Wednesday, October 24, 2012

Tooth Whitening is safe...BUT

My office manager Brittany informed me today that we've been getting quite a few questions on whitening. I recently wrote a blog on whitening options. Although I stated that whitening is very safe, there are contraindications which could lead to complications. Many patients believe that simply whitening their teeth will solve all of their oral concerns. If whitening is not done properly or monitored, it could be a painful and costly mistake.

Some contraindications for tooth whitening include:
  • Women that are pregnant or lactating
  • Children under the age of 16
  • Sensitive teeth
  • Allergies to peroxides
  • gingivitis/periodontitis
  • Decayed teeth
  • Pre-existing filling, crowns or veneers
  • People prone to addictions or OCD behaviors
Peroxides are potential mutagens. This means that DNA within the nucleus of the cell are much more likely to mutate. These mutations are potentially carcinogenic. Therefore it is a good idea to avoid whitening in women that are pregant or lactating.

In young teeth, the pulp of the tooth is much larger than in adults. This means that the pulp is much more likely to be irritated. In adults this may lead to some sensitivity. In young people, it may lead to extreme sensitivity or irreversible damage to the pulp.

People with gum and bone recession have exposed root surfaces. These surfaces are much more sensitive than the crown portion of the tooth since they are not protected by an enamel layer.

Whitening decayed teeth is not a good idea since they are much more susceptible to permanent damage.

Pre-existing restorations really aren't a definite contraindication. The problem is that they will not whiten. So after whitening is performed they will likely need to be redone to ensure a uniform coloration.

People that are prone to addictive or OCD behaviors can whiten, but we must be careful that they do not develop a "whitening addiction". Excessive whitening will cause irreversible morphologic changes to the enamel and irreversible damage to the pulp.

Potential complications:
  • Temporary tooth sensitivity
  • Temporary irritation of the gums
  • Nerve damage from excessive whitening
  • Damage to the enamel
  • Oral cancer

One example of a dangerous product ad
Whitening that is performed and supervised by a dentist is quite safe. We run into significantly more complications when the treatment is unsupervised or when certain at home remedies are used. I've seen some products advertised on the internet that promote abrasive techniques that are not much different than using sandpaper on your teeth. I've also seen some products that use acids. Yeah, your teeth will whiten, but at a significant cost to the structural integrity of the tooth. Avoid these scams!!!!!

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

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