Safety risks associated with tooth whitening procedures include tooth sensitivity, soft tissue (gum, lips, and tongue) irritation, secondary decay, negative effect on tooth restoration, demineralization, systemic effects caused by ingestion of the whitening gel. All of the risks mentioned can be prevented with proper usage and post-whitening treatment.
The ingredients of the teeth whitening gel will set the guide line of frequency and exposure time. The directions provided by the manufacturer should not be ignored. Not all whitening products have the same ingredients, some can be used at night and others should not. Overuse of whitening products can cause severe discomfort and possibly cause irreversible damage to the tooth.
The American Dental Association considers whitening products containing 10% carbamide peroxide or 3.5% hydrogen peroxide to be safe for over the counter purchase. The ADA seal of acceptance is neither an obligation nor an implication of safeness or effectiveness. The higher percentages should only be used with proper knowledge and understanding of risk potential and prevention. The ADA promotes the use of higher percentage whitening after a consultation with a dentist.
The use of whitening agents is not advised if you are aware of any active disease; periodontal or gum tissue disease, untreated cavities or decay. The ingredients used in whitening agents can worsen the irritation and discomfort of uncontrolled gum diseases. Tooth decay or cavities should be treated before the consideration of tooth whitening. Whitening can cause severe pain when in contact with a decayed tooth. Whitening agents can also inhibit the bond of the filling material if used within two weeks of the dental visit.
Tooth whitening can potentially cause damage to existing tooth restorations in your mouth if not used properly. The tooth needs saliva absorption to rehydrate and re-mineralize before exposure of any acidic or sugar substance. Restorative materials do not allow the penetration of whitening agents or staining substances therefore tooth restorations do not stain or whiten. Restorations remain unchanged, while the natural tooth behind the restoration is left dehydrated and demineralized post-whitening. If the rehydration process is disrupted, it is possible the tooth will not re-mineralize before the acid or sugar substance enter the pores of the tooth and cause the restoration to leak or fail.
Accidental ingestion of small amounts of whitening gel can cause sore throat, nausea, vomiting, abdominal swelling, and ulcerations of the stomach, esophagus, and oral mucosa. When using repetitive applications of a tooth whitening agent, it is important to use a controlling device such as, custom fitted teeth whitening trays to lessen the chance of ingestion.
Concerns remain in regard to long-term safety of unsupervised bleaching procedures due to abuse and overuse of the product and possible underlying or undiagnosed oral health problems. For optimal safety and to ensure proper diagnosis and treatment, a dental examination is advised.