Chronic exposure to 35% carbamide peroxide tooth bleaching agent induces histological and hematological alterations, oxidative stress, and inflammation in mice

Previous studies have demonstrated the side effects of tooth whiteners on the gastric mucosa. However, the impact of dental bleaching products on the liver, kidney, and heart remains obscure. The present study investigated the toxic potential of 35% carbamide peroxide (CPO) containing tooth whitening product (TWP) on the liver, kidney, heart, and stomach of mice, pointing to the role of oxidative stress and inflammation. Mice received 250 or 500 mg/kg body weight CPO-TWP orally for 3 weeks and samples were collected for analyses. Both doses of CPO-TWP induced a significant increase in circulating liver, kidney, and heart function markers. CPO-TWP-administered mice showed several histological alterations and a significant increase in liver, kidney, heart, and stomach lipid peroxidation levels along with diminished glutathione, superoxide dismutase, and catalase. In addition, administration of CPO-TWP provoked anemia, leukocytosis, and a significant increase in circulating levels of pro-inflammatory cytokines. In conclusion, exposure to 35% CPO-TWP induced functional, histological, and hematological alterations, oxidative stress, and inflammation in mice. Therefore, the frequent use of tooth bleaching agents should be monitored very carefully to avoid the application of excess amounts as well as the intake.