Contents
Introduction
The general public is constantly being exposed to high-resolution images of perfect teeth and this is causing people to be unsatisfied with their own yellow, discolored teeth.
Most of us would like a whiter smile and this demand is reflected in the large number of teeth whitening products available.
However, the effectiveness of whitening options varies greatly with some methods delivering excellent results while others can do more harm than good.
In this article, Dr. Lara continues her series on teeth whitening by discussing the methods that work and exposing the ones that don’t.
Teeth whitening is an ever-growing field with countless products and methods promising noticeable changes in your smile. While we will not discuss specific products in this article, it should give you a clear understanding of the various methods and how they work.
In-Office Whitening
In-office whitening is a type of professional teeth whitening performed for you by a qualified dentist. Appointments for in-office whitening typically last about an hour and a half, require strict oversight by a dentist, and produce the fastest results of any type of teeth whitening. Using a protective gum barrier, the dental profession applies a high strength whitening gel to the teeth for 15-20 minute sessions, monitoring your comfort and the gel’s effect throughout.
Supervision is necessary because the active ingredient is a very high concentration of hydrogen peroxide (typically around 40%), which has the potential to cause painful chemical burns on any soft tissue (gums, lips, cheeks, tongue) that it touches. When performed by a trained dental profession, this type of whitening is extremely safe and causes very little side effects.
Various brands of in-office whitening require an accessory to activate or accelerate the whitening action. The most common is a specifically shaped light that emits a bright blue light within the visible light spectrum but very close to Ultraviolet rays. These brands require the use of barriers with sunscreen to prevent burning of the skin around the mouth. Other brands utilize a dental laser for activation of the whitening gel.
In-office whitening is the most expensive type of teeth whitening performed today, and its immediate results of 8-10 shades whiter on average make it worth the higher cost for many people who need a smile boost as quickly as possible.
At-home whitening
At-home teeth whitening uses professional-strength gel in custom-fitted mouth trays to produce the highest levels of tooth color change. The custom whitening trays, when made by a dentist, will last for many years, and then refills of the gel are purchased as needed to maintain a beautiful white smile. The patient actually performs the whitening process himself at home. Because you can use at-home whitening gel as often as you’d like, you can achieve the greatest whitening results over time. As long as the trays fit properly (confirmed by the dentist), and you use the gel as directed, there are no safety concerns.
At-home whitening gels typically either hydrogen peroxide or carbamide peroxide as the active ingredient, and they are available in many different concentrations, ranging from 10-35% carbamide peroxide or 5-10% hydrogen peroxide. A lower concentration will work slower and cause less tooth sensitivity. A higher concentration gives faster results with a higher risk for sensitive teeth and soft tissue irritation.
At-home professional teeth whitening is in a moderate price range, less expensive than in-office whitening but more costly than over-the-counter products. If you maintain your trays for many years, and your only investment becomes the inexpensive refill kits of gel, then they are quite cost-effective. Comparing cost versus benefit, they are the best investment for teeth whitening.
Over-the-counter products
OTC teeth whitening products vary widely in active ingredients, concentration of those ingredients and delivery methods. They include whitening strips, whitening pens, swabs, and gels in generic trays. Each product contains specific instructions for use, and when used appropriately, they are perfectly safe.
OTC whitening products also vary widely in cost. Some are almost as expensive as professional products, and the only benefit is skipping the dental visit. Others are quite inexpensive. In general, the whitening products you can purchase at the pharmacy are low-to-moderate in cost, ranging from $20-50 USD.
Many OTC whitening products work quite well and contain the same active ingredients as professional products, that is a peroxide compound. Usually, over-the-counter products are only available in lower concentrations. Their lower concentration and inconsistent contact with the tooth surface lead to a slightly lower effectiveness in whitening results. Most people experience only mediocre teeth whitening results when using OTC products. In 10-14 days of whitening, you could expect 3-4 shades difference.

Whitening Strips

whitening trays

Whitening toothpaste
DIY teeth whitening
DIY or homemade whitening products are risky business. While some are perfectly safe, others can erode or abrade away irreplaceable tooth enamel and leave you with teeth that appear yellower than before!
Oil pulling is an ancient practice used to draw toxins out of the mouth by gently swishing or “pulling” oil through the teeth for 10-20 minute sessions. The claim is that oil pulling whitens teeth by extracting stains. Unfortunately, this claim is unfounded. While some studies do show improvements in oral health through the practice of oil pulling, there is no cosmetic benefit.
Homemade charcoal pastes can be damaging to enamel. The irregular shape of the charcoal particles may scratch and abrade the enamel surface, thinning it over time. The charcoal does not absorb stains, as is so often claimed. It may produce a minor initial whitening effect by polishing away superficial stains, in the same way, whitening toothpaste would. Over time, though, it can wear away enamel, which is very dangerous!
Homemade pastes with fruit juices and baking soda are also dangerous. All fruit juice is acidic and will have an erosive effect on tooth enamel. There is nothing good about putting acid on your teeth. Do not do it!
Because these homemade methods do not involve the use of a peroxide chemical (which is the only chemical proven to actually bleach teeth to a whiter color), they do not produce any noticeable shade changes. Due to their lack of effectiveness and potential for damage, you should not attempt any of the methods of DIY teeth whitening.
Summary of teeth whitening methods
In-Office Whitening

Method
A high concentration of peroxide whitening gel is applied to the patient’s teeth by a qualified dental team. Because this procedure is performed in the dentist’s office, the process can be further enhanced with high-tech lighting or laser systems.
Results
Speed
Safety
Highest safety level of all methods
Cost
At-Home Whitening

Method
After a thorough consultation, the dentist will prescribe and supply the patient with custom made mouth trays and professional-strength peroxide whitening gel to use by themselves at home.
Results
Best results with the potential to achieve the greatest level of shade change.
Speed
Safety
High level of safety when used properly.
Cost
Moderate cost
OTC WHITENING PRODUCTS

Method
This category includes products like whitening toothpaste, whitening strips, whitening pens, and home whitening kits.
Results
Speed
Slow, may require consistent use for 30 days before desired shade change is reached.
Safety
High level of safety when used properly.
Cost
Low-to-moderate cost.
DIY TEETH WHITENING

Method
Results
Speed
Safety
Cost
Authors & Contributors

Dr. Lara T. Coseo
Author

