Evaluation of Charcoal and Sea Salt–Lemon-based Whitening Toothpastes on Color Change and Surface Roughness of Stained Teeth

Abstract

Aim: To compare the efficacy of two naturally based commercially available whitening toothpastes charcoal and sea salt–lemon on stain removal of teeth in terms of color change and surface roughness. Materials and methods: Twenty-seven intact bovine incisors were selected and randomly allocated into three main groups (n = 9) according to the tested toothpaste [I: Signal Complete 8 Charcoal; II: sea salt–lemon essence Closeup natural smile; and III: Signal Complete 8 Original (control)]. Following 4 successive days of staining protocol, each specimen in its corresponding group was brushed with the toothpaste using toothbrush simulator apparatus for three brushing cycles. Color assessment using Vita Easyshade spectrophotometer and surface roughness (Ra) measurement using contact type profilometer were performed for each specimen at baseline, after staining, and after each tooth brushing cycle. Results: Nonparametric color data and parametric surface roughness data were analyzed. The color difference (ΔE) from after-staining protocol to different tooth brushing cycles (1,2,3) showed no significant difference on each cycle between the tested groups (p >0.05). While for color difference (ΔE) from baseline to the last tooth brushing cycle 3, the difference between groups was statistically significant where group II, sea salt–lemon-based toothpaste, had a significantly lowest (ΔE00) value (p <0.001) indicating more whitening effect in relation to others. However, a significant increase in surface roughness was present in all tested groups (p <0.001); meanwhile, there was no significant difference between tested groups (p >0.05). Conclusion: After three tooth brushing cycles, none of the natural whitening toothpastes or conventional toothpastes produced had effective whitening results nor completely removed the stains back to the initial baseline tooth color. Sea salt–lemon-based whitening toothpaste had a whitening effect better than the charcoal-based toothpaste. All of the tested toothpastes increased the degree of surface roughness. Clinical relevance: Charcoal and sea salt–lemon-based whitening toothpastes do not guarantee to whiten nor completely remove the stains back to normal and their effects on enamel surface roughness should be highly clinically considered and managed.