Baltimore Sun

Is it safe to whiten your teeth at home?

- By Hannah Seo

From toothpaste­s to gels, strips, mouth trays and rinses, there is a dizzying array of products that claim to lighten, brighten and whiten your teeth. And with so many options lining drugstore shelves, it can be daunting to figure out the right method for you.

But are at-home teeth whitening products as effective as they claim? And are they safe? We asked some experts to find out.

How does teeth whitening work?

Teeth whitening products sold over the counter work in one of two ways, the experts we spoke with said. They either scrape away stains using physical force or bleach those stains with the same chemicals used for in-office whitening procedures.

Physical abrasion: Products that have any sort of grittiness — whether they’re whitening toothpaste­s, regular toothpaste­s or just baking soda — will act as an abrasive and physically file away stains on the surfaces of your teeth, said Dr. Dorota KopyckaKed­zierawski, a dentist at the University of Rochester Medical Center. Many regular toothpaste­s contain a little bit of texture for this reason, and brushing itself is an act of physically scraping off stains and debris.

Chemical bleaching: Most whitening strips, gel-filled mouth trays and rinses work by putting your teeth in contact with chemical bleaching agents such as carbamide peroxide or hydrogen peroxide. One major difference between these products and inoffice versions, said Timothy Bromage, a professor of molecular pathobiolo­gy at the NYU College of Dentistry who specialize­s in bone and tooth biology, is that the concentrat­ions of chemicals in over-thecounter products are much lower.

Which products work?

Physical abrasion and chemical bleaching products are both effective at whitening teeth, said

Dr. Laura Tam, dean of dentistry at the University of Toronto.

When toothpaste is advertised as “teeth whitening,” it usually means it has more of an abrasive quality than regular toothpaste, she said, but even regular toothpaste­s that don’t have any “whitening” claims on their packaging will work.

Chemical bleaching products can similarly reduce external stains — whether from coffee, tea, red wine or cigarettes. They can also be effective at reducing stains that occur in the inner layer, or dentin, of the teeth, which can develop after blunt force or traumatic tooth injuries, or in children after taking certain antibiotic­s, Kopycka-Kedzieraws­ki said. Pigmented foods and drinks can also seep into the enamel and stain the insides of teeth. Some people with naturally very porous enamel are especially prone to this kind of staining.

The only trade-off with at-home chemical bleaching products is that since the concentrat­ions of chemicals are much lower, they will take longer to work than in-office methods, Tam said. And not everyone will see whitening effects on their internal teeth stains. People’s enamel will absorb bleaching agents differentl­y, she said, so the efficacy can vary. And some people just have naturally darker teeth than others due to genetics.

LED light whitening kits are another popular product. They involve applying a whitening gel to your teeth and holding a tray in your mouth, or biting into a mouth tray full of gel, and using a bright light to illuminate the gel. In theory, they work because LED light can activate the bleaching chemicals to get them to work faster, Tam said. Unfortunat­ely, she added, “the body of evidence does not suggest you can activate the bleaching agent using anything like light or heat.” Because these products involve applying bleaching chemicals to your teeth, you might still see whitening results, but the LED light process is probably not adding much.

Are these products safe?

Abrasive teeth whitening products are generally safe, Tam said, but scrubbing your teeth with particles that are too hard, or brushing with abrasive material for longer or more often than is recommende­d, can wear down the enamel.

This can be counterpro­ductive to your whitening efforts, Bromage said, since the enamel is what makes your teeth look white. Dentin, the stuff that makes up the inner part of the tooth, is a yellow-brown color. If you wear down the white enamel too much, the color of the dentin starts to show through.

For those looking for a product that won’t be too harsh, Kopycka-Kedzieraws­ki recommende­d choosing one with a seal of acceptance from the American Dental Associatio­n, which means it has been deemed safe and effective by the organizati­on.

In general, Tam said, at-home chemical bleaching treatments are safe and effective when used as advertised. But it’s best to go with products that have lower concentrat­ions of chemicals and shorter exposure times, she said. Using chemical-based treatments incorrectl­y, by leaving them on for too long or applying the chemicals too high so they reach your gums, can put you in danger of damaging your teeth and gums.

In this vein, Bromage said, over-the-counter whitening products should not hurt, especially on first applicatio­n. Pain is a sign that you are either overdoing it or that there’s something happening that requires your dentist’s attention.

Anything that claims to be “extra strong” is probably best avoided, Tam said.

The bottom line

Teeth whitening is never a permanent fix, Tam said. At-home results can last from a few weeks to a few months. (In-office whitening procedures can last for a year or more.) And because teeth naturally darken with age, Tam said, you will see regression no matter which treatment you opt for.

It’s also important to keep in mind that none of these whitening procedures will work on fillings, crowns or other dental hardware, Kopycka-Kedzieraws­ki said. Whitening will lighten your natural teeth, which could create unevenness if your fillings are darker. In those cases, your dentist can recolor those mismatches by painting over them with matching shades.

In the end, Kopycka-Kedzieraws­ki said, everybody’s teeth are different. The natural color of your teeth, the porosity of your enamel and the sensitivit­y of your teeth can make you react differentl­y to whitening treatments. When in doubt, check with your dentist.

 ?? RYAN JENQ/THE NEW YORK TIMES ?? A variety of teeth whitening products available on the market claim to help brighten your smile. But which methods actually work?
RYAN JENQ/THE NEW YORK TIMES A variety of teeth whitening products available on the market claim to help brighten your smile. But which methods actually work?

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