MICROMORPHOLOGICAL ALTERATIONS OF DENTAL ENAMEL FOLLOWING TOOTH WHITENING PROCEDURES

Abstract

The present study examines the micromorphological alterations of dental enamel following contemporary tooth-whitening procedures. Tooth whitening is widely used in aesthetic dentistry; however, its impact on enamel structure remains a subject of scientific interest. Whitening agents—particularly hydrogen peroxide and carbamide peroxide—can penetrate enamel prisms and initiate oxidative reactions that may affect the mineral content, surface roughness and overall integrity of the enamel. Numerous in-vitro and in-vivo studies indicate that high-concentration bleaching materials may cause increased porosity, erosion of the interprismatic matrix, loss of calcium and phosphate ions, and changes in surface hardness. These alterations depend on several factors, including the concentration of bleaching agents, exposure time, pH of the material, and whether remineralizing agents are used during or after treatment. Additionally, microscopic analyses such as SEM, AFM and EDS provide detailed evidence of enamel surface modification post-bleaching. Despite these potential effects, studies also show that appropriate remineralization techniques—including fluoridation, CPP-ACP application, and nano-hydroxyapatite therapy—can effectively restore or even enhance the enamel’s microstructure. This paper aims to systematize current scientific data, evaluate the severity of micromorphological changes, and highlight the clinical significance of post-whitening enamel management strategies.