Hydrogen peroxide is praised for its antiseptic and healing properties. In fact, there is a new urban myth proclaiming that hydrogen peroxide is universally beneficial for all the body organs and tissues. Regarding dental health, this couldn’t be further from the truth as evidence shows that hydrogen peroxide is actually toxic for the cells in the inner part of the teeth, also known as the dental pulp. Without a doubt, hydrogen peroxide does a really good job at bleaching and disinfecting teeth; hydrogen peroxide- based bleaching gels are essential for dentists and there is solid evidence demonstrating the efficacy of these protocols. On the other hand, there is a lot of uncontrolled information and advice, recommending hydrogen peroxide as an ideal everyday mouthwash. Taking into account that over-the-counter hydrogen peroxide concentrations can be as high as the formulas used by dentists in bleaching sessions (20-30%) and the growing popularity of hydrogen peroxide as an alternative therapy, the danger of potential long-term teeth damage by using high concentrations of hydrogen peroxide as a casual mouthwash are unknown, underestimated and largely under-discussed.
It is speculated that lower concentrations of hydrogen peroxide may have significantly less toxic effects on dental pulp cells, because there is more time to dilute and degrade the peroxide that reaches the pulp. However, the long-term or even short-term effects of daily use of hydrogen peroxide as a mouthwash have never been evaluated. If a few bleaching sessions can cause detectable damage in the dental pulp, then, based on the existing evidence, it is reasonable to assume that using hydrogen peroxide mouthwash on a daily basis may not be the safest option at all.
Wu TT, et al. 2013. Hydrogen peroxide induces apoptosis in human dental pulp cells via caspase-9 dependent pathway. J Endod. 39(9):1151-5.
Torres CR et al. 2013. Influence of concentration and activation on hydrogen peroxide diffusion through dental tissues in vitro. ScientificWorldJournal. 2013:193241.
Cintra LT et al. 2013. The number of bleaching sessions influences pulp tissue damage in rat teeth. J Endod. 39(12):1576-80.
Dias Ribeiro AP, et al. 2009. Cytotoxic effect of a 35% hydrogen peroxide bleaching gel on odontoblast-like MDPC-23 cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 108(3):458-64.
Arana-Chavez VE, Massa LF. 2004. Odontoblasts: the cells forming and maintaining dentine. Int J Biochem Cell Biol. 36(8):1367-73.
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