7. What should be considered before a tooth whitening treatment?
Before engaging in tooth whitening treatment, a dentist should be consulted
Above 0.1% hydrogen peroxide, tooth bleaching is not just a simple cosmetic procedure. It is important that the dentists diagnose the cause of the staining, predict whether the stains can be removed or not, check whether patients have any other oral health problems, and counsel patients about the best way of dealing with this esthetical problem.
As mentioned in question 5, the most common undesirable side effects of tooth whitening treatments are irritations inside the mouth and teeth becoming over-sensitive to temperature changes. These effects usually disappear immediately or a few days after stopping treatment but can sometimes last for over a month. Moreover, consumers may occasionally swallow entire tooth whitening strips and, as a result, suffer from minor upsets of their digestive tract.
Hydrogen peroxide passes through dentin into pulp, but there are few studies on the long-term effects of bleaching products on pulp. Dental pulp is particularly vulnerable in people with conditions such as gum retraction that expose the dentin.
Health conditions such as pre-existing tissue injury or the concurrent use of alcohol and/or tobacco while using tooth whiteners may also exacerbate their toxic effects. Hydrogen peroxide, even at concentrations as low as 3%, may be especially harmful to oral tissues if they have been previously injured. Therefore, particular care should be taken in administering bleaching agents to patients with mouth diseases or lesions, and to those using alcohol and tobacco. This mixed exposure may be of concern since smokers are likely candidates for tooth bleaching.
Hydrogen peroxide can contribute to the development of existing tumours and therefore increase the risk of oral cancer in persons that already have an increased risk due to tobacco use, alcohol abuse, or genetic predisposition, especially when treatment is repeated. However, since hydrogen peroxide degrades quickly in the mouth, tooth whiteners are unlikely to be a cancer risk in all other population groups.
Hydrogen peroxide has not been shown to be a skin sensitiser.
As far as dental restorative materials are concerned, prolonged treatment with bleaching agents might cause small changes in amalgam surfaces and may possibly release some mercury. Hence, bleaching of teeth containing amalgam fillings should be approached with caution. More...