HYDROGEN-PEROXIDE - A REVIEW OF ITS USE IN DENTISTRY

SEVERAL DENTIFRICES THAT CONTAIN HYDROGEN PEROXIDE are currently being marketed, The increased use of bleaching agents containing (or genera ting) H2O2 prompted this review of the safety of H2O2 when used in ora l hygiene. Daily exposure to the low levels of H2O2 present in dentifr ices is much lower than that of bleaching agents that contain or produ ce high levels of H2O2 for an extended period of time. Hydrogen peroxi de has been used in dentistry alone or in combination with salts for o ver 70 years. Studies in which 3% H2O2 or less were used daily for up to 6 years showed occasional transitory irritant effects only in a sma ll number of subjects with preexisting ulceration, or when high levels of salt solutions were concurrently administered. In contrast, bleach ing agents that employ or generate high levels of H2O2 or organic pero xides can produce localized oral toxicity following sustained exposure if mishandled. Potential health concerns related to prolonged hydroge n peroxide use have been raised, based on animal studies. From a singl e study using the hamster cheek pouch model, 30% H2O2 was referred to as a cocarcinogen in the oral mucosa. This (and later) studies have sh own that at 3% or less, no cocarcinogenic activity or adverse effects were observed in the hamster cheek pouch following lengthy exposure to H2O2, In patients, prolonged use of hydrogen peroxide decreased plaqu e and gingivitis is indices. However, therapeutic delivery of H2O2 to prevent periodontal disease required mechanical access to subgingival pockets, Furthermore, wound healing following gingival surgery was enh anced due to the antimicrobial effects of topically administered hydro gen peroxide. For most subjects, beneficial effects were seen with H2O 2 levels above 1%.