Going for a whiter smile

It seems as if every other commercial on TV touts the benefits of having whiter teeth. There are over-the-counter products and professional dentist procedures that claim to give you that return-to-white smile.

However, according to some local dentists, there are some things to consider before using any of these techniques.

Why do people want whiter teeth?

"A lot of people think that it means good health," said Leola dentist Thomas Dudas. "But that's not always the case. There can be underlying problems in a mouth of white teeth."

In the last two decades, teeth whitening or bleaching has become one of the most popular aesthetic dental treatments, according to the American Dental Association's website. The focus of dentists in the past was on in-office bleaching of non-vital teeth that had discolored as a result of trauma to the tooth or from endodontic treatment. More recently the field changed with the development of dentist-prescribed, home-applied bleaching products and techniques, according to the American Dental Association.

The teeth-whitening market has four categories: professionally applied that is done in a dental office; dentist-prescribed and used in the patient's home; consumer-purchased over-the-counter and applied by patient at home; and homeopathic options.

Whitening products available for home use include gels, rinses, chewing gums, trays, toothpastes, paint-on films and strips. The latest tooth whitening trend: Treatments or kits in retail settings, such as mall kiosks, salons and spas, according to the ADA.

There are factors to consider when using any of the at-home kits, such as type of stain, age of patient, concentration of the active agent, treatment time and frequency.

"Everyone is different and so are their teeth," said Lancaster dentist Dr. Ron Reinmiller. "But white teeth are a good first impression to many people."

Dudas agreed and said there are many factors to consider when researching whitening products.

Although the over-the-counter whitening products are eligible for the ADA Seal of Acceptance, they must contain 10 percent carbamide peroxide to be approved, according to the ADA.

"Many of the products on the market do not contain this type of bleach," Dudas said.

Carbamide peroxide breaks down into hydrogen peroxide and urea, allowing the hydrogen peroxide to be the active bleaching agent, according to the ADA. One of the most commonly observed side effects of the carbamide peroxide is tooth sensitivity or irritation of the soft tissue in the mouth, Dudas said.

"You do want to proceed with caution before using one of these products and be sure you do not have any underlying dental or mouth issues," Dudas said.

The professional teeth bleaching techniques use hydrogen peroxide in concentrations ranging from 15 percent to 35 percent and can be coupled with a light or laser, which is said to speed up the whitening process.

"Although these have a higher concentration of hydrogen peroxide, they are being used by a professional who is educated about the chemical and will oversee the process," according to the ADA's website.

Both hydrogen peroxide and carbamide peroxide may change the inherent color of the teeth, but have different considerations for safety.

According to Reinmiller, the over-the-counter teeth whitening products need to be used with caution.

"You should always be evaluated by a professional before you use such a product," said Reinmiller, "and any restorative dental work should be done after the teeth whitening."

In-office procedures, which can cost upward of $400, have found themselves against some tough competition with over-the-counter products — ranging from daily whitening toothpaste for less than $5 to kits, complete with trays and laser lights, for less than $100.

Although published studies suggest bleaching is a safe procedure, investigators continue to report adverse effects on hard tissue, soft tissue, and restorative materials, according to the ADA.

Some of this may be the misuse or overuse of the products, Dudas said.

"Abusing the whitening kits can be hard on your mouth and gums," Dudas said. "If you want to have white teeth, you have to take care of your teeth."

This includes being careful of what you eat or drink, seeing your dentist regularly and brushing and flossing regularly and properly, Dudas said.

Dudas, who has treated all ages with teeth-whitening procedures, even teens, said that people can become obsessed with this trend and that can be "a bad thing."

"It's not necessarily a cosmetic thing," Dudas said. "It's more about your mouth's health."

To maintain your teeth's health and color, it is best to take care of them by brushing, flossing and avoid stain-causing foods and drinks, such as tea, coffee and berries, Dudas said.

cesbenshade@lnpnews.com