Do-it-yourself tooth bleaching kits may cause problems without supervision

August 20, 2001

DALLAS - Aug. 20, 2001 - People who want to brighten their smiles are opting for over-the-counter bleaching kits instead of visiting their dentist's office. While generally safe, these products have the potential to cause an infection or nerve damage, say UT Southwestern Medical Center at Dallas oral surgeons.

Dr. David McFadden, associate professor of oral and maxillofacial surgery, suggests consulting a dentist so pre-existing conditions can be diagnosed and treated before starting any type of bleaching regimen.

"If a person has deep cavities, the bleach could have an unimpeded route to the blood vessels, nerves and bone that are found at the root of the tooth," McFadden said. "It can potentially cause a bad toothache or precipitate an infection."

People with active periodontal disease may also notice soft-tissue shrinkage.

"This is not gum recession, but many patients perceive this as a negative side effect. In actuality, bleaching provides short-term improvement," McFadden said. "The effervescent action of the bleach helps keep the teeth cleaner."

The color of one's teeth is determined by genetics. Dentin, a hard, yellow substance that surrounds the pulp, shows through the enamel so most teeth appear slightly yellowish. Other factors that affect tooth color are aging, tetracycline medications, over-fluoridated water and chromogenic agents found in coffee, tea and carbonated drinks.

"Many over-the-counter bleaching agents are weak and will not create a drastic change in tooth color," McFadden said. "And since the bleaching trays are not custom-fitted to your teeth, the uneven distribution of bleach may cause spotting." Overusing bleach to attain perfectly white teeth could also cause tooth damage, McFadden said.

"Using too much bleach can cause extreme tooth sensitivity. The pain related to overuse usually causes people to stop bleaching before it does any significant harm," McFadden said. "But it's possible that they could damage the nerve enough to require root-canal therapy."

There are other, albeit more costly, options for people with severely discolored teeth. Porcelain veneers - thin, semi-translucent porcelain shells that are permanently bonded to teeth - can provide an aesthetic improvement. For laser bleaching, a dentist applies a bleaching agent to the teeth, then uses an argon laser to activate it.

A less expensive route to whiter teeth are custom-made bleaching trays from your dentist, an option that costs about $300. Although results vary from person to person, this process generally lightens teeth two to three shades and lasts up to three years.

But the simplest solution to maintaining your pearly whites is also the most overlooked: brushing your teeth after every meal.

"Food and beverages can stain the plaque and make teeth appear yellow," McFadden said. "If people would just brush their teeth more often, it would reduce the amount of plaque that accumulates."

UT Southwestern Medical Center

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