AWARENESS and presented in statistics. RESULTS People take

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

Tasleem Abitha S
Undergraduate student
Saveetha Dental College, Saveetha University 
Chennai, India.

Co – Guide 
Dr. Vishnu Priya
Assistant Professor 
Saveetha Dental College, Saveetha University 
Chennai, India.

Corresponding Author 
Mrs. Gayathri R
Department of Biochemistry 
Saveetha Dental College
Saveetha University 
162, Poonamallee High Road
Chennai = 600077
Tamil Nadu, India.

Faculty Email ID     :  [email protected]
Telephone Number  :  +91 97106 80545

Word count              : 1355



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


A group of people who have undergone tooth bleaching in homes as well as clinics were selected
and examined with the questionnaire prepared. The information collected through the survey is analysed and presented in statistics.


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 their 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.


Oral health is an important part of systemic health. So from this survey Awareness on demineralisation and side effects of tooth bleaching was given to the common people of South India. 


Teeth whitening, Demineralisation, Home remedies, Enamel Erosion, White lesions. 


Tooth bleaching is also called as Tooth whitening which is either the restoration of a natural tooth shade or whitening beyond the natural shade 1. 
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 is 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 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 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 is also 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, weakened Dentin, and over bleaching leads to damage to enamel 8 creating white lesions on the outer surface of the teeth leading to demineralisation.

Demineralisation in the tooth structure takes place by dissolving calcium, phosphorus, etc. This enamel erosion leads to cavities in teeth and also become more favourable to bacteria growth that causes decay. Demineralised teeth are very sensitive to diverse stimuli like sensitive to hot and cold foods and drinks, brushing may be sensitive and uncomfortable, tempting the patient to cut (or) skip brushing short, which is usually fatal to the patients teeth. So if the demineralised sensitive teeth are not properly maintained by the patients, then it affects and damages the whole teeth structure making treatment difficult.

So proper maintenance should be followed by the individuals who have undergone whitening to maintain the bleached teeth in an accurate manner 9 Like Brushing and flossing of mouth after eating and drinking, maintaining improved diet, daily oral hygiene, do touch up treatments, using straw for drinking harsh beverages, following routine dental check ups to treat there demineralised teeth before it turns into actual cavities. And demineralised teeth are often treated by performing remineralisation in dental clinics, in which fluoride gel / substance is applied on the affected tooth structure ( fluoridation ), or at home by maintaining proper hygiene and switching to special formula toothpaste with extra fluoride 1011.

The aim of the survey is to create awareness and assess the effect of demineralisation in bleached teeth among South Indian population.


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. The information collected through the survey is analysed and presented in statistics.






One hundred and sixteen people were examined for the survey. Out of which the reason of 50 % of the participants to take up tooth bleaching is to gain a good impression at there first sight with an beautiful winning smile (fig.1) whereas the other 18.1% of the participants prefer tooth bleaching on a purpose of making there teeth white and bright. Tooth whitening also gives good self confidence to the participants and also as a dentist’s recommendation 31.9% of the participants have undergone this treatments. 

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 participants must be attention seekers, beauty conscious and also economically rich backgrounder. As a big bright smile seems to have an influence upon the people and makes the individual more likeable and approachable 12. 

Coffee and Tea are the main cause of tooth discolouration for around 61 participants out of 116 despite brushing there teeth twice a day (fig.2). 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 13 14.

According to the Survey, Baking soda and lemon orange peels are the widely used home remedies to bleach participants teeth (fig.3). In modern times, baking soda was used as tooth powders to brush people’s teeth 15 and now it is being used to whiten people’s teeth . In this survey, main part of the participants 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 participants to whiten there teeth. Oil pulling is noting but an Indian Ayurvedic folk practice in which oil is swished around or held in the mouth 16. It 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 17. 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 participants claim the fact that, tooth bleaching leads to demineralisation which affects the structure of the tooth along with our bones (fig.4). And it also creates white lesions on the outer surface of the teeth (enamel) along with cavities due to demineralisation which is faced by around 60 participants from the survey (fig.5). 

Due to this reason participants whoever undergone Tooth bleaching in dental clinics once in there life, gave up on it because of there health issues and dental problems. Majority of the participants have undergone teeth whitening one year back and they are not satisfied with there treatment because of demineralisation along with white lesions and cavities 18.

And the divergent event noted additional from the survey is that, the participants from the survey have recommended the non-participants not to take up tooth bleaching in clinics as the 
procedure and chemicals used for the treatment contains some side effects as it cannot be handled by our tooth structures easily, leading to cavities and enamel erosion, which is harmful when compared with the home remedies. Home remedies for tooth bleaching are also not safer when it crosses the number of time done without limit. Too much bleaching will cause the teeth to appear very translucent 19. Treatment in home for whitening teeth can have significant negative effects on tooth enamel 20. 

From this 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. Other than a social message, in every home, Awarenesses and correct method of brushing and daily oral hygiene should be thought by every parent and adult of there family for the growing young generation to prevent them from future consequences. 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

So from this survey awareness on demineralisation and side effects of tooth bleaching was given to the people of south India.


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