Side effects of tooth whitening - Problems & Risks

You should always visit your dentist for a complete dental examination before using any over the counter tooth whitening product. The dentist will check for any existing conditions and advise you whether or not your teeth are suitable for tooth bleaching.

It is also very important to follow the instructions on the product label very carefully. Overuse of the product is not healthy for your mouth and under use can result in very little effect.

Tooth sensitivity is called the condition when a cold or hot, sweet or sour stimuli in the mouth or even air or touch causes an intense pain to some teeth. All bleaching gels cause some degree of tooth sensitivity problems, but the level of discomfort is not the same for everyone. This is normal and an expected side effect.

Sensitive teeth caused by tooth whitening is a temporary condition that usually disappears within 48 hours after the whitening treatment is stopped.

If you do experience tooth sensitivity, you can reduce or eliminate the symptoms by:

• Using the whitening tray or strips for a shorter period of time (15 minutes instead of the 30 minutes usually recommended by the manufacturer) or only once instead of two times a day.
• Stopping the teeth whitening treatment for some days. Usually it will relieve the symptoms in one or two days. The bleaching results are additive so discontinuing the treatment for a few days will not affect the final result, it will simply take longer.
• Replace the whitening product that you use with another with lower concentration of bleaching agent at least until the symptoms subside.
• Visit your dentist for a dental examination. Many times the reason of sensitivity is an undetected tooth decay that makes the tooth vulnerable to the bleaching agent.
• Use a toothpaste for sensitive teeth for the period during and a little after the bleaching treatment. Modern desensitizing toothpastes contain special ingredients such as potassium nitrate with very good results in fighting the tooth sensitivity symptoms.
• If over the counter desensitizing toothpastes prove ineffective, you can ask your dentist to prescribe a special desensitizing gel with high fluoride concentration that helps to remineralize the enamel and relieve tooth sensitivity.

Gum irritation is another common side effect that is experienced after a tooth whitening treatment. Gum irritation may be chemically or physically induced teeth whitening problem. Main causes are:

• Bleaching trays that do not fit properly are a common source of gum irritation because they can traumatize the soft tissues and irritate the gums. The condition is usual after using at home tray based whitening systems. Professional tray based whitening rarely causes similar problems because the trays are fabricated specifically for the person who will wear them. These ‘custom’ made trays help to minimize the possibility of gum irritation caused by the tray itself. Whitening strips that use a thin, flexible plastic strip to deliver the bleaching agent are also unlikely to cause any trauma to gums.
• The reaction of the peroxide based whitener, that is used in all kinds of whitening systems, with the soft tissues of the mouth is the second source of gum irritation. Unlike the physically caused gum irritation, which is a problem of tray based systems mainly, this type of chemical irritation seems to be common in all types of tooth whitening methods because it is caused by the whitening agent itself.

Usually gum irritation is only mild in severity without causing serious discomfort. If gum irritation is a problem caused by not well fitting bleaching trays prefer the use of ‘custom’ made trays. If you already use a professionally made tray and you still have problems, visit your dentist to adjust their shape to fit the shape of your gums.

If gum irritation is caused by the bleaching agent :

• Discontinue the use for some days or use the product for less time..
• Be more careful not to place too much gel in the trays because it will overflow and come in closer touch with your gums.
• Position the trays or the strips in a way that will minimize the contact of the gums with the peroxide whitener.
• After removing the bleaching tray or whitening strip, wash your gums to remove any residues of the bleaching agent.
• If you have gum disease it is expected that you will experience gum irritation problems during tooth bleaching. Gum disease has to be treated before stating a tooth whitening procedure.

• Uneven whitening – Fillings, crowns and other restorations. Regardless of the tooth whitening product used, there are cases that some teeth will not whiten at all or they will not whiten the same as the rest of the teeth. These uneven teeth whitening problems may even worsen the aesthetic appearance of the patient. You must know that only natural teeth can whiten. If you have dental restorations, fillings, crowns, veneers or bridges, they will not whiten like the tooth structures around them and they will look darker after the tooth whitening. They will have to be replaced with lighter colored ones to match the color of the whitened natural teeth.
• Darkly stained teeth - Stains that do not whiten. Dark stains caused by tetracycline or other medication are very difficult to whiten and may require a different cosmetic procedure such as veneers, bonding, or crowns. Similar problems have also the teeth that have stains caused by fluorosis, tooth trauma or root canal treatment
• Unrealistic expectations. Always have realistic expectations if you do not want to get disappointed. Before starting a tooth bleaching treatment, especially if you are using an over the counter whitening product, you must be aware that you will not get the same shining bright white color like the one you see on the teeth of TV or film stars. It is unlikely than any one of these bright white teeth is the result of a simple bleaching treatment rather than expensive cosmetic restorations.
• 'Whitening addiction’ is a term used to describe a condition characterized by repeated overuse of whitening products in pursue of a super bright white tooth color. Beside the fact that very white teeth look unnatural and may worsen your aesthetic appearance (as the others perceive it), the main problem is that the results may be catastrophic for the health of your teeth causing dental erosion. Overuse of whitening products will gradually wear away the enamel on the surface of the teeth, causing irreversible damage to the teeth and/or gums.

To minimize the risk of experiencing side effects of tooth whitening, you should:

• Visit your dentist for a complete dental examination before using any over the counter tooth whitening product. The dentist will check for any existing conditions and advise you whether or not your teeth are suitable for tooth bleaching and which method is best for you.
• Follow carefully the instructions on the package of over the counter whitening systems.
• Do not overuse whitening products. Never use the bleaching products for more time or more often than directed in an effort to get better or faster results because you will possibly end up with damaged teeth.
• Prefer the in-office professional tooth whitening. The bleaching procedure is always safer if done under the supervision of a dentist. The dentist will also help you to set realistic expectations and avoid overuse of whitening products.

Dental professionals consider tooth whitening as a safe cosmetic dental procedure, particularly if done under the supervision of a dentist. Even the over-the-counter (OTC) teeth whitening products are generally considered safe and effective, when used as directed on healthy teeth.

If you want to improve your smile’s appearance you should first visit a cosmetic dentist for consultation. Cosmetic dentists have the expertise to analyze your cosmetic needs, and propose a complete plan of cosmetic dental procedures that will best fit your expectations and finances.