus original, and (2) bleached versus darkened. This data was submitted to the one-way ANOVA test. Multiple comparisons were conducted using the Tukey test (alpha = 0.05).

Results: When the specimens were subjected to bleaching agents, there was a significant increase in the brightness (L* parameter) of the enamel exposed to the gel and also to the bleaching solution. However, higher brightness was observed for the PC (gel) group. As for the axis a* parameters, there were no significant differences between the bleaching products. Regarding the axis b* parameters, the PC group underwent major changes (indicating a color change toward blue chroma), statistically greater than those of the Plax group. After bleaching, there was a significantly greater color change (deltaE*) in the PC group. Although the Plax solution caused a color change, it was less than that produced by the gel. The slightest color change was observed in the control group, in which no bleach was used. The mouthwash containing hydrogen peroxide was able to lighten the darkened human enamel, but to a lesser degree than the lightening produced by 10% carbamide peroxide.

MeSH terms

  • Azo Compounds / chemistry
  • Benzenesulfonates / chemistry
  • Benzoates / therapeutic use
  • Carbamide Peroxide
  • Color
  • Coloring Agents / chemistry
  • Dental Enamel / drug effects*
  • Gels
  • Humans
  • Hydrogen Peroxide / therapeutic use*
  • Image Processing, Computer-Assisted / methods
  • Materials Testing
  • Mouthwashes / therapeutic use*
  • Peroxides / therapeutic use
  • Saliva, Artificial / chemistry
  • Sodium Dodecyl Sulfate / therapeutic use
  • Time Factors
  • Tooth Bleaching Agents / therapeutic use*
  • Tooth Discoloration / drug therapy*
  • Urea / analogs & derivatives
  • Urea / therapeutic use


  • Azo Compounds
  • Benzenesulfonates
  • Benzoates
  • Coloring Agents
  • Gels
  • Mouthwashes
  • Peroxides
  • Plax
  • Saliva, Artificial
  • Tooth Bleaching Agents
  • Carbamide Peroxide
  • Sodium Dodecyl Sulfate
  • methyl orange
  • Urea
  • Hydrogen Peroxide
  • 2-naphthol orange