Effects of whitening toothpaste and bleaching treatment on resin composite discoloration caused by cigarette smoke and electronic vapor aerosol

Authored by  X Zhao, F Zanetti, L Wang , H Malmstrom*, S Majeed, M Peitsch, J Hoeng, Y Ren*

Published in American Journal of Dentistry    
* This author is not affiliated with PMI.

To compare the effects of whitening toothpaste and bleaching with 6% hydrogen peroxide (H202) on discoloration of dental resin composite caused by cigarette smoke (CS) and electronic vapor product (EVP) aerosol.


40 resin composite discs were divided into three groups: 15 each for CS and EVP aerosol exposure and 10 for air exposure (control). Exposures were performed for 12 days, with daily brushing with regular toothpaste. Two whitening sessions, including 21 days of brushing with whitening toothpaste and 3 days of treatments with take-home bleaching (6% H202), were performed after the exposure. Color and gloss were assessed before exposure, at every 5 days of exposure, and after each whitening session.

After 15 days of exposure, marked disclosure of resin composite was observed in the CS group (ΔE = 23.66 ± 2.31), minimal color change in the EVP group (ΔE = 2.77 ± 0.75), and no color change in the control group. Resin composites exposed to CS did not recover their original color after treatment with whitening toothpaste (ΔE = 20.17 ± 2.68) or take-home bleaching (ΔE = 19.32 ± 2.53), but those exposed to EVP aerosol reverted to baseline after treatment with whitening toothpaste (ΔE = 0.98 ± 0.37), and no further change in color was observed following take-home bleaching. The gloss of resin composites exposed to CS, EVP aerosol, and air decreased equally with exposure time. Brushing with whitening toothpaste recovered the gloss similarly in all groups, but no further change was observed following take-home bleaching ( AM J Dent 2021;34:63-69)