An In-Depth Exploration of Natural and Herbal Tooth Whitening Agents: Efficacy, Safety, and Clinical Applications

Abstract

Discoloration refers to the alteration of the original color of an object, resulting in an unpleasant or damaged appearance. Tooth discoloration can occur due to trauma, residual intracanal medicaments or obturating materials, as well as extrinsic factors such as tea, coffee, and chromogenic bacteria. To reduce or eliminate discoloration, whether in a vital or non-vital tooth, several treatment options are available. The simplest and most cost-effective treatment is bleaching. The bleaching materials used not only diminish discoloration but also have side effects, including compromised tooth strength and cervical resorption. To mitigate these side effects, natural products have been developed, tested, and refined. This review article emphasizes various bleaching procedures, the mechanisms of action, and the effectiveness of natural bleaching agents.

Keywords

Bleaching agent - dental erosion - dental esthetic - tooth - teeth whitening - inflammation

Publication History

Received: 27 August 2025

Accepted after revision: 24 November 2025

Article published online:
29 December 2025

• References

• 1 Gasmi Benahmed A, Gasmi A, Menzel A. et al. A review on natural teeth whitening. J Oral Biosci 2022; 64 (01) 49-58
• 2 Pirwani D, Rasala T, Bhede KJ. et al. Natural excipients as teeth whitening agents: A review. Int J Pharm Sci Rev Res 2023; 79 (02) 102-107
• 3 Parinitha MS, Annapoorna BM, Sowmya HK. Effect of power bleaching on the fluorosis stained anterior teeth case series. J Clin Diagn Res 2014; 8 (08) ZJ01-ZJ03
• 4 Halasabalu Kalgeri S, Mull P, Shivakumar AT. et al. Managing Vital and Nonvital Tooth Bleaching Among Endodontists and General Dental Practitioners: A Knowledge, Attitude, and Practice Study. Plast Aesthet Nurs (Phila) 2024; 44 (04) 228-238
• 5 Boitsaniuk S, Kochan O, Levkiv M. Modern concepts of teeth whitening—a narrative review. EUREKA Health Sci 2022; 30 (06) 31-43
• 6 Plotino G, Buono L, Grande NM. et al. Nonvital tooth bleaching: a review of the literature and clinical procedures. J Endod 2008; 34 (04) 394-407
• 7 Irusa K, Alrahaem IA, Ngoc CN. et al. Tooth whitening procedures: a narrative review. Dent Rev 2022; 2 (03) 100055
• 8 Brook AH, Smith RN, Lath DJ. The clinical measurement of tooth colour and stain. Int Dent J 2007; 57 (05) 324-330
• 9 Guan YH, Lath DL, Lilley TH. et al. The measurement of tooth whiteness by image analysis and spectrophotometry: a comparison. J Oral Rehabil 2005; 32 (01) 7-15
• 10 Gerlach RW, Zhou X. Vital Bleaching with Whitening Strips: Summary of Clinical Research on Effectiveness and Tolerability. J Contemp Dent Pract 2001; 2 (03) 1-16
• 11 Kwon SR, Wertz PW. Review of the Mechanism of Tooth Whitening. J Esthet Restor Dent 2015; 27 (05) 240-257
• 12 Tabassum A. Classification of tooth staining. J Clin Dentistry Oral Health 2021; 5 (01) 1-4
• 13 Sulieman M. An overview of tooth discoloration: extrinsic, intrinsic, and internalized stains. Dent Update 2005; 32 (08) 463-471
• 14 Noorsaeed AS, Lanqa SAM, Alshehri RA. et al. Causes and Management of Tooth Discoloration: A Review. J Pharm Res Int 2021; 33 (60) B 969-976
• 15 Watts A, Addy M. Tooth discolouration and staining: a review of the literature. Br Dent J 2001; 190 (06) 309-316
• 16 Joiner A, Luo W. Tooth colour and whiteness: A review. J Dent 2017; 67: S3-S10 Suppl)
• 17 Alqahtani MQ. Tooth-bleaching procedures and their controversial effects: A literature review. Saudi Dent J 2014; 26 (02) 33-46
• 18 Coelho AS, Garrido L, Mota M. et al. Non-Vital Tooth Bleaching Techniques: A Systematic Review. Coatings 2020; 10 (01) 61
• 19 Butera A, Maiorani C, Rederiene G. et al. Evaluation of the Effectiveness of Different Types of Professional Tooth Whitening: A Systematic Review. Bioengineering (Basel) 2024; 11 (12) 1178
• 20 Féliz-Matos L, Hernández LM, Abreu N. Dental Bleaching Techniques; Hydrogen-carbamide Peroxides and Light Sources for Activation, an Update. Mini Review Article. Open Dent J 2015; 8: 264-268
• 21 Portillo FRL, Urias AEV, Arredondo TG. et al. Internal tooth bleaching: a review. Int Surg J 2025; 12 (06) 1053-1059
• 22 Abidia RF, El-Hejazi AA, Azam A. et al. In vitro comparison of natural tooth-whitening remedies and professional tooth-whitening systems. Saudi Dent J 2023; 35 (02) 165-171
• 23 Barbuzan-Caragyov A, Hajaj T, Cojocariu AC. et al. Efficiency of Natural Ingredients in Teeth Whitening. Dent Mater 2022; 38 (Suppl 1) e6-e7
• 24 Xie P, Lu J, Wan H. et al. Effect of toothpaste containing d-limonene on natural extrinsic smoking stain: a 4-week clinical trial. Am J Dent 2010; 23 (04) 196-200
• 25 Sheshadri R, Shivakumar AT, Mahendran B. et al. Kalgeri Sowmya Halasabalu. Evaluation of Bromelain, A Pineapple Extract as a Bleaching Agent on Human Enamel and Determining its Concentration by Reverse-HPLC Method. J Orofac Sci 2023; 15 (01) 31-37
• 26 Aydın N, Karaoğlanoğlu S, Oktay EA, Ersöz B. Determination of the whitening effect of toothpastes on human teeth. Odovtos. 2022; 24 (01) 67-75
• 27 Amelia H, Febriani M, Rachmawati E. Potencial of Various Natural Bleaching Ingridients on Teeth Discoloration. J Adv Med Dent Scie Res 2022; 10 (01) 109-114
• 28 Ribeiro JS, Barboza AD, Cuevas-Suárez CE, da Silva AF, Piva E, Lund RG. Novel in-office peroxide-free tooth-whitening gels: bleaching effectiveness, enamel surface alterations, and cell viability. Sci Rep 2020; 10: 10016
• 29 Maciel CRO, Amorim AA, Oliveira RFL. et al. Whitening efficacy of popular natural products on dental enamel. Braz Dent J 2022; 33 (03) 55-66
• 30 Kohli S, Yin ASY, Nam WL. et al. OSC47: Efficacy of Four Different Types of Bleaching Agents on Stained Natural Teeth using Spectrophotometer. J Indian Prosthodont Soc 2018; 18 (Suppl 1) S28
• 31 Müller-Heupt LK, Wiesmann-Imilowski N, Kaya S. et al. Effectiveness and Safety of Over-the-Counter Tooth-Whitening Agents Compared to Hydrogen Peroxide In Vitro. Int J Mol Sci 2023; 24 (03) 1956
• 32 Al-Angari SS, Alharbi A, Altaweel M. et al. Effectiveness and adverse effects of over-the-counter whitening products on dental tissues. Front Dent Med 2021; 2: 684953
• 33 Team BDJ. BDJ study on dangers of teeth whitening products provokes significant media interest. BDJ Team 2019; 6 (07) 1
• 34 Bharadwaj RS, Kalgeri SH, Shivakumar AT. et al. Revolutionizing Dental Health Care: An In-Depth Exploration of Technological Advancements. Eur J Gen Dent 2024; 13 (01) 1-14
• 35 Carrillo-Perez F, Pecho OE, Morales JC. et al. Applications of artificial intelligence in dentistry: A comprehensive review. J Esthet Restor Dent 2022; 34 (01) 259-280
• 36 Parinitha MS, Doddawad VG, Kalgeri SH. et al. Impact of Artificial Intelligence in Endodontics: Precision, Predictions, and Prospects. J Med Signals Sens 2024; 14: 25
• 37 Tabatabaian F, Vora SR, Mirabbasi S. Applications, functions, and accuracy of artificial intelligence in restorative dentistry: A literature review. J Esthet Restor Dent 2023; 35 (06) 842-859
• 38 Awdaljan MW, Roque JC, Choi J. et al. Introducing a novel approach to dental color reproduction using AI technology. J Esthet Restor Dent 2024; 36 (12) 1623-1637
• 39 Maggio B, Gallagher A, Bowman J. et al. Evaluation of a whitening gel designed to accelerate whitening. Compend Contin Educ Dent 2003; 24 (07) 519-520
• 40 Sun J. d-Limonene: Safety and clinical applications. Altern Med Rev 2007; 12 (03) 259-264
• 41 De Paula E, Kossatz S, Fernandes D. et al. Administration of ascorbic acid to prevent bleaching-induced tooth sensitivity: a randomized triple-blind clinical trial. Operat Dent 2014; 39 (02) 128-135
• 42 Mazilu Moldovan A, Sarosi C, Moldovan M. et al. Preparation and characterization of natural bleaching gels used in cosmetic dentistry. Materials (Basel) 2019; 12 (13) 2106
• 43 Qi F, Otsuki M, Hiraishi N. et al. Effect of photo-thermal acceleration on in-office bleaching. Odontology 2021; 109: 828-835
• 44 Kalyana P, Shashidhar A, Meghashyam B. et al. Stain removal efficacy of a novel dentifrice containing papain and Bromelain extracts- an in vitro study. Int J Dent Hyg 2011; 9: 229-233
• 45 San Miguel SM, Opperman LA, Allen EP, Svoboda KK. Use of antioxidants in oral healthcare. Compend Contin Educ Dent 2011; 32 (09) E156-E159
• 46 Carey CM. Tooth whitening: what we now know. J Evid Based Dent Pract 2014; 14 (Suppl) 70-76
• 47 Mangaiyarkarasi S, Manigandan T, Elumalai M. et al. Benefits of Aloe vera in dentistry. J Pharm BioAllied Sci 2015; 7: S255
• 48 Ghalem BR, Mohamed B. Antibacterial activity of leaf essential oils of Eucalyptus globulus and Eucalyptus camaldulensis. Afr J Pharm Pharmacol 2008; 2: 211e5
• 49 Poulsen J, Nielsen KA, Bauer-Brandl A. Raman Imaging as a powerful tool to elucidate chemical processes in a matrix: Medicated chewing gums with nicotine. J Pharm Biomed Anal 2022; 209: 114519
• 50 Ishwarya G, Vidhya S, Mahalaxmi S. Marginal integrity of aesthetic restorations following intracoronal bleaching with sweet potato extract as an additive: An SEM study. Heliyon 2020; 6 (02) e03424