title: Effects of bleaching agents and Tooth Mousse(™) on human enamel hardness.
abstract: OBJECTIVE
  The aim of this laboratory study was to investigate the effect of three commercial bleaching agents and Tooth Mousse(™) containing 10% w/w casein phosphopeptide-amorphous calcium phosphate on the hardness of tooth enamel.
  
  
  METHODS
  Sixteen human enamel specimens were exposed to one of three commercial bleaching agents with or without subsequent exposure to Tooth Mousse(™) . Nanoindentation was used to measure the hardness and reduced modulus before and after treatments.
  
  
  RESULTS
  When bleaching materials were applied for a short period of time following the manufacturers' instructions, there was an increase in enamel hardness and reduced modulus for some bleaching groups, with no statistically significant difference from the baseline values. After extended bleaching periods a statistically significant decrease in enamel hardness and reduced modulus was found and after applying Tooth Mousse(™) post-bleaching, the hardness and reduced modulus returned to close to baseline values.
  
  
  CONCLUSIONS
  The application of bleaching agents for an extended period of time significantly decreases enamel hardness and the reduced modulus. The application of Tooth Mousse(™) after bleaching was able to reestablish the baseline enamel hardness and reduced modulus, decreasing the adverse effects of bleaching enamel.
authors.affiliation: Primary Health Care Corporation, Qatar and Melbourne Dental School, University of Melbourne, Carlton, Vic., Australia.
authors.forename: Asmaa
authors.initials: A
authors.lastname: Alkhtib
authors.forename: David J
authors.initials: DJ
authors.lastname: Manton
authors.forename: Michael F
authors.initials: MF
authors.lastname: Burrow
authors.forename: Saeed
authors.initials: S
authors.lastname: Saber-Samandari
authors.forename: Joseph E A
authors.initials: JE
authors.lastname: Palamara
authors.forename: Kārlis A
authors.initials: KA
authors.lastname: Gross
authors.forename: Eric C
authors.initials: EC
authors.lastname: Reynolds
mesh_terms: D000077463:Carbamide Peroxide; D002364:Caseins / Q000494:pharmacology*; D003743:Dental Enamel / Q000187:drug effects*; D055119:Elastic Modulus / Q000187:drug effects; D006244:Hardness / Q000187:drug effects; D006801:Humans; D006861:Hydrogen Peroxide / Q000009:adverse effects; D010545:Peroxides / Q000009:adverse effects; D058205:Tooth Bleaching Agents / Q000009:adverse effects*; D014508:Urea / Q000009:adverse effects / Q000031:analogs & derivatives
chemical_list: D002364:Caseins; D010545:Peroxides; D058205:Tooth Bleaching Agents; C447032:casein phosphopeptide-amorphous calcium phosphate nanocomplex; D000077463:Carbamide Peroxide; D014508:Urea; D006861:Hydrogen Peroxide