Safe Solutions for Teeth Whitening

A beautiful smile can brighten any day. Nowadays, teeth whitening treatments are quite popular and often done to improve appearance. However, are these treatments safe? If there are any associated risks, are there any safer alternatives?

A quick online search would indicate that teeth whitening is one of the most requested dental treatments. This dental procedure improves the aesthetic value of teeth and smiles. Social media reinforces that a perfect smile with white teeth is of the utmost importance. So, to meet demand, various teeth-whitening products have emerged and are gaining popularity.

Tooth enamel is naturally white and slightly translucent to brighten smiles. Therefore, not surprisingly, people with tooth discoloration or stains are seeking teeth whitening treatments in greater numbers.

Tooth discoloration can be caused by both intrinsic factors and extrinsic factors. Intrinsic factors such as genetics, age, developmental disorders, high fluoride levels, and consumption of certain antibiotics can cause eruption and staining of teeth. On the other hand, extrinsic factors that commonly cause tooth discoloration include smoking and consuming pigmented foods or drinks like coffee and tea. Stains on the tooth surface result from the adsorption process of colored compounds contained in foods and beverages.

Mechanical and chemical wear and tear is another major cause of enamel erosion and, thus, discoloration of teeth. Daily routine care may not be adequate for removing discoloration. Therefore, in addition to helping to prevent tooth decay and gum disease, many modern oral care products now focus on teeth whitening.

Are there risks associated with teeth whitening?

Some chemicals used in whitening oral care products may come with related risks. For example, hydrated silica, pearlite, and alumina are commonly used to remove extrinsic stains mechanically. Hydroxyapatite is used as a preventive agent for dental plaque and as an adhesion agent for white calcium phosphate on the tooth surface. Furthermore, protease enzymes such as bromelain and papain can also be used to remove stains due to the degradation of proteins.

However, hydrogen peroxide (H2O2) is the most widely used whitening agent both at home and in dental practice. A concentrated H2O2 and water solution is used for about 30 minutes to oxidize the organic chromophore adhering to teeth. This concentrated solution is oxidative, and it is harmful to the soft tissues of the teeth if not used properly. Therefore, water-soaked gauze is used to protect the tongue and gums. Nevertheless, H2O2 in teeth whitening services can irritate dental pulp for a short while. Furthermore, H2O2 also acts as an antibacterial agent that can trigger an imbalance of oral microbes.

In the long term, the use of high concentrations of H2O2 can damage the protective layer and organic matrix in the teeth. Moreover, teeth whitening services using H2O2 can trigger various orthodontic problems such as tooth decay, tooth sensitivity, and tooth loss. Tooth sensitivity occurs because applying a concentrated H2O2 solution changes the structure of the tooth surface. In addition, other side effects of teeth whitening procedures include degradation of tooth minerals, pulp damage, tooth erosion, and an increased risk of demineralization of tooth enamel.

Safer solutions for teeth whitening

Due to advances in dental research, we now have products that minimize damage. Desensitizing agents such as potassium nitrate, sodium monofluorophosphate, and the Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) combination showed significantly lower intensity and incidence of sensitivity.

Various medicines can reduce tooth sensitivity. For example, a single-blind randomized controlled trial showed that the use of high concentrations of carbamide peroxide in teeth whitening procedures reduced sensitivity. A systematic review and meta-analysis indicate that the use of nonsteroidal anti-inflammatory drugs (NSAIDs) can also be used to suppress the production of inflammatory mediators. These inflammatory mediators are released when whitening agents penetrate dental tissue. It can trigger tooth sensitivity due to sensitized nociceptors. Therefore, dental care professionals use NSAIDs to help prevent sensitivity after teeth whitening procedures.

Chemical activation of the 35% H2O2 whitening gel increases the effectiveness of teeth whitening while reducing toxicity. Test results showed that the chemical activation of 35% H2O2 gel with peroxidase, iron sulfate, and manganese chloride could minimize H2O2 residues and pulp cell toxicity by reducing oxidative stress on dental cells.

Because there are several whitening agents available, your dentist can recommend your best options. Typically, during a preventative (cleaning) visit, dental hygienists also do teeth whitening. Your dentist might also be able to suggest teeth whitening products such as toothpaste for routine oral care.

The popularity of teeth whitening continues to increase. Although there are some risks associated with it, teeth whitening is a common procedure performed in a dentist’s office. Talk to your dentist to decide if teeth whitening is the right option for you.