The effects of etching, micro-abrasion, and bleaching on surface enamel

J Dent Res. 1993 Jan;72(1):67-71. doi: 10.1177/00220345930720011001.

Abstract

Conservative techniques for improving the appearance of discolored teeth have become popular in the past decade. These include: in-office bleaching with 30% hydrogen peroxide, which is applied on etched enamel with a gauze pad and then exposed to a bleaching light; home bleaching with a mild form of peroxide, such as 10% carbamide peroxide, which is applied on the tooth surface with custom-made mouthguards; and enamel micro-abrasion with 18% hydrochloric acid, which is applied in a pumice slurry. In this study, the in-office bleaching and enamel micro-abrasion techniques were performed on extracted teeth for investigation of their microscopic effects on the surface enamel. Specimens treated only with 37% phosphoric acid showed an enamel loss of 5.7 +/- 1.8 microns. The specimens treated with 37% phosphoric acid followed by 30% hydrogen peroxide showed enamel loss of 5.3 +/- 1.6 microns; this loss was probably not caused by the hydrogen peroxide, but rather by the etching with 37% phosphoric acid which preceded the hydrogen peroxide application. A direct application of 18% hydrochloric acid for 100 s resulted in a loss of 100 +/- 47 microns. The extent of enamel loss was much greater when the 18% hydrochloric acid was applied in a pumice slurry for the same period of time (360 +/- 130 microns), and the effect was time-dependent. Thus, the pumice and rotary prophy cup used in conjunction with the 18% hydrochloric acid contributed markedly to the loss of surface enamel, enhancing the non-selective stain-removing action of the hydrochloric acid. Therefore, the hydrochloric acid-pumice technique must be used clinically with caution.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acid Etching, Dental / adverse effects*
  • Adolescent
  • Analysis of Variance
  • Carbamide Peroxide
  • Child
  • Dental Enamel / drug effects*
  • Dental Enamel / ultrastructure
  • Drug Combinations
  • Humans
  • Hydrochloric Acid / adverse effects
  • Hydrogen Peroxide / adverse effects
  • Microscopy, Electron, Scanning
  • Middle Aged
  • Peroxides / adverse effects
  • Phosphoric Acids / adverse effects
  • Silicates*
  • Silicic Acid / adverse effects
  • Tooth Bleaching / adverse effects*
  • Tooth Bleaching / methods
  • Tooth Discoloration / therapy
  • Urea / adverse effects
  • Urea / analogs & derivatives

Substances

  • Drug Combinations
  • Peroxides
  • Phosphoric Acids
  • Silicates
  • Silicic Acid
  • Carbamide Peroxide
  • Urea
  • Hydrogen Peroxide
  • phosphoric acid
  • pumice
  • Hydrochloric Acid