Is prolonged bleaching more harmful to dental enamel than daily dietary and hygienic oral habits?

The ultrastructural and mechanical properties of enamel surface were evaluated after prolonged bleaching treatments with 10% carbamide peroxide in the presence or absence of orange juice (erosive challenge) and toothbrushing (abrasive challenge). In total, 145 incisor bovine teeth were used in this study. Twenty-five samples were prepared for the ultrastructural evaluations, and 120 samples were prepared for microhardness and roughness tests. These 120 samples were divided into eight experimental groups (n = 15): G1- artificial saliva; G2- abrasion; G3- erosion; G4- dental bleaching; G5- erosion + abrasion; G6- bleaching + abrasion; G7- bleaching + erosion; and G8- bleaching + erosion + abrasion. All groups were tested at T0 (before treatment), T1 (14 days), T2 (21 days), and T3 (28 days). Two-way analysis of variance for repeated measures and the post hoc Sidak tests (p ≤ 0.05) were used. The roughness evaluation demonstrated an increase in damage for all experimental groups with an increase in the time period. For microhardness, the groups exposed to artificial saliva (AS) and abrasive challenge did not show any differences at any time points, while the other groups showed a decrease in microhardness from T0 to T3. Ultrastructural evaluation showed different surface alterations in response to the treatments. Despite prolonged bleaching periods, the procedure caused lesser enamel surface alterations than exposure to orange juice alone or in combination with brushing.