Potential of Strawberry (Fragaria x annanasea) Extract as Whitening Agent for Discolored Teeth

Abstract

The Bleaching technique has long been applied in dentistry. Strawberry (Fragaria x annanasea) is a non-dental material that can be used for natural bleaching. The strawberries contain ellagic acid and malic acid which can whiten teeth. Other ingredients found in strawberries also have a low pH so they can whiten teeth better when compared to other fruits. Strawberries also give bad side effects, namely increased tooth sensitivity. This research aims to explain the potential of strawberry (Fragaria x annanasea) extract as a whitening agent against discolored teeth. Based on reference sources obtained from journals, textbooks, and websites accessed through the databases of Google Scholar, Science Direct, EBSCO, and PubMed (National Library of Medicine, Bethesda, MD, USA) and searched for the keywords “Bleaching, Strawberries (Fragaria x annanasea), and Discoloration.” The types of journals taken are scientific and descriptive journals published from 2010 – 2020 and dental material textbooks from 2010 – 2020. The research concludes that the use of strawberry (Fragaria x annanasea) fruit extract can provide a whitening effect on teeth that have changed color and is the best solution compared to synthetic tooth whiteners. In addition, strawberries also provide side effects, namely increased tooth sensitivity.

Introduction

In the era of globalization as it is today, aesthetics is one of the things that people care about [1]. Technological developments make patients begin to understand and care about oral health and the desire to have a perfect smile. Teeth are one of the determining factors of aesthetics apart from having a function in the masticatory process. The outermost surface of the tooth is the enamel, the next layer is dentin and the innermost layer is the pulp [2].

Tooth enamel may become discolored, and the discoloration can be either physiological or pathological. Physiological discoloration that occurs in teeth can be caused by age, because the dentin layer is thicker, due to the formation of secondary and reparative dentin. The pathological discoloration is divided into two, namely extrinsic and intrinsic. Extrinsic discoloration can be caused by deposits on the outer surface of the teeth. Meanwhile, tooth discoloration is intrinsically caused by factors from within the pulp tissue [3].

For almost a century, dentists have performed teeth whitening procedures, also known as bleaching. Dental bleaching is a dental treatment that is popular among the public and continues to grow for aesthetics. Bleaching materials are widely used, there are natural bleaching agents and chemical bleaching agents. The chemical bleaching agent commonly used is hydrogen peroxide which is believed to be able to remove chromatic particles (dental particles that readily absorb dyes) on the teeth [4]. Hydrogen peroxide is indicated for removing stains on vital and non-vital teeth. Teeth whitening in non-vital teeth can be performed using external, internal techniques, or a combination of these two techniques. Vital teeth whitening can be performed with any type of product that can be used at home or work. One of the side effects that can occur after the bleaching procedure is increased tooth sensitivity. Overall, bleaching products are safe for use on humans. The teeth whitening process will certainly produce a very good aesthetic aspect so that it will improve the appearance of a person. Therefore, usually, workers in the entertainment sector often want to whiten their teeth bleached such as presenters, broadcasters, reporters, artists, models, singers, or people who will attend big events such as weddings, etc [4].

The use of natural ingredients is popular nowadays because many advantages can be taken when using natural materials, for example, it is safer, cheaper, and easier to obtain when compared to chemicals [5]. Strawberries (Fragaria x annanasea) are one of the natural ingredients that can now be used to whiten teeth that have changed color because strawberries contain ellagic acid (ellagic acid) and malic acid (melic acid) which can whiten teeth. Other ingredients found in strawberries (Fragaria x annanasea) also have a low pH, so they have a better ability to whiten teeth when compared to other fruits [6].

Yulita et al. (2019), stated that strawberry extract with a concentration of 100% and 75% was sufficient to give until day 5 (to get an intensity score = 1), while strawberry extract with a concentration of 50% and 25% took longer to reach an intensity score = 1. Strawberry extracts with concentrations of 100% and 75% were sufficient to give until the fifth day (getting an extension score <2), while 50% and 25% strawberry extracts took longer to reach an extension score of <2 [3]. Karmawati et al. (2020), showed that the effect of a strawberry extract with 100% concentration on the disappearance of extrinsic stains did not even take up to 5 days of treatment for some respondents, because the respondents' staining score had reached 0 before the 5th day. It can be concluded that strawberry fruit extract with a concentration of 100% can clean extrinsic stains on teeth effectively within 2 to 4 days. Based on this background, writing an article with a literature review study is interesting to study more deeply to know the potential of strawberry extract (Fragaria x annanasea) as a whitening agent for teeth that have changed color [7].

Method

This study was conducted based on reference sources/references obtained from journals, textbooks, and websites accessed through databases of Google Scholar, Science Direct, EBSCO, and PubMed (National Library of Medicine, Bethesda, MD, USA) and searched for the keywords “Bleaching, Strawberries (Fragaria x annanasea), and Discoloration.” The types of journals taken are scientific and descriptive journals published from 2010 – 2020 and dental material textbooks from 2010 – 2020.

Result

Teeth Whitening (Dental Bleaching)

Teeth whitening is a conservative and effective method of lightening discolored teeth and has been practiced in dentistry for centuries. During development, careful observation and research on various materials and techniques enabled the dentistry profession to introduce effective, safe, and predictable methods for whitening teeth. Carbamide Peroxide (