Teeth Whitening at Home

STORY BY
Erika Hargrove

When all your friends tromped to their dentists to have their teeth whitened, you thought that absurd. Not for wanting blinding smiles, but for bothering to—and paying for—dental appointments, handmade bleaching trays...well, that's what drugstores are for.
Right there on Aisle 8 sit zillions of Advanced Tooth Whitening Systems! Each one more Advanced! than the other. Oscar-winning smiles from the comfort of your couch.
But experts at The University of Texas Dental Branch at Houston are siding with your wiser friends. In short: until you've talked to your dentist, don't try this at home. It could save your teeth—or your life.

Bite the Bullet–Call Your Dentist

Joe C. Ontiveros, D.D.S., M.S., director of esthetic dentistry at the UT Dental Branch, lent credence to the controversy and concerns dentists are now having about over-the-counter (OTC) whitening products and their possible connection to oral cancers and other serious oral diseases. The concern about these products stems from peroxide's known capability of producing free radicals, which have been implicated in various biological consequences, Ontiveros said.
“The foremost reason to see your dentist before bleaching is to have an oral exam performed. The dentist can determine the cause of discolored teeth, screen for periodontal disease, check for decay, assess the condition of existing restorations and identify any exposed roots,” he added.
If you have tooth or gum sensitivity, your tooth roots might be exposed from receding gums. Bleaching can make it worse.

The concentration of certain chemicals in tooth whiteners can also vary from product to product, causing potential damage and susceptibility to cancers and disease. Individuals can be protected from overexposure to these chemicals by a dentist who can monitor the levels and adjust the whitening procedure appropriately.

Kathy O'Keefe, D.D.S., M.S., clinical associate professor at the Dental Branch, who also works in private practice in Houston , acknowledges that one of the possible dangers to the at-home systems are the one-size-fits-all bleaching trays that simply cannot keep the bleaching product from leaking into the mouth.

“At a dental office, an impression is made of the patients' teeth first, so when the tray is made, it wraps around the teeth and therefore the bleach stays in the concentrated area,” she says.
Another reason to make that appointment is that some people will not get that blinding white smile no matter what product they use—particularly those with tetracycline stains that run through the entire tooth. In those cases, porcelain veneers, crafted by an esthetic dentist are used. And those patients with veneers cannot use OTC bleaching products because the chemicals will change the surface of the veneer.

Addicted to Whiter White

Researchers also have found that consumers often can't resist the desire for whiter teeth, leading to abuse of over-the-counter products. O'Keefe says her office has a built-in system that helps to prevent such behavior. “We only sell two boxes of bleach at a time,” O'Keefe says. “This way we can monitor how much the patient uses.” Jessica Neff, a senior manager in development for a large over-the-counter tooth whitening company, says she went through a period where she tried products that were painful, damaging, inconvenient or just simply ineffective.
Neff admits that she was a “victim” of the whitening craze that boomed about five years ago. Addicted to “whiter than white,” Neff says “I was constantly going from one system to the next, looking for the best way to brighten my smile, until I finally realized I was ruining the substructures of my teeth.”

Neff now uses the product she promotes, a topically-applied whitener designed by a New York esthetic dentist. And even though Neff believes her product is a safe, revolutionary system, she says the company still recommends consulting a dentist before use.
Brown Teeth and First Impressions Tooth whitening is recommended by job recruiters, dating services, meddling grandmothers and both men's and women's magazines as the easiest, most cost-effective way to make one personal change that will catapult a first, second and third impression.

“Procter and Gamble completed a study regarding tooth brightness and appearance. An overwhelming majority (90 percent) of these surveyed viewed people with whiter teeth as healthier and more attractive,” Ontiveros says. “Many people feel this may influence professional advancement and personal relationships.” Neff says that a recent report by Mintel, a supplier of product and consumer intelligence, showed that there are largely more females, along with 18-24 year olds, concerned about oral appearance issues, such as whitening.
For that reason, researchers say, these groups will be watched more closely when evaluating the possible connection between oral cancer and whiteners.

Bleaching is Safe... the Right Way

Ontiveros makes it clear that the general idea of whitening your teeth to remove natural discoloration is safe and can be effective. In fact, a large number of clinical trials in humans over the last 10 years have demonstrated the safety of bleaching. “Hydrogen peroxide exposure from tooth whiteners is limited to the oral cavity and is incapable of reaching systemic levels,” he says. “Human saliva also contains many protective enzymes, which help prevent potential damage to cells during oxidative reactions in the oral cavity.”

Although a direct connection between oral cancers and over-the-counter tooth whitening has not been made, enough factors are present to have researchers looking for more and to have you looking for your friends—so you can tell them they were right all along.