Dental Health Articles
Teeth Whitening: Does it really work?
By Nick K. Nguyen, DDS, APC
Teeth whitening is a billion dollar industry with its popularity soaring over the past several years in large part due to media exposure. Television shows, such as "Extreme Makeover" and "The Swan", along with hundreds of articles and advertisements have created an image where having beautiful white, straight teeth is the mainstream. Manufacturers have become keenly aware of this by flooding stores and infomercials with products promising to give whiter and brighter smiles. With so many products now on the market, not only is the consumer confused, but dentists are also left in a daze. A question to ask is "Do these products, such as over the counter toothpastes, paint on gels, white-strips, mouth rinses, professional take home trays and 1 hour laser systems, really work or are we spending our money in a hopeless endeavor?" Well, depending on who you talk to and what clinical studies you read, you will get a different answer.
In reality, this is a very difficult question to answer. It depends on the type and depth of the stain, the size and shape of the teeth, and the whitening procedure. In general, superficial stains from smoking, chewing tobacco, food and beverages such as coffee, colas, curry, licorice, and teas can easily be removed with the right whitening agent. Yellow stains are much easier to whiten than grayish stains. A common cause for grayish stains is tetracycline antibiotic staining commonly seen in the general public. The success of an effective whitening procedure depends on how deep the tetracyline stain penetrates into the tooth structure. This is dependent on the amount of exposure the individual had to tetracycline as a child. If the stain is relatively shallow, it can be effectively faded with air abrasion of the superficial enamel, followed with a professional deep whitening procedure. Tooth colored fillings, crowns and veneers will not whiten. Other endogenous stains due to other types of medications, genetics, childhood sickness, decalcification, and flourosis are very hard to remove and may require specialized whitening procedures or other cosmetic techniques. The good news is that there is a right answer for every type of stain!
In general, over the counter products such as whitening toothpastes are not as effective in whitening teeth compared to others. In fact, many individuals report an increase in tooth sensitivity, especially to cold. Often, whitening toothpastes contain abrasives, meant to scratch off stains if used repetitively. Not only may this be ineffective, but over time, the abrasive can also remove superficial tooth structure. Even professional teeth whitening procedures, such as home trays and one-hour in office whitening, can cause tooth sensitivity leading to extreme discomfort and pain. Fortunately, the mechanism for sensitivity is usually reversible. Basically, the whitening peroxide gels dehydrate the fluids in the teeth, with one to two days for the teeth to naturally re-hydrate and return to normal. There are also professional in-office products that can be used to reduce and prevent sensitivity during whitening.
I would recommend that individuals consult their dentist before choosing any whitening product as trial and error on the part of the consumer may not only yield a disappointing result, but can also lead to irreversible damage to teeth. Even good whitening products can lead to disappointing results if used on the wrong type of stain while also possibly subjecting the individual to unnecessary tooth sensitivity.
Did you know?
...that if you have gum disease, or if you clench or grind their teeth, you are much more likely to experience painful tooth sensitivity to whitening products?