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The Truth About Tooth Whiteners

Sure, they whiten your teeth. But how effective are they really, and are they safe?

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By Maria Ricapito
WebMD the Magazine - Feature

"I noticed my teeth were yellow in the past three Christmas cards," says Francesca Castagnoli, 39, an author and blogger based in Montclair, N.J. She wanted to try whitening her teeth, but her severe dental phobia kept her from scheduling a professional bleaching. And she'd heard that at-home whitening could be painful when applied to a cracked tooth or might leave bondings looking darker than ever (since they won't lighten) -- both of which were front and center in her smile.

But when picking photos to use for the next holiday card, she saw that she was "Yellow Tooth Lady" in every one, she says. "So I bit the bullet, and tried out some bleaching strips at home."

Stains happen when dark foods (such as beets and berries) and beverages (think colas and tea) or substances in cigarette smoke adhere to plaque or tartar on the tooth's surface or penetrate into porous enamel, says Gerard Kugel, DMD, professor and associate dean for research at Tufts University School of Dental Medicine in Boston. On top of that, tooth enamel thins with age, exposing the yellowish dentin underneath.

Choosing a Tooth Whitener

Although you get the most effective tooth whitening from your dentist (who supervises the use of stronger bleaching concoctions), you can whiten your smile at home. The results, however, might be less dazzling.

Look for a product with hydrogen or carbamide peroxide, both of which penetrate enamel and oxidize -- that is, lighten -- stains, Kugel says. He finds strips and trays to be the most effective for overall whitening. Why? Real results are about the concentration of peroxide and its time on the teeth. "Higher levels bleach faster," Kugel says, "but also open you up to the possibility of more sensitivity." So if you do start to feel pangs of tooth sensitivity, he suggests using whitening products only every other day or using sensitive-formula toothpaste.

Tooth-Whitener Safety

Kugel has studied the effects of peroxide on soft tissues. Because drugstore trays, for example, aren't customized to your bite, they can put some peroxide on your gums. This can be irritating, but doesn't appear to be harmful, he says. He finds over-the-counter strips better at placing peroxide squarely on the teeth.

Whitening may backfire if, like Castagnoli, you have visible bonding or fillings. They're matched to your teeth -- and can't be lightened by peroxide. Thus the downside of DIY whiteners (their lack of speed) is also a plus: "If you go slow, you can whiten your teeth just enough," Kugel says.

Castagnoli is now champing at the bit for picture day. "It was getting to the point where I was covering my mouth whenever I smiled," she says. "Now I really can't believe how much better my teeth look."

Other Whitening Products for Home

What about other drugstore products with the whitening label? Kugel gives the lowdown:

Brushing it off. Whitening toothpastes contain mild abrasives that remove superficial stains trapped in plaque, taking you a few shades lighter but very slo-o-o-wly.

Getting liquid. Mouthwashes are better for fresh breath; they contain low levels of peroxide and are on teeth only for the seconds it takes to swish. You won't get much, if any, whitening action with these.

Stringing it along. Floss might attack between-teeth stains, but "there is very little data about whether it whitens teeth," Kugel says. "It's just cleaning your teeth well," which, of course, is a good thing.

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