In pursuit of pearly whites

In the past, only movie stars had blinding, bright-white teeth. Now, cosmetic dentistry has gone mainstream.

“As we baby boomers get older, it’s one of the easiest ways to look 20 years younger,” said Dr. Kimberly Harms, an American Dental Association (ADA) spokeswoman, of the current teeth-whitening craze. “You can’t do that with many other body parts.”

Cosmetic dentistry has become a billion-dollar industry. Dentists have “smile boutiques” in their offices. They’re taking marketing courses and producing high-end toothpaste blends. Entrepreneurs are setting up teeth-whitening clinics in spas, hotels and drugstores. Women can get package deals on teeth whitening, lip plumpers and Botox.

As many people sink their teeth into bleaching trays full of chemicals, consumers are left to wonder: Is this trend safe?

According to Harms, most of the teeth-whitening products contain some form of hydrogen peroxide, a common household chemical. “There’s no evidence that it’s unsafe for anybody,” Harms said. “But if you’re pregnant, it just makes common sense to wait.”

But according to health experts, teeth-bleaching products have very little oversight. Since they are not classified as drugs, the U.S. Food and Drug Administration does not regulate them, meaning long-term safety data don’t exist.

When faced with the wide array of whitening products in the drugstore—from strips to trays to special toothpastes and mouth rinses—the ADA Seal of Acceptance is a helpful tool. The organization has conducted its own testing to make sure label claims are accurate. Most of the products contain hydrogen peroxide or carbamide peroxide (hydrogen peroxide is the active ingredient). The products offered in a dentist’s office will have a higher concentration of chemicals.

Not surprisingly, those in-office products also work faster and have longer-lasting results. And in the office, technicians make a special bleaching tray (similar to a mouth guard) that conforms exactly to a patient’s teeth. That means the bleaching solution is less likely to leak into other parts of the mouth and tongue.

Dentists often combine bleaching solutions with ultraviolet (UV) light, regular bright light or lasers in order to speed up the whitening process. With these in-office procedures, patients can expect their teeth to become eight shades whiter with just one treatment. The teeth stay white for about three months.

Drugstore whitening rinses, by contrast, take approximately 12 weeks to whiten the teeth. The rinses and whitening pastes don’t get the teeth quite as white and don’t last as long.

The most common side effect of whitening is sensitive teeth. After bleaching, said Dr. Dan Peterson of Family Gentle Dental Care in Gering, Neb., some patients’ teeth are more sensitive to hot and cold. Bleaching solutions also sometimes irritate the gums, so dentists do not recommend them for people with gingivitis. Other patients have experienced swollen and burned lips from bleaching equipment that uses UV light.

The most serious red flag was raised in 2004, when Dr. Bruce Davidson, a Georgetown head and neck surgeon, presented a poster at an American Academy of Otolaryngology conference that drew a tentative link between overuse of the whiteners and the development of mouth cancer.

Davidson grew concerned when two patients in their 20s developed cancerous growths on their tongues. The patients had very few of the normal risk factors for mouth cancer, but both happened to be zealous users of over-the-counter tooth-whitening products with ill-fitting bleach trays that could have leaked.

Davidson raised the question—could there be a link? He never conducted any further studies. “Given our small data set and inconclusive data, we did not pursue publication,” Davidson said.

For those who are concerned about appearances but want to limit their chemical exposure, Peterson suggested an old home remedy: brush with a little bit of salt and baking soda. You can also add a few drops of hydrogen peroxide to that mixture as long as you don’t swallow it, he added.

“Just a little bit of that on the toothbrush will whiten your teeth over time,” Peterson said (adding that fluoride toothpaste should still be used).

New York dentist Dr. Adina Carrel suggested another popular home remedy for brighter teeth: crush a ripe strawberry and combine it with a half-teaspoon of baking soda. Leave this mixture on your teeth for just five minutes once a week. Any longer, and the acid in the berry could damage your enamel.

In his quiet community, Peterson added, it’s not as much of a priority to have “toilet-bowl-white teeth” as it might be in more fashion-conscious cities. “It all depends on your mindset,” he said.