Tooth whitening products and the risk of oral cancer

Food Chem Toxicol. 2006 Mar;44(3):301-15. doi: 10.1016/j.fct.2005.07.012. Epub 2005 Sep 29.

Abstract

Tooth whitening products (TWP) containing hydrogen peroxide (HPO) or carbamide peroxide (CPO) were evaluated in relation to potential oral cancer risk from their use. HPO is genotoxic in vitro, but such activity is not expressed in vivo. The genotoxic risk of HPO exposure of the oral mucosa encountered from TWP use is likely therefore to be vanishingly small. Available animal data on the carcinogenicity of HPO are of limited relevance to risk assessment of oral hazard of HPO exposure from TWP, and where relevant, do not indicate that there is an increased oral cancer risk for people using TWP. Clinical data on HPO-containing TWP only show evidence of mild, transient gingival irritation and tooth sensitivity, with no evidence for the development of preneoplastic or neoplastic oral lesions. Exposures to HPO received by the oral cavity, including areas commonly associated with oral cancer, are exceedingly low and do not plausibly pose a risk for the promotion of initiated cells or for induction of co-carcinogenic effects in conjunction with cigarette smoke or alcohol. The use of TWP was concluded not to pose an increased risk for oral cancer in alcohol abusers and/or heavy cigarette smokers. Furthermore, TWP were concluded to be safe for use by all members of the population, including potential accidental use by children.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Carbamide Peroxide
  • Carcinoma, Squamous Cell / chemically induced*
  • Carcinoma, Squamous Cell / epidemiology
  • DNA Damage
  • Drug Combinations
  • Humans
  • Hydrogen Peroxide / adverse effects*
  • Mouth Neoplasms / chemically induced*
  • Mouth Neoplasms / epidemiology
  • Peroxides / adverse effects*
  • Risk Assessment
  • Risk Factors
  • Safety
  • Tooth Bleaching / adverse effects*
  • Tooth Bleaching / methods
  • Urea / adverse effects
  • Urea / analogs & derivatives*

Substances

  • Drug Combinations
  • Peroxides
  • Carbamide Peroxide
  • Urea
  • Hydrogen Peroxide