Nowadays, bleaching is one of the most common procedures in aesthetic
dentistry. When comparing bleaching to other treatment options for vital teeth
whitening such as crowns or ceramic laminates, it proved to be more conservative.
Bleaching is not only a well-established technique but also provides effectiveness and
patient satisfaction. Carbamide peroxide and hydrogen peroxide are the active
components used for bleaching. Although bleaching is a well-tolerated method, some
patients still report sensitivity during and after bleaching. Hydrogen peroxide is
considered the main agent responsible for this hypersensitivity. The bleaching effect is
the result of the oxidation reaction of the tooth pigments by means of the hydrogen
peroxide molecules. Serious damage to the pulp tissue can be the result of the
reaction’s by-products reaching the pulp. The deleterious effect of the bleaching agents
is not only on the pulp but also on the gingival tissues and bone, where bone
inflammation and resorption have been reported. Therefore, efforts have been made to
obtain effective tooth bleaching with less or no harmful effects on enamel, pulp, and
oral mucosa and with no contraindications. Natural alternatives to peroxide bleaching
have been mentioned in the literature. These alternatives can produce an oxidative
reaction and stain removal effects, without deleterious outcomes. Natural products give
us some certainty about non-cytotoxic biological behavior, resulting in little or no
harmful effects. Also, the organic acids present in raw fruits have demonstrated the
ability to maintain or improve the color of the teeth. Therefore, the development of new
tooth-bleaching agents based on natural products with comparable aesthetic results and
minor side effects would be beneficial.
Keywords: Activated Charcoal, Bromelain, Caffeic acid, Caproic acid, Carbamide peroxide, Citric acid, Dairy products, Ellagic acid, Glycolic acid, Hydrogen peroxide, Lactic acid, Limonene, Malic acid, Miswak, Natural bleaching agents, Natural bleaching salts, Oil pulling, Papain enzyme, Plant-based bleaching agents, Salvadorine, Silica, Tooth bleaching, Tooth whitening.
