In clinical training, when we talk about products we use for teeth whitening, we find that the great majority contain Hydrogen Peroxide or Carbamide Peroxide--but do we really understand the difference between the two? And in what cases would we use one over the other?
What is Hydrogen Peroxide? What is Carbamide Peroxide?
Hydrogen Peroxide, commonly known as peroxide, is a chemical compound which contains hydrogen and oxygen and has a potent oxidising and reducing effect. In general, it is used for the fabrication of other chemicals and to whiten paper and fabrics. Nevertheless it is also used in dentistry, primarily in whitening products.
On the other hand, Carbamide Peroxide is a chemical composed of Hydrogen Peroxide and Urea. In concrete, the concentration of Hydrogen Peroxide constitutes one third of the composition and as we know, it is also used in dentistry as a whitening agent.
Main differences between the two whitening agents
Decomposition
Carbamide Peroxide decomposes much more slowly than hydrogen peroxide, since urea stabilies the mixture and increases the duration of its effectiveness. Because of this, products with Carbamide Peroxide realease 50% of their peroxide in the first two hours, while the other 50% will be expelled gradually during the following hours.
On the other hand, hydrogren peroxide releases the main part of its peroxide in the first 30-60 minutes. Because of this, products composed of hydrogen peroxide take less time during the day. All of this means that nighttime whitening products are composed of Carbamide Peroxide while daily products those used in the clinic are composed of hydrogen peroxide.
Product shelf life
In general, products made from Carbamide Peroxide have a longer shelf life than those made from hydrogren peroxide. Nevertheless, refridgeration is the best way to optimize shelf life.
Sensitivity
There is not a notable difference in product when it comes to sensitivity. However when we treat a patient who has dental sensitivity, it is better to use lower concentrations of Carbamide Peroxide. For another solution, we can help the client avoid aches and pains due to sensitivity with products like Prevdent Serum Remineralising Sponges (nHAp) and that way we can use whichever whitener independent of its composition.
Results
Both achieve the same final results, although treatments in clinic using Hydrogen Peroxide obtain a more impactful initial result while those using Carbamide are more suitable to maintain the whitened effect.
Examples of Whiteners with Hydrogen Peroxide and Carbamide Peroxide
Carbamide Peroxide: Opalescence PF 10% Whitening Kit
Characteristics:
- Formulated to prevent dehydration and improve colour.
- Patented PF Formula to strengthen enamel and protect against cavities.
- 10% Carbamide Peroxide to minimize the risk of sensitivity.
- Maximum efficacy for nighttime treatment.
- Application time: 8-10 hours.
- Average duration of treatment: between 5 and 10 applications.
Hydrogen Peroxide: Morning Whitening Kit 6%
Characteristics:
- Clinical morning whitenting by PrevDent
- 6% hydrogen peroxide, nHAP
- Reminiralisation and reduction of sensitivity with nano-Hidroxiapatita
- Twice daily use for 30 minutes for between 10 and 14 days.