title: An exposure-based risk assessment approach to confirm the safety of hydrogen peroxide for use in home tooth bleaching.
abstract: Hydrogen peroxide has a long history of safe use in a wide variety of medical and consumer products, including oral care products. The use of hydrogen peroxide in tooth bleaching has been extended to home use. Because this represents a new use, questions have been raised regarding safety, particularly the potential for peroxide tooth-whitening products to increase the risk of oral cancer in high-risk individuals (e.g., smokers and drinkers). These concerns are based on limited experimental data in animals that hydrogen peroxide has extremely weak tumor promoting activity and a lack of publicly available data on exposure to peroxides from the home use of tooth-whitening products. This paper provides a weight-of-evidence cancer hazard characterization for hydrogen peroxide and presents a quantitative risk assessment that confirms a favorable human safety profile risk associated with low levels of exposure to hydrogen peroxide from the use of tooth-whitening products. This includes a lack of tumor promotion risk which is important because tooth-whitening products are often used by chronic smokers and drinkers, who may represent a susceptible subpopulation because of their exposure to other known carcinogens.
authors.affiliation: The Procter & Gamble Co., Rusham Park Technical Centre, Egham, Surrey, UK. mahony.c@pg.com
authors.forename: C
authors.initials: C
authors.lastname: Mahony
authors.forename: S P
authors.initials: SP
authors.lastname: Felter
authors.forename: D A
authors.initials: DA
authors.lastname: McMillan
mesh_terms: D000428:Alcohol Drinking; D000818:Animals; D002273:Carcinogens; D003257:Consumer Product Safety; D004781:Environmental Exposure; D006801:Humans; D006861:Hydrogen Peroxide / Q000633:toxicity*; D015201:Meta-Analysis as Topic; D009062:Mouth Neoplasms / Q000453:epidemiology / Q000209:etiology; D016877:Oxidants / Q000633:toxicity*; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking; D014073:Tooth Bleaching / Q000009:adverse effects*
chemical_list: D002273:Carcinogens; D016877:Oxidants; D006861:Hydrogen Peroxide