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| - Last Updated on June 28, 2024 by Dr Priyamvada
Quick Take
We came across an advertisement of a teeth whitening serum which claims to whiten yellow teeth without the use of peroxide, with ‘natural’ ingredients. Upon fact checking, we term this as half true.
The Claim
According to a social media post, a teeth whitening serum can magically whiten yellow teeth without using peroxide (as shared by the brand name Perfora). It claims to be safe and uses ‘natural’ ingredients.
Fact Check
What are Bromelain and Papain enzymes?
Bromelain and papain are proteolytic enzymes, meaning they have the ability to break down proteins. Here’s what they do:
- Bromelain: This enzyme is derived from pineapples, specifically from the stems and juice of the fruit. Bromelain has been used for various medicinal purposes due to its anti-inflammatory and digestive properties. In teeth whitening products, bromelain is sometimes included for its ability to break down protein-based stains on the teeth surface. It can help remove plaque and surface stains, contributing to a brighter smile.
- Papain: Papain is extracted from the latex of the papaya fruit. Like bromelain, papain is a proteolytic enzyme that breaks down proteins. It has usage in traditional medicine for its anti-inflammatory and wound-healing properties. In teeth whitening products, papain is utilised for its ability to break down protein-based stains, helping to remove surface discolourations and promote a whiter appearance of the teeth.
What is PAP (Phthalimido-Peroxy Caproic Acid)?
PAP, or Phthalimido-Peroxy Caproic Acid, is a newer compound used for teeth whitening (this is an active ingredient used in the teeth whitening serum in place of Hydrogen peroxide). Acting as an alternative to hydrogen peroxide (as a whitening agent), PAP effectively targets tooth discoloration by breaking down chromogens, the molecules responsible for stains. This process lightens teeth (without the release of free radicals), which penetrate enamel and dentin to oxidise and dismantle staining molecules. Widely used in whitening gels, toothpaste, and strips, PAP offers a promising alternative to traditional hydrogen peroxide-based agents. While generally safe when used as directed, some individuals may experience temporary tooth sensitivity or gum irritation after the treatment.
Does a teeth whitening serum actually work?
Yes, to some extent. some of those do work. But wait, it’s not that simple! The market is full of unreliable teeth whitening solutions too which can actually be harmful to the teeth enamel. One instance is the widespread use of Hydrogen peroxide in teeth whitening products. This can be harmful to the teeth if used too frequently and in high concentrations. Hydrogen peroxide causes enamel erosion (damage to the outermost layer of a tooth) and inflammation of the gums.
However, the good thing about this product is that they have used PAP. This is a safer alternative when compared to Hydrogen peroxide. PAP offers reduced teeth sensitivity and there’s a lesser risk of gum inflammation.
Moreover, one study suggests that it may still cause surface roughness (the teeth whitening serum contains Hydrated Silica, which is a mild abrasive), although results vary. Nevertheless, whitening with PAP could potentially reduce or eliminate many of the adverse side effects associated with peroxide.
To add more, most PAP whitening products now include hydroxyapatite, denoted by a plus symbol as a suffix (PAP+). This addition enhances safety by not only whitening teeth but also aiding in enamel remineralization. Still, since this is a new chemical compound, there’s less research about its effectiveness and potential risks.
How effective are PAP and Bromelain?
The effectiveness of PAP teeth whitening varies because some studies found it less effective than hydrogen peroxide. One study discovered that while PAP effectively removed coffee stains from teeth. But, its performance was lacking when it came to removing tea and red wine stains. Interestingly, the use of PAP actually made the appearance of teeth worse when they had tea and red wine stains.
In contrast, another study determined that hydrogen peroxide produced the most significant change in tooth colour compared to PAP and bromelain.
Is PAP really peroxide-free, as claimed?
The short answer will be no. There has been a consistent concern regarding whether it is genuinely peroxide-free, despite its marketing as such. A brief investigation reveals that PubChem classifies PAP as belonging to the peroxide family. PAP is a synthetic organic peroxy acid that derives from caprolactam and phthalic anhydride. Sulfuric acid combines with hydrogen peroxide to form peroxy acid.
What do the dentists say?
We checked with Dr Snigdha, BDS, MDS Oral Medicine & Diagnostic Radiology, Vananchal Dental College and Hospital, Garhwa, Jharkhand. She says, “It’s important for patients to be careful when considering over-the-counter teeth whitening products. I advise consulting a dentist before starting any whitening treatment. Tooth discolouration can be due to various factors, including diet, smoking, medications, and underlying conditions. While OTC products may offer cosmetic improvements, they may not effectively address the main problem. These products can possibly harm oral tissues and worsen existing dental issues, especially with frequent and high-concentration use. Without proper diagnosis and guidance, patients may damage their gums or enamel. It’s essential to recognise that natural tooth colour variations are normal. And, extra white teeth may not always be achievable or desirable.”
We also checked with Dr Pooja Sharma, BDS, MDS Orthodontics, NIMS University Jaipur, Rajasthan, about OTC teeth whitening products. She says, “I strongly advise consulting a dentist before use. While promising quick results, their safety varies, and not all discolourations can be treated by them alone. Applying without diagnosis can worsen conditions. Teeth naturally have a shade of yellow, excessive whitening leads to unrealistic expectations. For cosmetic enhancement, options like veneers or crowns may be better under the expertise of a dentist. Overuse of such teeth whitening products can harm oral tissues, causing gum inflammation or enamel damage. Even if you are using such products, limit their use to four weeks and seek professional advice if problems continue.”
We have also fact checked several oral health claims. Some of them are Can Nicotine Replacement Therapy guarantee smoking cessation? Can dental anaesthesia vaccinate people without consent?
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