From the shores of Miami to sunny California, teeth whitening is all the rage. Today, it is one of the most popular cosmetic dental treatments in the United States and increasingly so in countries around the world. But recent news of countries clamping down on how the industry operates should give you pause for thought. The question really is: how safe is teeth whitening and is the downside worth the risk?
What Is Teeth Whitening?
Whitening your teeth is done via a simple cosmetic dental process that involves cleaning your teeth of surface stains and discoloration to restore their color or, in the case of a bleach, make them whiter than their natural shade. The teeth whitening industry was pegged at about 11 billion dollars in 2013 and has been growing ever since.1 One report projects that between 2014 and 2019 the segment will grow at a compound annual growth rate (CAGR) of 3.40 percent 2
What National Health Authorities Recommend
In the UK, illegal teeth whitening can attract an unlimited fine (this was limited to GBP 5000 until recently, but the cap was removed after the proliferation of high street beauty shops and teeth whitening centers that skirted the law). An EU-wide ban following a decree from Brussels now rules that any product that contains more than 0.1 percent of hydrogen peroxide bleach cannot be sold in a home kit or administered by anyone other than a qualified dental professional. The American Dental Association’s Council on Scientific Affairs suggests that any kind of bleaching product be used only after you’ve spoken to a dentist. They also caution against unsupervised use by anyone who has crowns, fillings, or dark stains.3
Options For Teeth Whitening
You can choose to get your teeth whitened by a dentist or use an over-the-counter (OTC) or dentist-prescribed tooth whitening product at home. The dentist will review your history, checking for any allergies and sensitivities, to determine what method is best for you. Nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed for pain relief before the procedure and the dentist will make sure that surrounding tissue is properly protected and isolated.4
Another trend in the field is to use lasers in conjunction with hydrogen peroxide-based whitening. Dubbed “power whitening” because of its ability to speed up the whitening effect, it uses a laser or a light that is shined on your teeth so the chemical (bleaching product) can be activated. Laser whitening is supposed to help lighten your teeth by as much as five to six shades.5 However, the procedure is controversial, with many conflicting research reports. One study showed that adding light activation to the whitening process did not impact color stability, nor did it have superior benefits6 In fact, another study found that the use of light might even increase how sensitive your teeth are during the bleaching7
Products devised for home use include everything from toothpastes, paint on films/strips, gels, rinses, and even chewing gums. Some are available OTC, while others can be prescribed by dentists for at-home use by their patients.8
Risks Of Teeth Whitening
While many teeth whitening products are effective in whitening the teeth, potential side effects or risks have raised hackles in some countries in Europe. Concern largely revolves around who administers the treatment. For instance, the British Dental Association believes it is a safe procedure if done by a qualified professional. Mishandling the bleach, incorrectly fitting the mouthguard so the bleaching gel leaks, or allowing the bleach to come in contact with the skin and thereby causing chemical burns ‒ these are some of the mistakes that can be avoided.
Sensitivity to touch and temperature is a common side effect among those with receding gums, cracks in their teeth, or faulty restorations when a high concentration bleach is used. Gum irritation is very common but ceases once bleaching effect stops after the treatment, or if the peroxide concentration is made milder.
Home kits and products usually have carbamide peroxide that breaks down to form hydrogen peroxide – a bleaching agent – when put in water. Unfortunately, using these products too often could cause the chemical to strip much of your enamel away, which could be painful. Over time, the teeth may actually even seem blotchy as the dentin, which is of a darker hue, becomes visible with the enamel gone.
Even if the whitening is done properly, it might mask an underlying problem like dental decay, caries, or leaking restorations.9
Most aestheticians without a dentistry or dental hygienist background are not adept at taking medical history and may not be able to ascertain whether you are a suitable candidate, raising the possibility of serious side effects.
Not Everything Is Bad
Done correctly, teeth whitening can be a safe procedure and one of the most effective ways to get that million dollar smile without surgery. However, it is important to find a good dentist who is qualified to conduct the treatment and to have any underlying issues addressed before getting your pearly whites to look white again.
|↑1||ERICKSON, ANGELA C. “How Dental Industry Insiders Thwart Competition From Teeth-whitening Entrepreneurs.” (2013).|
|↑2||Global Teeth Whitening Products Market 2015-2019, Technavio|
|↑3, ↑4, ↑8, ↑9||American Dental Association Council on Scientific Affairs. “Tooth whitening/bleaching: treatment considerations for dentists and their patients.” Chicago: ADA (2009).|
|↑5||Tooth Whitening, Oral Health Foundation|
|↑6||Bernardon, J. K., N. Sartori, A. Ballarin, J. Perdigão, G. Lopes, and L. N. Baratieri. “Clinical performance of vital bleaching techniques.” Operative Dentistry 35, no. 1 (2010): 3-10.|
|↑7||He, Li-Bang, Mei-Ying Shao, Ke Tan, Xin Xu, and Ji-Yao Li. “The effects of light on bleaching and tooth sensitivity during in-office vital bleaching: a systematic review and meta-analysis.” Journal of dentistry 40, no. 8 (2012): 644-653.|