Whitening Products - What's Good and Bad From a Dentist's Perspective

With the plethora of whitening products on the market today, people get confused as to which are the best to use. From professional in-office whitenings, to whitening toothpastes and chewing gums, there are a long list of products out there claiming to best whiten your teeth. I'm here to give you the inside scoop from a dentist's perspective. So lets take a look at today's most popular whitening products and their ingredients to come up with how effective and safe each really are.

Before & After

Paint on teeth whiteners, better known as whitening pens, typically contain about 5-6% hydrogen peroxide as their active ingredient. The whitening pens do whiten teeth over time, but consumers should know that it will take a significantly greater amount of time to reach optimal whitening results due to its low peroxide content. Also, it is important to "paint" them on without getting the material onto your lips, gums, and/or tongue because irritation can occur. But once it is painted on the teeth and allowed to fully dry, creating a thin film-like material on the teeth's surface, skin irritation is unlikely.

The much advertised teeth whitening strips typically work to whiten teeth fairly well, compared to most over-the-counter products; however consumers need to be careful not to ingest the material, as one of the most common complaints is strip dislodgment and people tasting and ingesting the peroxide. One may think, "Well, I just won't swallow it?" But trust me that it's more difficult than you may think; saliva will start building up in your mouth and your natural reaction will be to swallow. And it definitely doesn't take a rocket scientist to figure out that ingesting "bleach" over time cannot be too healthy, even if it is in such small quantities!

Many also complain about gum irritation and teeth sensitivity with the whitening strips. For gum irritation, there's not much I could tell you besides simply try to keep the material away from your gums. If you feel it on your gums, wipe it off with a tissue before it starts burning and damaging them. If teeth sensitivity occurs, just switch to using the strips every other day or even every two to three days if need be. It will take longer to achieve optimum results, but at least you won't be in as much pain. You could also try using Sensodyne toothpaste to lessen teeth sensitivity. Just put some Sensodyne in a tray or strip and let it sit on your teeth for as long as need be. I also tell my patients to wipe away the excess material that's unnecessary for teeth whitening, like on the back side of the teeth (meaning on the tongue/palate side) or even on the back teeth that people don't even see when you smile! Having the bleaching material on more teeth surfaces than needed will do nothing more than just increase your sensitivity and pain.

In my opinion, it is best to stay away from whitening mouth rinses, whitening toothpastes, and whitening gums. Although they are all considered to be generally safe, I believe that there are simply more negative side effects than positive ones. Lets take a look at why.

Whitening mouth rinses are typically made with about 1.5-2% hydrogen peroxide, which is so low that it will take quite a long time to achieve whitening results with such a product; although whitening will be achieved over time. The drawbacks are all of the negative side effects that result from having bleaching material contact the rest of the oral cavity, like your gums, cheeks, and tongue. I mean, would you swish with a mouthful of bleach after doing the laundry? How about diluting it by adding a few drops into a mouthful of water and swishing with that? Doesn't sound like such a hot idea, does it?


Whitening Works

So you may be wondering what could be the negative consequences of having bleaching material contact your gums, cheek, and tongue? Well the answer is somewhat disturbing! Some possible (and fairly common) side effects of using whitening mouth rinses include gum damage, gum recession, application site burn, lip swelling, stomatitis (inflammation of the oral lining mucosa), bad taste in mouth, sloughing of oral skin, and itchy, burning, brown/black hairy tongue and/or throat. Seems like a lot to endure just for whitener teeth, no? Imagine having a black hairy tongue and white teeth? Not all that pretty in my opinion! Plus, with only 1.5-2% hydrogen peroxide- which is as high as they can add without creating even worse side effects and keeping it "safe" to use- your teeth aren't even going to get all that white anyway.

Whitening toothpastes and chewing gums are generally considered to be safe, but my personal opinion differs a bit and I'll explain why I'm not a fan. Whitening toothpastes and gums whiten teeth with an ingredient called silica, which is a ground-glass type of material that is found in dental composite (white) filling materials and porcelain ceramic crowns, used as a filler for wear resistance and translucency; prophylactic pastes and pumices, used to polish roughened dental restorations and teeth after cleanings; and so on. Thus, these whitening toothpastes and gums essentially whiten teeth by abrading away the surface stains, very similar to how one exfoliates his/her skin. The only difference is, tooth enamel does not grow back like skin does.

One may then wonder if it's damaging to the teeth enamel when dentists use these silica-containing prophy pastes to polish your teeth with after a cleaning; and the answer is no, since it's only used 2-4 times per year at most. If a patient were to brush his/her teeth twice a day with that paste, I would once again say it doesn't sound like such a good idea. I know from speaking with my own patients that many like the idea of brushing their teeth with harsh abrasives. But it's important to know that in actually abrasive toothpastes, hard toothbrush bristles, and applying pressure while brushing are all greatly damaging to the teeth enamel and do not clean your teeth any better than using a mild toothpaste, soft bristle toothbrush, and applying light brushing pressure. In fact, only enough force as is created by holding the toothbrush between your index finger and thumb is required to remove plaque buildup on teeth. And calculus (AKA tartar) cannot even be removed without a professional dental cleaning no matter how hard you try to brush it off! And as a side note, the whitening toothpastes and gums really don't work at whitening all that well anyway!

Looking good!

Professional one-hour in-office teeth whitening is usually about 30-35% carbamide peroxide, which works as an oxidizing agent that penetrates the porocities in the enamel and breaking down to allow oxygen into the enamel, thereby ultimately bleaching your teeth. This oxidizing reaction is believed to be very safe and undamaging to the teeth, but could cause high levels of temporary sensitivity for many patients that typically lasts for about a day or so after the procedure.

A question I am often asked is, "Are professional in-office whitenings better than over the counter products at whitening my teeth?" And the answer is yes and no; here's why. Most in-office teeth whitening products contain pretty much the same ingredients, give or take depending on the product, as do most over the counter products. However, the percentage of peroxide is just much greater with the professional whitening systems, making them work significantly faster at whitening your teeth to their maximum whitening potential. And although many dentists are too afraid to tell their patients this, over-the-counter products really do have the ability to get your teeth just as white as any in-office procedure a dentist can give you; it's just going to take longer and require a bit more time and effort on your part.

Over-the-counter whitening gels' active ingredient is typically carbamide peroxide, however in much lower percentages than the in-office procedures. Usually one can expect to find less than 10% peroxide to 22% peroxide at most in these over-the-counter products. These whitening gels have to be applied using trays that people could either buy from the drugstore or have their dentist custom-make for them. Once again what this should tell you as a consumer is that these over-the-counter whitening trays will whiten your teeth just as well as a professional whitening systems can; it'll just take a longer amount of time to achieve the same whitening results.

So why would one get a dentist-made take home whitening tray you may ask? The answer is simple. The trays a dentist makes for you are custom formed to precisely fit your individual teeth and keep the material away from your gums. The benefits of this are that less material can be used, only a drop required per tooth; they are much less bulky and comfortable to wear; only the area you want whitened is exposed to the peroxide, thereby decreasing teeth sensitivity; and the material doesn't seep through and into your mouth and surrounding gums, causing burns and sore spots, thus higher percentages of peroxide can be applied safely.

It's important to note that most product manufacturers don't display the percentage of peroxide contained in their products, so unfortunately it becomes up to you as the consumer to research and find out more about them to see how fast and effective each will be at whitening your teeth. Also be sure to take into account each product's pros and cons by reading as many customer testimonials as you can online before spending your hard earned money. Now that I've given you a fairly good background on the different teeth whitening options, I hope it can help you in making a more informative decision based on your own individual whitening needs. Happy whitening!


Bahareh Safaie DDS

Bahareh Safaie, DDS

16101 Ventura Blvd Ste 350

Encino, Ca 91436

Tel: 818-78-TEETH (818-788-3384)

Fax: 818-788-3385

Web: www.DashingDentistry.com

Email: [email protected]

Blog: http://DrSafaie.blogspot.com



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