Is teeth whitening legit?

[croberti]

Hey Everyone,

I've been looking at some teeth whitening products as my teeth have become yellowish from (I believe) drinking so much diet coke. I was wondering if you guys could answer a few questions:

a) Do teeth whitening products really work?
b) Is it safe?

I've read they strip the enamel off of your teeth, which has me concerned. I'm looking at getting a free trial of dazzle white pro as it's only ~$6 to try, so the price is right. Has anyone heard anything about dazzle white regarding the safety/effectiveness of the product? I really don't want to damage my teeth's enamel -- rather have healthy yellow teeth than unhealthy white ones.

Any help here would be greatly appreciated.

Regards,
Carl Roberti

[mbornfeld]

Dear Mr. Roberti,

First, it would be useful to make a distinction between two different types of tooth staining: extrinsic stain and intrinsic stain.

Extrinsic stain is the type of tooth discoloration that occurs as a result of extraneous foreign material that deposits on the surfaces of the teeth from food, beverages, recreational drugs such as tobacco or marijuana, and the metabolic breakdown products of bacterial action on salivary and blood proteins. In contrast, intrinsic stain is the term applied to any undesirable coloration of the material of which the teeth themselves are composed-- due to the true intrinsic optical properties of the teeth rather than what is deposited on the teeth.

The appropriate means of managing extrinsic stain would include professional dental cleaning, attention to proper oral hygiene, and perhaps modification of the behavioral factors (diet, recreational drug use) that are delivering the source of the staining into contact with the teeth. For example, if the discoloration of your teeth is indeed due to consuming Diet Coke as you suspect, a reasonable response would be to go to your dentist for a professional tooth cleaning, reduce Diet Coke consumption, and be more diligent in your oral hygiene regimen. At the very least, this would be appropriate to more accurately identify whether your staining is of the intrinsic or extrinsic variety, or a combination of both. After a meticulous professional cleaning, any remaining discoloration would be due to the intrinsic color of the teeth themselves, and you would then have the opportunity to decide whether additional measures are warranted.

As to whether tooth whitening products work-- they do, but they confer at best some modest benefit. Badly discolored teeth will not be whitened nearly as much as would be necessary to bring them to a "normal" appearance. Another important consideration is that the improvement from a single course of treatment is temporary, so repeated re-applications of the product (every couple of months or so) are necessary to maintain the whitening.

The answer to your second question-- whether these products are safe-- is another significant issue that is not yet fully known. The conventional wisdom is that these products ARE safe when used as directed, but many over the counter consumer products are not used as directed. The most conspicuous side effect of whitening systems is that they may provoke temporary tooth sensitivity. This is not a particularly dangerous side effect, because it is self-limited, and resolves when use of the product is discontinued. However, tooth sensitivity can discourage repeat use of a product, which is a significant logistical flaw for a product that needs to be used repeatedly. A more potentially important issue is whether these whitening products may be carcinogenic (see Do Teeth Whiteners Lead To Oral Cancer?). There is some question as to whether repeated bleaching causes any structural or chemical damage to the teeth themselves. And it is known that some users have experienced undesirable optical changes in their teeth after long-term use-- white opacities, excessive translucency, and even bluish discoloration. All in all, it makes good sense to proceed with caution, and to be vigilant for the emergence of any untoward side effects when using whitening products. No doubt, more will be known after these products have been in general use for a few more years.

As for choosing a product-- I am unfamiliar with the particular brand to which you refer, but I usually guide my patients to one of the more mainstream manufacturers. The reason is that the active ingredient in dental whiteners is usually an oxygen-based bleach-- either hydrogen peroxide, sodium perborate, or carbamyl peroxide-- all of which are chemically unstable and all of which possess a short shelf-life. Most small manufacturers and distributors-- especially those that distribute through an affiliate program such as the one you cite-- do not have the resources to efficiently manufacture and distribute their product or maintain the freshness of their inventory. The risk here is that the product you buy may have lost its potency be the time it's in your hands.

I would recommend that you discuss your options with your dentist at your next check-up. He will be able to provide you with guidance as to the most appropriate means of improving the color of your teeth.

Hope this helps...

[jstevenson]

I didn't know that teeth whitening might be a possible cause for cancer. This sounds downright scary.