title: Effect of external tooth bleaching on dental plaque accumulation and tooth discoloration.
abstract: OBJECTIVE
  Treatment of dental discolorations with external bleaching is becoming very common in dentistry, however, possible irreversible alterations on enamel surface due to bleaching procedures is a topic of discussion. The aim of this study was to evaluate the clinical effects of bleaching by measuring the dental plaque accumulation on human enamel and tooth discoloration in vivo.
  
  
  METHODS
  Forty-four teeth in eleven patients not revealing any restorations or periodontal problems were enrolled in this study. Bleaching agent applied only to labial surfaces of incisors using commercial 35% hydrogen peroxide gel. Dental plaque and tooth color measured in the same group of participants, at the end of non-brushing periods lasting 3 and 5 days, respectively, before and after bleaching.
  
  
  RESULTS
  The results of the comparison of pre- and post-bleaching measurements showed that, after a non-brushing period lasting 3 day, discoloration scores and plaque accumulation scores for bleached surfaces were lower than the non-bleached surface scores. However, at the end of a non-brushing period lasting 5 day, even the color measurement score in post-bleaching period was lower than the pre-bleaching counterpart, plaque index measurements showed higher plaque accumulation scores in the bleached group.
  
  
  CONCLUSIONS
  According to these results, bleaching with 35% hydrogen peroxide seem to favor plaque accumulation after non-brushing period lasting 5 day and tooth discoloration after bleaching is not in correlation with the amount of plaque accumulation.
authors: Institute of Dentistry and Department of Oral & Maxillofacial Surgery, University of Helsinki, BIOMEDICUM, Helsinki University Central Hospital, Helsinki, Finland. ulvi.gursoy@helsinki.fi
authors: Ulvi Kahraman
authors: UK
authors: Gursoy
authors: Digdem Isin
authors: DI
authors: Eren
authors: Ozden Ozel
authors: OO
authors: Bektas
authors: Feridun
authors: F
authors: Hurmuzlu
authors: Vildan
authors: V
authors: Bostanci
authors: Hakan
authors: H
authors: Ozdemir
mesh_terms: D000328:Adult; D003773:Dental Plaque / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006861:Hydrogen Peroxide / Q000009:adverse effects / Q000494:pharmacology* / Q000627:therapeutic use*; D008297:Male; D014075:Tooth Discoloration / Q000188:drug therapy*
chemical_list: D006861:Hydrogen Peroxide