8. Conclusion – Are oral hygiene products and tooth whiteners containing hydrogen peroxide safe and should they be freely available to consumers?
- The use of toothpastes, mouth-rinses or tooth whitening products containing up to 0.1% hydrogen peroxide does not pose a risk to the health of the consumer under normal or reasonable foreseeable conditions of use. Toothpastes and mouthrinses should not contain more than 0.1% hydrogen peroxide.
The use of tooth whitening products containing 0.1 to 6 % hydrogen peroxide entails potential risks.
With increasing concentration of hydrogen peroxide and frequency of application there will be an increasing risk linked to the use of these products and it cannot be anticipated what the exposure would be if the products were to be freely and directly available to the consumer.
Available data does not allow determining a level of hydrogen peroxide and a frequency of application that would result in exposure which would be considered safe for the consumer. Independent long-term safety evaluations are needed.
The potential risk can be reduced if the absence of risk factors and the proper use are ensured by a dentist:
- If products containing 0.1 to 6 % hydrogen peroxide are only used after consultation with and approval of the consumer's dentist to ensure the absence of risk factors.
- Some population groups need to be particularly careful when using tooth whitening products: persons with damaged fillings or other restorations, with pre-existing mouth diseases or injuries, or who use tobacco and/or alcohol.
- The use of tooth whitening products is not recommended before or immediately after dental restoration.
- If the products are used only as intended in terms of frequency and duration of application to avoid reasonably foreseeable misuse.
Independent long-term safety evaluations should be performed, because good clinical data and long-term epidemiological studies that assess the possible adverse effects within the mouth are lacking.1
Potential health risks of tooth whitening products to children and adolescents could not be assessed due to the absence of specific data.