BIOCHEMISTRY – MANUSCRIPT Awareness on effect of

                                      BIOCHEMISTRY – MANUSCRIPT 

Awareness on effect of tooth bleaching and demineralisation among South Indian population – A survey 

Type of manuscript : Survey article 
Running Title : Tooth bleaching and its demineralisation

Tasleem Abitha S

Undergraduate student
Saveetha Dental College, Saveetha Institute of Medical and Technical sciences
Chennai, India.

Dr. Vishnu Priya

Assistant Professor 
Saveetha Dental College, Saveetha Institute of Medical and Technical sciences
Chennai, India.

Corresponding Author 

Mrs. Gayathri
Department of Biochemistry 
Saveetha Dental College
Saveetha Institute of Medical and Technical sciences
162, Poonamallee High Road
Chennai = 600077
Tamil Nadu, India.

To create awareness and assess the effect of demineralisation in bleached teeth among South Indian population


Tooth bleaching is also called as Tooth whitening which is either the restoration of a natural tooth shade or whitening beyond the natural shade. 
It’s also refers to removing dirt and debris from the teeth. This removes the stain leaving the enamel crack open and exposed. Some of the cracks are quickly re-mineralised by saliva, while others are filled up again with organic debris.

Tooth bleaching are mostly preferred by the people whose teeth looks more yellow and brownish in colour which is known as Teeth Discolouration. They are of two types : Extrinsic and Intrinsic and age-related. 2

Extrinsic : This occurs when the outer layer (Enamel) of the tooth is stained. Coffee, Wine, Cola or other drinks can stain teeth. Other factors such as 
dental plaque and calculus, tobacco, metallic compound, etc. 3 4 

Intrinsic : This occurs when the inner layer (Dentin) of the tooth darkens or 
gets a yellow tint. These stains are caused by certain dental materials, dental
conditions like caries 5, trauma, infections, medications, root resorption 6, nutritional deficiencies, genetic defects and hereditary diseases. 

Betel chewing are one of the major reason for tooth discolouration. 5 Tooth bleaching is one of the most commonly preferred treatment among cosmetics dentistry for making people’s teeth look clean and beautiful. Inspite of all the 
advantages of tooth bleaching, there are certain side effects in it like, 
increased sensitivity of the teeth 6 and irritation of the gums and mucous membrane 7, and over bleaching leads to damage to enamel 8 and weakened Dentin 9. 

In the recent world, people wanted there teeth to look white and attractive when they smile, so even without consulting a dentist they take up bleaching method to whiten there teeth without remembering the future consequences. So finally, they end up having demineralised teeth along other side effects. So this survey was taken to create an awareness on Tooth bleaching and its demineralisations. 

This was an online survey undertaken by using the link
This survey was taken by about 116 people who have undergone the treatment of tooth whitening in home as well as in dental clinics.


One hundred and sixteen people were examined for the survey. 
Out of which 50% of the people’s reason to take up tooth bleaching is to gain a good impression at there first sight with an beautiful winning smile. And 18.1% of the population prefer Tooth bleaching on a purpose of making there teeth white and bright. And the other 31.9% of the population prefer Tooth bleaching to maintain a good self esteem and also as there dentists suggestion. 

So from the above study it is noted that, majority of the individuals not only gives importance to there physical looks and outfits but also to the way they talk, laugh and smile. These individuals must be attention seekers, beauty conscious and also economically rich backgrounder. But why people are going wild even when they knew the consequences to be faced ? Because a big bright smile seems to have an favorable influence upon the people and makes the individual more likeable and approachable.10 But as well the person should be aware of the side effects too.

61 people believe that there teeth is getting stained more because of consuming Coffee and Tea despite brushing there teeth twice a day. From the study it is analysed well that, when people do there brushing and cleaning correctly using the right technique and the suitable toothpaste (or) tooth powder for there teeth itself, there are 85% of the chances to reduce teeth discolouration, which will further not allow the individuals to follow tooth bleaching/whitening techniques. 11 12

So for the growing young generation, Awarenesses and correct method of brushing and flossing there teeth should be thought by there parents and adults of there family. So that they won’t end up bleaching and spending money for there teeth in the future. And it is also every parents duty to make kids follow the right habit.

According to the Survey, Baking soda and lemon orange peels are the widely used home remedies to bleach participants teeth. In modern times, baking soda was used as tooth powders to brush people’s teeth 13 and now it is being used to whiten people’s teeth. In this survey, main part of the people selected Baking soda as there remedy to bleach teeth, as it is cheap in price, gives instant whiteness, easy to use with more good benefits and lesser side effects. 

Next to it, Early morning oil pullings are done by most of the people to whiten there teeth. Oil pulling is noting but it is an Indian Ayurvedic folk practice in which oil is swished around or held in the mouth. 14 Its is followed by n number of people all around the world to keep there mouth clean and healthy. This method has more number of benefits to be cherished and one among them is Tooth whitening. 15 
And from the survey it is analysed that, Oil pulling among Indian population is very common and followed by even young children. 

82% of the people claim the fact that, tooth bleaching leads to demineralisation which affects the structure of the tooth along with our bones. And also 60 people out of 116 people have faced white lesions along with cavities in there teeth due to demineralisation. Due to this reason people whoever undergone Tooth bleaching in dental clinics once in there life, gave up on it because of there health issues and dental problems. 

Home remedies for tooth bleaching are also not safer when it crosses the number of time done without an limit. Too much bleaching will cause the teeth to appear very translucent. 16 Treatment in home for whitening teeth can have significant negative effects on tooth enamel. 17

So proper maintenance should be followed by the participants who have undergone whitening to maintain the bleached teeth in an accurate manner. 18 Like 

Brush of floss mouth after eating and drinking 19
Do touch up treatments
Chewing gums
Using straw for drinking harsh beverages 20

Around 69 people out of 116 people are unhappy with there treatment of Tooth bleaching. People take up this treatment with interest and more enthusiasm, where they are lacking the interest to know the dangers and side effects of the treatment. So due to lack of care and poor maintenance of the teeth they end up with demineralisation leading to white lesions along with cavities and caries. Hence from this survey, Awareness on Tooth bleaching and demineralisation was produced among the South Indian population.

From the survey it is seen that 69% of the people who took tooth bleaching treatment a year before are not satisfied with the process due to demineralisation of there teeth. So rather than treatments usage of home remedies to whiten there teeth are more safer and easier than other clinical procedures. And it also gives instant whitening to the teeth and also easily affordable by everyone. So from this survey Awareness on demineralisation and side effects of tooth bleaching was given to the common people.


^ Herekar M; Mangalvedhekar M; Fernandes A (Dec 2010). “The Most Prevalent Tooth Shade in a Particular Population: A survey”. Journal of the Indian Dental Association. 4 (12).
^Chi AC, Damm DD, Neville BW, Allen CA, Bouquot J (11 June 2008). Oral and Maxillofacial Pathology. Elsevier Health Sciences. pp. 70–74. ISBN 978-1-4377-2197-3.
^ Rajendran A; Sundaram S (10 February 2014). Shafer’s Textbook of Oral Pathology (7th ed.). Elsevier Health Sciences APAC. pp. 386, 387. ISBN 978-81-312-3800-4.
^ “Facts About Tooth Staining and Discoloration”. Retrieved 2017-09-28.
^ Crispian Scully (21 July 2014). Scully’s Medical Problems in Dentistry. Elsevier Health Sciences UK. ISBN 978-0-7020-5963-6.
^ Watts, A; Addy, M (2001-03-24). “Tooth discolouration and staining: Tooth discolouration and staining: a review of the literature”. British Dental Journal. 190 (6): 309–316. doi:10.1038/sj.bdj.4800959. ISSN 1476-5373.
^ Li, Y (1996). “Biological properties of peroxide-containing tooth whiteners”. Food and Chemical Toxicology. 34 (9): 887–904. doi:10.1016/s0278-6915(96)00044-0. PMID 8972882.
^ 1 Haywood, Van & Houck, V.M. & Heymann, H.O.. (1991). Nightguard vital bleaching: Effects of various solutions on enamel surface texture and color. Quintessence Int. 22. 775-782. 
^ Lewinstein, I.; Hirschfeld, Z.; Stabholz, A.; Rotstein, I. (February 1994). “Effect of hydrogen peroxide and sodium perborate on the microhardness of human enamel and dentin”. Journal of Endodontics. 20 (2): 61–63. doi:10.1016/S0099-2399(06)81181-7. ISSN 0099-2399. PMID 8006565.
^ Gladstone, G. (2002). “When you’re smiling, does the whole world smile for you?”. Australasian Psychiatry. 10: 144–146. doi:10.1046/j.1440-1665.2002.00423.x.
^ Fridus van der Weijden; Dagmar Else Slot (Nov 2, 2012). “The effectiveness of toothbrushing”. Dental Tribune.
^ Curtis, Jeannette (13 November 2007). “Effective Tooth Brushing and Flossing”. WebMD. Retrieved 2007-12-24.
^ 1 “Toothpowder Mountain Built From Shells”. Popular Mechanics. Feb 1924.
^ Sooryavanshi S, Mardikar BR (1994). “Prevention and treatment of diseases of mouth by gandoosha and kavala”. Ancient Science of Life. 13 (3–4): 266–70.
^ Hujoel PP, Cunha-Cruz J, Banting DW, Loesche WJ (2006). “Dental flossing and interproximal caries: a systematic review”. J Dent Res. 85 (4): 298–305.
^ Betke, H; Kahler, E; Reitz, A; Hartmann, G; Lennon, A; Attin, T (2006). “Influence of bleaching agents and desensitizing varnishes on the water content of dentin”. Operative dentistry. 31 (5): 536–42. doi:10.2341/05-89. PMID 17024940.
^ Azer, SS; Machado, C; Sanchez, E; Rashid, R (2009). “Effect of home bleaching systems on enamel nanohardness and elastic modulus”. Journal of Dentistry. 37 (3): 185–90. doi:10.1016/j.jdent.2008.11.005. PMID 19108942.
^ “Teeth Whitening – Cost, Types, Results & Risks”. DocShop. Retrieved 2015-10-
^ “Tips for Keeping Teeth White”. WebMD. Retrieved 2015-10-27.
^ “Maintaining Your White Smile Article | Whitening Basics | Colgate® Oral Care Information Whitening & Bonding”. Retrieved 2015-10-27