THE EFFECT OF TEETH WHITENING PRODUCED BY VARIOUS NATURAL FOOD SUBSTANCES

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THE EFFECT OF TEETH WHITENING PRODUCED BY VARIOUS NATURAL FOOD SUBSTANCES:
1Malini Murali, 2, *Dr. Sai Krishna,
P.,
5Dr. Prasanna, S., 6
Dr. Shankar
1
CRRI, Tagore Dental College and Hospital
2Professor and
HOD, Department of Oral
3
Reader, Department of Oral and Maxillofacial Path
4
Associate Professor, Department of Microbiology, Tagore Dental College
5
Senior Lecturer, Department of Oral and Maxillofacial Path
6
Professor, Department of Oral and Maxillofacial Pathology, Tagore Dental College
7
Lecturer, Department of Oral and Maxill
ARTICLE INFO
ABSTRACT
Introduction:
bleaching are termed as bleaching agents. Various bleaching agents (artificial and natural) are readily
available in the market.
Aim:
Present study was aime
whitening of the extracted natural teeth that are stained with tea decoction.
Material and method:
food substances (lemon, carrot, apple, baking soda) in two different methods (direct application,
soaking).
Result:
soda, carrot and apple.
Conclusion:
in day to day commodities like tooth paste or other tooth cleaning products after
Copyright © 2018, Malini Murali et al. This is an open
distribution, and reproduction in any medium, provided
INTRODUCTION
Whitening or bleaching
of teeth is a procedure that removes
the stains and the substances that bring about bleaching are
known as bleaching agents. Bleaching is done to enhance the
overall aesthetic look of the patient which eventually boosts
their self-esteem. Social and psycho
logical research has shown
that appearance is one of the non-
verbal communications that
play an important role in determining the quality of our
interactions with other person (Goldstein,
whitening or bleaching has been grouped into 2 main
categories: Professional and natural methods. The professional
methods are in turn classified into: In office application
(Professionally applied), professionally prescribed and over
the-
counter bleaching. The professional methods of bleaching
revolve aro
und using peroxide based agents like hydrogen
peroxide and carbamide peroxide (Craig
and
*Corresponding author: Dr. Sai Krishna, P.,
Professor and HOD, Department of Oral and Maxillofacial Pathology, Tagore
Dental College and Hospital, India.
ISSN: 0975-833X
Article History:
Received 29th July, 2018
Received in revised form
06th August, 2018
Accepted 15th September, 2018
Published online 31st October, 2018
Citation:
Malini Murali, Dr. Sai Krishna, P., Dr. Makesh Raj, L.S., Dr. Kannan, I., Dr. Jai Santhosh Manikandan, Dr. Prasanna, S., Dr.
Dr. Jude, J. and Dr. Pravina Fernando, L., 201
8
International Journal of Current Research, 10, (10),
74405
Key Words:
Bleaching, Natural bleaching agent,
Food substance, Lemon, Apple,
Carrot, Baking soda.
RESEARCH ARTICLE
THE EFFECT OF TEETH WHITENING PRODUCED BY VARIOUS NATURAL FOOD SUBSTANCES:
AN IN-VITRO STUDY
P.,
3Dr. Makesh Raj, L.S., 4Dr. Kannan, I., 5
Dr. Jai Santhosh Manikandan,
Dr. Shankar
, K.A., 5Dr. Jude, J. and 7
Dr. Pravina Fernando
CRRI, Tagore Dental College and Hospital
, India
HOD, Department of Oral
and Maxillofacial Path
ology, Tagore Dental College and
Reader, Department of Oral and Maxillofacial Pathology, Tagore Dental College and
Associate Professor, Department of Microbiology, Tagore Dental College
and
Senior Lecturer, Department of Oral and Maxillofacial Pathology, Tagore Dental College and
Professor, Department of Oral and Maxillofacial Pathology, Tagore Dental College
Lecturer, Department of Oral and Maxill
ofacial Path
ology, Tagore Dental College and
ABSTRACT
Introduction:
Process of removing the stains from tooth is termed as bleaching. Substance used for
bleaching are termed as bleaching agents. Various bleaching agents (artificial and natural) are readily
available in the market.
Present study was aime
d in
evaluating the efficacy of lemon, apple, carrot, baking soda in the
whitening of the extracted natural teeth that are stained with tea decoction.
Material and method:
Teeth were stained with tea decoction and bleaching was done using natural
food substances (lemon, carrot, apple, baking soda) in two different methods (direct application,
soaking).
Result:
Bleaching efficacy of lemon was superior in
both the methods when compared with baking
soda, carrot and apple.
Conclusion:
Because of superior bleaching property of lemon, it
in day to day commodities like tooth paste or other tooth cleaning products after
access article distributed under the Creative Commons Att
ribution
the original work is properly cited.
of teeth is a procedure that removes
the stains and the substances that bring about bleaching are
known as bleaching agents. Bleaching is done to enhance the
overall aesthetic look of the patient which eventually boosts
logical research has shown
verbal communications that
play an important role in determining the quality of our
1993). The tooth
whitening or bleaching has been grouped into 2 main
categories: Professional and natural methods. The professional
methods are in turn classified into: In office application
(Professionally applied), professionally prescribed and over
-
counter bleaching. The professional methods of bleaching
und using peroxide based agents like hydrogen
and
Supeene, 1999).
Professor and HOD, Department of Oral and Maxillofacial Pathology, Tagore
Owing to the harmful effects of the chemical agents, the use
and promotion of natural substances for teeth whitening are
popular in the recent times. Effectiveness of the natural agents
has been comparable to that of the professionally applied
agents with the added advantage of being cost effective and
biologically safe (Brinda
et al.,
professionally applied bleaching agents have established to be
effective, concerns regarding the safety of these have always
remained doubtful
. Hence, the natural agents get their upper
hand and paves way for further research
The contemplation of this study is to see the efficacy of natural
food products like fruits, vegetables in the bleaching of stained
teeth.
MATERIALS AN
D METHODS
The objective of this in-
vitro study was to evaluate the efficacy
of lemon, apple, carrot, baking soda in the whitening of the
extracted natural teeth that are stained with tea decoction.
Permanent anterior teeth were collected for the study. Teeth
International Journal of Current Research
Vol. 10, Issue, 10, pp.74405-74407, October, 2018
DOI: https://doi.org/10.24941/ijcr.32276.10.2018
Malini Murali, Dr. Sai Krishna, P., Dr. Makesh Raj, L.S., Dr. Kannan, I., Dr. Jai Santhosh Manikandan, Dr. Prasanna, S., Dr.
8
. “
The effect of teeth whitening produced by various natural food substances: An
74405
-74407.
Available online at http://www.journalcra.com
z
THE EFFECT OF TEETH WHITENING PRODUCED BY VARIOUS NATURAL FOOD SUBSTANCES:
Dr. Jai Santhosh Manikandan,
Dr. Pravina Fernando
, L.
ology, Tagore Dental College and
Hospital, India
ology, Tagore Dental College and
Hospital, India
and
Hospital, India
ology, Tagore Dental College and
Hospital, India
Professor, Department of Oral and Maxillofacial Pathology, Tagore Dental College
and Hospital, India
ology, Tagore Dental College and
Hospital, India
Process of removing the stains from tooth is termed as bleaching. Substance used for
bleaching are termed as bleaching agents. Various bleaching agents (artificial and natural) are readily
evaluating the efficacy of lemon, apple, carrot, baking soda in the
whitening of the extracted natural teeth that are stained with tea decoction.
Teeth were stained with tea decoction and bleaching was done using natural
food substances (lemon, carrot, apple, baking soda) in two different methods (direct application,
both the methods when compared with baking
Because of superior bleaching property of lemon, it
can be used as an active ingredient
in day to day commodities like tooth paste or other tooth cleaning products after
standardisation.
ribution
License, which permits unrestricted use,
Owing to the harmful effects of the chemical agents, the use
and promotion of natural substances for teeth whitening are
popular in the recent times. Effectiveness of the natural agents
has been comparable to that of the professionally applied
agents with the added advantage of being cost effective and
et al.,
2015). Although the
professionally applied bleaching agents have established to be
effective, concerns regarding the safety of these have always
. Hence, the natural agents get their upper
hand and paves way for further research
(Yeh et al., 2005).
The contemplation of this study is to see the efficacy of natural
food products like fruits, vegetables in the bleaching of stained
D METHODS
vitro study was to evaluate the efficacy
of lemon, apple, carrot, baking soda in the whitening of the
extracted natural teeth that are stained with tea decoction.
Permanent anterior teeth were collected for the study. Teeth
INTERNATIONAL JOURNAL
OF CURRENT RESEARCH
Malini Murali, Dr. Sai Krishna, P., Dr. Makesh Raj, L.S., Dr. Kannan, I., Dr. Jai Santhosh Manikandan, Dr. Prasanna, S., Dr.
Shankar, K.A.,
The effect of teeth whitening produced by various natural food substances: An
in-vitro study”,

with de
ntal caries, developmental anomaly, fracture and intra
coronal discolouration were excluded. 108 selected teeth were
washed with 2% hydrogen peroxide followed by 2 days of
soaking in normal saline and then it was stained with tea
decoction. This staining w
as brought about by immersing the
teeth in this beverage for 10 days. The tea extract was freshly
prepared and changed every day
(Figure 1)
soaked in hydrogen peroxide for 60 seconds and considered as
positive control. 6 teeth were kept in Ha
nk’s balanced salt
solution and considered as negative control. The remaining 96
teeth were divided into 4 groups, namely A, B, C and D, each
containing 24 numbers. Each group (A, B, C, D) were treated
with the four chosen variables lemon, apple, carrot an
soda respectively. The 4 groups (24 teeth each) were in
divided into 2 sets, Set 1 (direct application) and Set 2
(soaking), containing 12 teeth in each set. Among the 2 sets,
teeth from 1st
set was directly rubbed with the respective
variable for 60 seconds and the teeth from 2
nd
in the extract derived out of each variable respectively (Figure
2).
Figure 1.
Staining of the teeth using tea decoction
Figure 2.
Different types of bleaching done (Direct b, c, d, e &
soaking f)
The extract for 2nd set was standard
ized as follows:
 Lemon-
each tooth was soaked in 5ml of 1:2
concentration of lemon juice for 6 hours.
 Apple -
each tooth was soaked in 5ml of extract
obtained from mashed apple for 6 hours.
 Carrot- each
teeth was soaked in 5ml of extract
obtained from mashed carrot for 6 hours.
74406 Malini Murali et al.
T
he effect of teeth whitening produced by various natural food substances:
ntal caries, developmental anomaly, fracture and intra
-
coronal discolouration were excluded. 108 selected teeth were
washed with 2% hydrogen peroxide followed by 2 days of
soaking in normal saline and then it was stained with tea
as brought about by immersing the
teeth in this beverage for 10 days. The tea extract was freshly
(Figure 1)
. 6 teeth were
soaked in hydrogen peroxide for 60 seconds and considered as
nk’s balanced salt
solution and considered as negative control. The remaining 96
teeth were divided into 4 groups, namely A, B, C and D, each
containing 24 numbers. Each group (A, B, C, D) were treated
with the four chosen variables lemon, apple, carrot an
d baking
soda respectively. The 4 groups (24 teeth each) were in
-turn
divided into 2 sets, Set 1 (direct application) and Set 2
(soaking), containing 12 teeth in each set. Among the 2 sets,
set was directly rubbed with the respective
nd
Set were soaked
in the extract derived out of each variable respectively (Figure
Staining of the teeth using tea decoction
Different types of bleaching done (Direct b, c, d, e &
ized as follows:
each tooth was soaked in 5ml of 1:2
concentration of lemon juice for 6 hours.
each tooth was soaked in 5ml of extract
obtained from mashed apple for 6 hours.
teeth was soaked in 5ml of extract
obtained from mashed carrot for 6 hours.
 Baking soda-
Each teeth were soaked into an extract
derived out of 3 teaspoon of baking soda, 2 tea spoon of
glycerine for 6 hours. (Figure 2) respectively.
The shade of the teeth
was analysed using Digital shade
analyser, before and after bleaching. The data was subjected to
WILCOXON signed ranks test to find the significance of
results.
RESULTS
The results revealed that lemon, apple, carrot and baking soda
showed statistically
significant results of bleaching when
applied directly. Lemon and baking soda showed statistically
significant results while soaking, whereas, apple and carrot
showed insignificant results while soaking. Overall, lemon
showed the highest significance follo
Apple and carrot showed significance only when it is applied
directly and was comparatively l
(Table 1).
Table 1.
Efficacy of different bleaching variables using Wilcoxon
signed rank test
Bleaching agent N
Mean + standard deviation
Before
Lemon Direct 12
10.28 ± 3.088
Soaking 12
10.67± 3.114
Apple Direct 12
9.2± 3.261
Soaking 12
10.5± 2.236
Carrot Direct 12
12.83± 1.992
Soaking 12
12.42± 1.730
Baking soda Direct 12
9.33± 3.939
Soaking 12
10.00± 3.191
DISCUSSION
The
touch of aesthetics into dentistry has grown to be one of
the prime factors. Meeting up to the patients’ expectations of a
beautiful smile has pushed dentists to strive more to discover,
learn and invent. One such important procedure in the ladder to
a bea
utiful smile is teeth whitening.
influenced by various factors. It could be influenced from
within the tooth (intrinsic) or from its external surface
(extrinsic). The intrinsic stains are caused due to chromogenic
substances prod
uced or incorporated into the tooth commonly
through the dental pulp before or after eruption. The extrinsic
stains are those deposited on the outer surface of the tooth over
time (Watts and Addy,
2001;
vary in extent, distribution, colour and tenacity. Identifying the
cause of the stain is essential before proceeding with further
treatment. Mild stains could be removed by scaling followed
by pumice polishing. The to
(Hattab et al., 1999).
Professional bleaching is commonly done
using peroxide based agents. There has been tremendous
evolution of this material. Earlier, first generation materials
used were in liquid form. Owing to its disadvantages of lower
con
centration, not remaining in trays for too long, the second
generation of gel form was used. This increased the contact
time with the tooth and lessens the chance of soft tissue
contact. The third generation differed in vehicle and colour.
The mechanism of
action is that the oxidation of the stains
breaks it down into smaller less noticeable molecules. To
hasten up the process light activated systems have also been
found (Mithra et al., 2012).
methods of bleaching have been commo
proven effective, investigators continue to report adverse
he effect of teeth whitening produced by various natural food substances:
Each teeth were soaked into an extract
derived out of 3 teaspoon of baking soda, 2 tea spoon of
glycerine for 6 hours. (Figure 2) respectively.
was analysed using Digital shade
analyser, before and after bleaching. The data was subjected to
WILCOXON signed ranks test to find the significance of
The results revealed that lemon, apple, carrot and baking soda
significant results of bleaching when
applied directly. Lemon and baking soda showed statistically
significant results while soaking, whereas, apple and carrot
showed insignificant results while soaking. Overall, lemon
showed the highest significance follo
wed by baking soda.
Apple and carrot showed significance only when it is applied
directly and was comparatively l
ess significant than the former
Efficacy of different bleaching variables using Wilcoxon
signed rank test
Mean + standard deviation
Z value P
Value
Before
After
10.28 ± 3.088
8.42± 2.999 -3.093 0.002
10.67± 3.114
7± 2.763 -3.071 0.002
9.2± 3.261
7.58± 3.630 -2.555 0.011
10.5± 2.236
10.0± 2.174 -1.857 0.063
12.83± 1.992
11.67± 0.888 -2.070 0.038
12.42± 1.730
12.25± 1.357 -0.743 0.458
9.33± 3.939
6.83± 2.887 -2.953 0.003
10.00± 3.191
5.83± 2.525 -3.068 1.000
touch of aesthetics into dentistry has grown to be one of
the prime factors. Meeting up to the patients’ expectations of a
beautiful smile has pushed dentists to strive more to discover,
learn and invent. One such important procedure in the ladder to
utiful smile is teeth whitening.
The colour of the teeth is
influenced by various factors. It could be influenced from
within the tooth (intrinsic) or from its external surface
(extrinsic). The intrinsic stains are caused due to chromogenic
uced or incorporated into the tooth commonly
through the dental pulp before or after eruption. The extrinsic
stains are those deposited on the outer surface of the tooth over
2001;
Joiner, 2004). However, stains
vary in extent, distribution, colour and tenacity. Identifying the
cause of the stain is essential before proceeding with further
treatment. Mild stains could be removed by scaling followed
by pumice polishing. The to
ugher stains require bleaching
Professional bleaching is commonly done
using peroxide based agents. There has been tremendous
evolution of this material. Earlier, first generation materials
used were in liquid form. Owing to its disadvantages of lower
centration, not remaining in trays for too long, the second
generation of gel form was used. This increased the contact
time with the tooth and lessens the chance of soft tissue
contact. The third generation differed in vehicle and colour.
action is that the oxidation of the stains
breaks it down into smaller less noticeable molecules. To
hasten up the process light activated systems have also been
Although the peroxide based
methods of bleaching have been commo
nly practiced and
proven effective, investigators continue to report adverse
he effect of teeth whitening produced by various natural food substances:
An in-vitro study

effects on hard tissue, soft tissue, and restorative materials
(Attin et al., 2004; Dahl and Pallesen, 2003). The common
adverse effects of bleaching techniques are transient sensitivity
and oral irritation or ulceration and sometimes even affects the
vitality of the tooth. To overcome these adverse effects, the use
of organic and natural products has been encouraged and of
late there is an emerging trend towards its use at a larger scale.
In our study, we divided the natural teeth equally among the
natural bleaching products to be applied directly or indirectly.
Apart from this we also had positive and negative controls.
Keeping in mind, citric acid content in lime, tartaric acid
present abundantly in apple, carotenoids in carrot and usage of
baking soda widely for various reasons, this study was done to
find out bleaching efficacy of the above variable. We found
that lemon showed the highest significance in bleaching. This
could be attributed mainly to its citric acid content. Lemon
juice and lime juice are rich sources of citric acid, containing
1.44 and 1.38 g/oz, respectively. Lemon was the only variable
which showed equal significance by direct application and
soaking. The reason for this result could be because of the
same consistency of being liquid. The diet derived citric acid
contact with the tooth may also cause bleaching to some extent
with respect to its concentration (Penniston et al., 2008).
The variable that showed second highest significance was
baking soda (direct application). But it did not show any
significance while soaking. Baking Soda is a naturally
occurring substance and is basic in nature. It helps in
maintaining the pH balance and thus acts as a buffer. Baking
Soda is made from soda ash, also known as sodium
bicarbonate. The soda ash can be manufactured by passing
carbon dioxide and ammonia through a concentrated solution
of sodium chloride (table salt). Baking soda is commonly used
in toothpastes for its abrasivity, which leads to stain removal.
According to Kleber CJ et al, sodium bicarbonate can remove
the extrinsic stains, but are not capable to clean deeper,
intrinsic stains (Kleber, et al., 1997). Baking soda has also
been proven to be effective when used in combination with
hydrogen peroxide. According to Bhenya Ottoni Toste et al,
the decomposition of residual hydrogen peroxide was by
enhanced by almost 6 folds by the presence of baking soda
(Tostes et al., 2013). From the present study we can come to a
conclusion that efficacy of sodium bicarbonate is mainly
because of its abrasive nature rather than its chemical
composition. The variable to show the third highest
significance was apple (direct application). Apple contains
acids like tartaric acid, malic acid, folic acid. Like baking soda,
apple showed significance only when applied directly. This
again can be due to the added fibre content in apple which also
acted like an abrasive. According to Zheng LW et al, apple
vinegar is effective on in vitro tooth bleaching (Zheng et al.,
2014). Apple did not show significance on soaking. The reason
may be because the mashed apple was not the right vehicle for
the agents to bleach well. Proper extract can show positive
results. The fourth variable to show significance was carrot
(direct). Carrot contains nitrate, nitrite, glutamic acid, free
amino acids and trace amounts of caffeic acid, lactic acid and
glycolic acid. Which specific content of carrot brings about
bleaching is not exactly known. But the efficacy of carrot
could be because of its rich and varied acid content. However
carrot on soaking showed least significance when compared to
other 3 variables (Sharma et al., 2012).
Conclusion
It was compared as to which food substance can be used to
effectively whiten teeth. The hypothecation that food
substances can be effective was proved to be right. Hence,
these agents can be used as an active ingredient in day to day
commodities like tooth paste or other tooth cleaning products
after standardisation. This study can act as tool to promote the
use of natural food substances for bleaching for a greener
environment and can pave way for further research with
various other agents.
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74407 International Journal of Current Research, Vol. 10, Issue, 10, pp.74405-74407, October, 2018
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