8/21/2001
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."