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Tooth Whitening is Great . . . Just Don’t Have Unrealistic Expectations

Posted by on December 5, 2016 in Teeth Whitening | Comments Off on Tooth Whitening is Great . . . Just Don’t Have Unrealistic Expectations

Want to look real good for your Christmas card photo this year? This is the perfect time to go in for tooth whitening. After all, between Halloween, Thanksgiving, and Christmas festivities, you may have guzzled beer, wine, and mulled cider–all of which stain teeth. And even though seasonal sugary sweets don’t cause discoloration, bacteria in your mouth can eat those sugars and enamel, thus exposing yellow dentin.

You probably have seen how popular teeth whitening is, but may wonder just how safe it is. Dental expert Michelle McPhail says that it is one of the safest, and quickest cosmetic procedures. However, it is not recommended for young children or pregnant women.

Besides limiting those groups, pretty much any other person who is otherwise healthy can usually get this procedure. And even the side effects are minimal, with soft tissue irritation and tooth sensitivity being the main issues. So what’s the catch? According to a study at, researchers found that this procedure could cause more inflammation and pulp (center of your tooth) damage.

Does In-Office Bleaching Produce More Inflammation?

Researchers from Brazil wanted to know if the chemicals involved would damage the dental pulp of patients. Their study in the Journal of Applied Oral Science investigated using both in-office and at-home bleaching processes.


“Tooth bleaching is a technique of choice to obtain a harmonious smile, but bleaching agents may damage the dental pulp,” the authors wrote (J Appl Oral Sci, September-October 2016, Vol. 24:5, pp. 509-517).


Teeth bleaching is generally considered a conservative and effective technique, but the pulp’s inflammatory response should be better understood before a bleaching technique is used clinically, the researchers noted. They measured inflammatory events and cells involved in the human pulp response to at-home and in-office bleaching.


The researchers found that in-office bleaching with 38% hydrogen peroxide had “more intense inflammation, higher macrophages migration, and greater pulp damage” than the carbamide peroxide group. They noted, however, that these techniques did not induce migration of mast cells and actually increased the number of blood vessels.

But keep in mind that this study also found that in-office bleaching with hydrogen peroxide caused more inflammation. If you want to avoid any side effects, you could ask your dentist about carbamide peroxide instead, which is a low-dose whitener that can be used at home.

If you are worried that a take-home system won’t get you the results you want, you may want to consider an Opalescence system. It does use a stronger hydrogen peroxide gel, but it also contains potassium nitrate which reduces sensitivity.

While these take-home options can certainly mitigate issues from stronger whitening systems, one has to wonder if an increase in side effects is due to patients’ addictions to whitening! In fact, had an interesting article about how some people develop a body dysmorphic disorder and end up overbleaching because they are never satisfied with results:

Are You Obsessed with Whiter Teeth?

Unfortunately, many people don’t stop when they should. “Ten years ago, people weren’t even aware of bleaching,” says Irwin Smigel, DDS, president of the American Society for Dental Aesthetics. “Now every dentist I know has had to cut off at least one patient because of overbleaching. People come in with great, great pain, and I can see immediately from the color of their teeth and the irritation along the gums that they’ve been bleaching and bleaching.”


The urge to keep whitening may spring from the fact that teeth stubbornly refuse to maintain their same sparkling brightness for long. “Once you stop with the bleach, it regresses—your teeth start returning to their original color,” says Smigel. “Very few people are happy with the color once it starts regressing, so they’ll do teeth whitening again and again.” Dental laboratories are working to keep pace by creating new caps, fillings, and crowns in ever-brighter shades.


For some individuals, the pursuit of blindingly white teeth can become a true obsession. “There’s anorexia nervosa among certain people who desperately want to be thin, and there’s also a similar syndrome for people whose teeth are never white enough,” says John W. Siegal, DDS, a New York City dentist. This can go so far as to be classified as a form of body dysmorphic disorder (BDD)—a distorted view of one’s features that becomes so consuming that it interrupts daily functioning and requires psychiatric treatment—says Katharine A. Phillips, MD, a professor of psychiatry at Brown Medical School.

So while the study by Brazilian researchers may shed some light on side effects, the Prevention article may have some perspective that needs to be taken into account. Perhaps side effects can be reduced greatly if patients know that these results will fade and that they will have to wait until their dentist gives the go-ahead before they whiten again.

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