We’ve all heard people saying that whitening is bad for your teeth, but is there any truth to it?  It seems you only have to mention tooth whitening and someone (who seems to always work in a non-dental or non-scientific field), will assert that it’s bad for teeth, makes them weak, causes cavities, or that teeth get darker faster after whitening.  So, what does the data say?

Firstly, let’s define whitening.  Whitening is any process that makes teeth appear whiter.  Simple. However, there are two approaches: One is non-bleaching whitening, which is to say, removing surface stains.  This is akin to scrubbing a dirty floor to see the original color come through.  The second way is using bleaching products(1).  These bleaching products change the actual color of the enamel and can remove surface stains too.  As such tooth whitening has the ability to turn back the clock on your teeth – quickly and easily removing decades of staining from foods and drinks.  

Tooth whitening goes back to ancient times with the Egyptians known to use various concoctions – including urine – of dubious merit.  As little as 200 years ago services were available to file stained enamel from teeth and to treat with nitric acid to whiten, this worked, but also led to pain and decay(2).  I won’t waste another word on ancient techniques; if they were effective, we’d still be using them.  

In the 21st century, there are many over-the-counter products available and all work on a similar principle: The active ingredient, an oxide such as carbamide peroxide, is suspended in a gel that is applied to the teeth.  The active ingredient oxidizes stains and reveals the natural shades and translucency(1).  Some of the over-the-counter products can work well, but nothing matches custom trays made by a dental professional for the fit and contours that whiten all the way to the gum line, all the way across the smile.    

By contrast whitening toothpastes are typically abrasive forms of regular toothpastes.  These can be helpful in removing surface stains in people who smoke or drink a lot of tea/red wine.  However, they only remove surface stains, not intrinsic stains as the bleaching products do. 

Many people want a brighter, more youthful smile but are concerned that the’ll end up looking like George Hamilton.  Relax, the milder whitening gels take many hours to work and you can stop at any time or decide to keep going; it’s up to you!  

Whitening works very well for most people and can in some cases reduce the visibility of ‘fluorosed’ teeth by minimizing the contrast between the different colors of the teeth.  It is best to consult a dentist before embarking on this treatment due to the potential for exaggerating the appearance of stains, leading to frustrating results and expensive corrective treatment.  This is why it’s important to have a dentist assess your dental health before beginning whitening treatments. 

The most common problem with whitening is tooth sensitivity during or after treatment.  If your teeth are sensitive to hot or cold you may benefit from using a desensitizing toothpaste for a few weeks before and after bleaching to minimize any sensitivity.  Non-steroidal anti-inflammatory drugs such as Advil or aspirin also help eliminate any ‘zing’ of sensitivity.  The second most common problem with over-the-counter products is that people don’t realize that their restorations (crowns and fillings) do not whiten at all.  This creates a discrepancy in tooth color and can be both frustrating and expensive to fix.  Bleaching products are highly effective and have been the subject of many, many scientific studies to establish their efficacy, safety and long-term effects on teeth.  Does whitening cause dental decay?  No (4)

To conclude, is there any truth to any of the accusations against tooth whitening?  Published scientific papers show modest demineralization immediately after whitening, but tooth strength was normalized moments later thanks to salivary minerals(3).  Tooth sensitivity can be bothersome to some, but typically self-resolves.  The effects of whitening can last for years depending on how your teeth respond to stains, how they respond to the whitening and what you eat.  Those who love tea, red wine and coffee seem to pick up the most stains, with tea perhaps being the worst offender (and I ought to know).  We get used to our bodies aging each year; tooth whitening gives us the opportunity to remove decades of stains to reveal a youthful smile.  

So, why not give it a try?  I’m confident you’ll love the results!

Paul Doodes DDS, PhD.

References: 

1. NJ Dent J 2013  Sep;109(3):87-96. Elfallah HM et al.
2. Northwest Dent.  2010 Nov-Dec;89(6):19-21, 23-6. Perdigao J
3. J. Evid. Based Practice. 2014 Jun;14 Suppl:70-6.  Carey CM 
4. Oper Dent 2005 Mar-Apr;30(2):265-70. Al-Qunaian TA

© Paul Doodes.  All rights reserved.