Remineralization potential of a fluoridated carbamide peroxide whitening gel

Little knowledge exists regarding the potential remineralizing benefits of adding fluoride to carbamide peroxide-based whitening gels. The aim of this project was to evaluate whether a whitening system with fluoride will remineralize previously demineralized enamel.

Twenty-four extracted teeth were sectioned into quadrants labeled A to D. Tooth quadrants in groups A, B, and D were demineralized with a lactic acid, methyl-cellulose gel system to mimic incipient carious lesions. Group C was neither demineralized nor treated. Group D was demineralized, but not treated with a whitening gel. Groups A and B were exposed to one of two commercially prepared 10% carbamide peroxide whitening gels: one that was fluoride free (group A) and one that contained fluoride (0.463%NaF) (group B). Remineralization was evaluated histologically and analyzed statistically using paired t tests accepting p < 0.05 as significant.

Shade comparisons showed equal whitening efficacy of both gel A and B. Paired t tests show a significant reduction in lesion depth after treatment with the fluoride containing gel (B: mean lesion depth = 100 microm; p < 0.01), while there was no difference for the gel lacking fluoride (A: mean lesion depth = 110 microm).

Under the conditions of this study, the addition of fluoride to a tooth whitening system does not affect the gel's whitening efficacy. The addition of fluoride could provide remineralization properties to the gel. As tooth whitening therapies continue to grow and evolve, a strong focus should rest on improving these materials in ways that will provide ever greater patient benefits. Coupling the esthetic benefits of whitening with the preventive benefits of fluoride is a natural step in this direction.

Therapuetic quantities of fluoride can impact remineralization properties of commercially available tooth whitening gels without altering whitening properties.