Is Teeth Whitening Safe?

Many people wish their teeth were whiter, but some are nervous about the effects of bleaching. So, is teeth whitening safe?

Teeth whitening techniques have been well evaluated over the years, and the results obtained both in the dental office and at home are virtually guaranteed. The active bleaching ingredient in most whitening products is carbamide peroxide, which yields hydrogen peroxide, according to the American Dental Association (ADA).

Rest assured the dental professionals who manufacture these products have worked hard to ensure teeth whitening is both safe and effective. Keep in mind, however, that there are minor side-effects. There are often three areas of concern after whitening treatment: the gums (or gingiva), the teeth themselves and dental restorations. The extent to which you experience problems in any one of these areas depends on the type of treatment you receive, at-home or in-office.

Your Gums

People enjoy in-office (or chairside) whitening care for the peace of mind that it is being done right. As a matter of fact, the concentration of bleach used in the dental office is usually higher than at-home methods. The dentist will also use a bleaching lamp to increase the effect of the bleach on your teeth, allowing results to show more quickly.

If bleach touches the gums, however, an irritation can develop. And unfortunately, the higher the concentration, the greater potential for irritation. Although offices use special protection on your gums and roots to make sure the bleach remains harmless, any issue will usually heal on its own after the bleach is removed from the area.

An at-home method can either involve a dentist-prescribed system, which allows you to use a mouth guard-style tray to hold a gel in place; or an over-the-counter (OTC) product. This type of product can take the form of toothpaste, a rinse, trays or strips. The latter two are either custom-fitted or otherwise local to your teeth's surfaces, and may therefore be appealing to those who already suffer from gum disease.

Your Teeth

The next common side-effect is tooth sensitivity. Some people already suffer from tooth sensitivity, and find regular relief in products like Colgate® Sensitive, which protects the enamel to which a bleach is applied. Even then, there is the potential for transient sensitivity if your teeth tend to react to extreme temperatures. This usually doesn't last very long unless you have preexisting enamel problems that warrant a dental checkup.

Teeth with decay, broken fillings and fractured structures can generate a more significant and lasting discomfort, but there is no damage to the enamel under these circumstances.

Your Restorations

Finally, there have been some cases suggesting bleach can affect dental amalgam – or silver fillings – causing them to release mercury. Although many practices have chosen to discontinue this type of restoration, the Academy of General Dentistry (AGD) assures that it is not a real health issue. Not only is dental amalgam benign in its mercury content, but the bleach will not destroy other dental restorations like crowns and implants. There is also no professional concern over its effect on white color fillings; in fact, they may slightly whiten themselves.

Many non-dental professionals are offering bleaching services in settings such as at spas, salons and cruise ships. The reason it's safest in the dental office, however, is because your dentist will conduct an exam before performing or prescribing a teeth whitening treatment. He or she will make sure there are no broken teeth or decayed teeth, as well. Next, if your teeth are naturally sensitive, the dentist may treat them with a high concentration of fluoride several days before bleaching.

Is teeth whitening safe? It isn't always a perfect practice, but it is certainly a careful one. Therefore, you may be advised to take ibuprofen after your bleaching visit to counteract any subsequent irritation. So put your smile in the hands of your dentist, and your teeth whitening will be exactly to your liking.

About the author: James Burke Fine, DMD, is Assistant Dean for Postdoctoral Programs, Professor of Clinical Dentistry, and Director of Post Graduate Periodontics at Columbia University College of Dental Medicine, New York. He has been a principal investigator or co-investigator in funded research projects and has authored or co-authored numerous articles, chapters, and abstracts in the literature regarding periodontal disease, including co-authoring the text Clinical Guide to Periodontics. In addition, Fine has presented at invited lectures and seminars. He maintains a practice limited to periodontics in Hoboken, NJ, and in the faculty practice at Columbia University.