Objective To analyze the effect of personalized tooth whitening-enamel protection protocol based on radiographic image quantification on whitening efficacy and enamel protection indicators. Methods A total of 60 patients requiring tooth whitening treatment admitted to the Department of Stomatology, Stomatological Hospital of Zhejiang University School of Medicine from March 2024 to January 2025 were selected as the research subjects, and they were divided into the control group (n=30) and the observation group (n=30) by the random number table method. The control group received the traditional standardized whitening protocol, and the observation group received the personalized tooth whitening-enamel protection protocol based on radiographic image quantification. The whitening efficacy, enamel protection indicators, tooth sensitivity and adverse reactions were compared between the two groups. Results After treatment, the discoloration improvement rate, L* value and ΔE value of the observation group were better than those of the control group (P<0.05). The change in enamel thickness and enamel demineralization rate of the observation group were lower than those of the control group (P<0.05). The VAS score and sensitivity incidence rate of the observation group after treatment were lower than those of the control group (P<0.05). There was no statistically signiffcant difference in the incidence of complications between the two groups (P>0.05). Conclusion The personalized tooth whitening-enamel protection protocol based on radiographic image quantiffcation can ensure whitening efffcacy, reduce enamel damage, and decrease the incidence of tooth sensitivity.