The first publications describing techniques and chemicals for bleaching “non-vital” (root canal treated) teeth appeared in the latter half of the 19th Century. The bleaching agent of choice was chloride of lime. Other agents described for the bleaching of non-vital teeth included aluminum chloride and hydrogen peroxide, used either alone or in combination with heat. The active ingredient common to all the early medicaments was an oxidizing agent. Concern about the side effects of some of these agents was justified because some chemicals used were very poisonous, such as cyanide of potassium. The observation that carbamide peroxide caused lightening of teeth was made in the late 1960s by an orthodontist (Klusmier), who had prescribed an antiseptic containing 10% carbamide peroxide to be used in a tray for the treatment of gingivitis (inflammation of the gums). Believe it or not, this technique pioneered the method of home bleaching today, which only achieved general acceptance decades later. In a nutshell, carbamide peroxide and its breakdown products, hydrogen peroxide and urea bleach the colored organic molecules between the enamel crystals and in the dentin, therefore, leaving the teeth whiter looking.
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