Teeth Whitening

Professional teeth-whitening

The quickest professional teeth-whitening method (*est. $500 to $800) uses light therapy to speed up the bleaching action of peroxide, which is used in a much higher concentration by dentists (15% to 43%) than in over-the-counter products (3% to 10%). This combination of therapies can lighten teeth up to ten shades in about an hour. Most testers record an improvement of three to eight shades and note that some people may need up to four treatments to achieve the level of whiteness they desire. Results from professional teeth-whitening can last up to a couple years.

Many dentists do this procedure in their office using systems like the Zoom! Chairside Whitening System. Alternatively, you can go to a specialized whitening center in your local shopping mall, like those offered by BriteSmile. These are supervised centers where a dentist will examine your mouth to ensure that you are an appropriate candidate before you receive the tooth-whitening treatment. If there are any problems, you'll be referred to your own dentist first. The ADA approves the use of "blue spectrum" light in these procedures (used by BriteSmile and at your dentist's office), but not the use of lasers.

A slightly cheaper (*est. $300 to $600), but less convenient, teeth-whitening option is to purchase a home bleaching kit from your dentist. These kits require use for one to two hours per day, or overnight, for up to ten days. The advantage of choosing a tooth whitening kit from the dentist versus over-the-counter is, again, a higher percentage of peroxide, a customized mouth tray that's fitted by your dentist and results that last up to a couple of years. The ADA approves dentist supervised home kits containing 10% peroxide, but it does not recommend over-the-counter kits, primarily because of the lack of dentist supervision.

Home teeth whitening kits

If you're looking to spend less money and don't mind some inconvenience, over-the-counter tooth-whitening kits are a safe alternative if they're used according to directions. (Some dental experts have pointed out that consumers tend to overuse teeth-whitening products, thus it's always best to consult your dentist.)

Two Crest Whitestrips products, Premium and Classic, receive the most favorable reviews. Whitestrips are included in studies by Consumer Reports, Good Housekeeping, The Wall Street Journal and Prevention magazine. They are also tested in trials presented at the 2007 IADR meeting. They are the best-reviewed whitening products on Amazon.com and Drugstore.com, where contributors say they work well for the money and are easier to use than some other products.

Crest Whitestrips Premium (*est. $35) contain 10% peroxide gel. They should be worn twice a day for 30 minutes each time, for seven days. On average, they lighten more than three shades. Results should last about 12 months -- twice as long as the results with Crest Classic (*est. $25) , which contains 6% peroxide. Good Housekeeping refers to Crest Whitestrips Premium as a “Hall of Fame” product. In a 2004 study, Good Housekeeping testers find that these strips lighten teeth more than three shades. Two studies from the IADR meeting test Crest Whitestrips Premium against Oral-B Rembrandt Whitening Strips products. The Crest Whitestrips have superior results. (Both studies were funded by Procter & Gamble, the makers of Crest and Oral-B products.) In a Prevention magazine survey, the four testers of this product have good results.

Crest Whitestrips Classic (*est. $25) contain 6% peroxide gel. They are worn twice a day for 30 minutes each time, for two weeks. They are a gentler, albeit slower, alternative to Crest Whitestrips Premium. Experts find them to be convenient and effective, with average whitening of about three shades. Results can last up to six months. Some testers notice whiter teeth after only a few days of use. But in the Wall Street Journal study, testers are less enthusiastic about Crest Whitestrips Classic. They find only a half-shade improvement and are displeased by associated drooling. They prefer Colgate Simply White’s paint-on formula. Although Colgate Simply White is no longer on the market, other paint-on formulas are available. Crest Night Effects (*est. $15) is a gel that is painted onto the teeth before bed for two weeks. In a Good Housekeeping study, the Crest gel lightens testers’ teeth two to five shades. At least one tester, however, objects to the product’s “goopy” feel.

To the delight of testers in the Good Housekeeping study, another Crest Whitestrips product, Crest Whitestrips Daily Multicare (*est. $40) , is worn only five minutes a day for two weeks. On average, these strips lighten almost a shade.

If you would pay more for convenience, GoSmile Advanced Formula B1 (*est. $90) may be a good option. This system consists of individual tubes of gel that each come with a small brush. The gel is squeezed onto the brush and then scrubbed onto the teeth. It does not have to be removed. This product receives good marks wherever it is reviewed, including a Prevention.com survey, a CBS Morning Show interview with a dentist, a Real Simple review and a Good Housekeeping study. On Amazon.com, many reviewers give it the highest rating, although for some it does not work at all. Many testers see a difference immediately. The testers in the studies we find do not identify a specific shade reduction, but they are pleased with the whitening results. GoSmile contains 6% hydrogen peroxide.

When it comes to over-the-counter whitening products, experts and testers prefer teeth-whitening strips and paint-on whiteners to over-the-counter mouth-tray whiteners. Since the mouth trays are one-size-fits-all, they can be ill fitting. In a Good Housekeeping study, Aquafresh White Trays (*est. $35) provide the best whitening of the four products tested. This system also does well in the Real Simple testing. The pre-filled trays are worn 45 minutes a day for one week. On average, teeth become two shades whiter. Some testers, however, find the trays to be messy or uncomfortable. In reviews on Amazon.com and Drugstore.com, this product is often associated with pain and irritation. The reviews suggest that the product whitens well when the tray is a comfortable fit. In a Good Housekeeping study, two reviewers find another tray product, Ultra Plus+White (*est. $12) , to be ineffective. In addition, the foam mouth tray is extremely uncomfortable, even causing a sore throat in multiple testers. Rembrandt 2-Hour White, another gel with a mouth tray, is tested in a Good Housekeeping study. The tester’s teeth brighten three shades in two hours. No comments are provided regarding the tray’s comfort, however.

Another novelty to hit the market is tooth-whitening gum. Trident White (*est. $1.50) doesn't contain peroxide, but it does have a "patented technology" that supposedly breaks up surface stains. To see an effect, you need to chew two pieces for at least 20 minutes, four times a day -- not a problem if you are a habitual gum chewer. However, if you are simply seeking a way to whiten your teeth, you're better off picking a more convenient option. Testers at Good Housekeeping do claim to see one shade of improvement after chewing whitening gum for six weeks. However, this is a good place to point out that some studies have found a large placebo effect with tooth-whiteners, noting that, given a ‘sham whitener’, people claim to see an improvement. Plus, a product containing peroxide can produce a better result in one week.

Teeth-whitening side effects and safety

Many users of whitening products experience temporary tooth and gum pain, which in some cases can be severe. Reviews on Amazon.com, Epinions and Drugstore.com often mention pain and sensitivity. A 2006 study published in the Cochrane Database of Systematic Reviews examines data from 25 separate trials on whitening products. The most common side effects are “mild” or “moderate” tooth sensitivity and gum irritation. Tooth sensitivity corresponds to the concentration of peroxide; higher percentages of peroxide are apt to cause more irritation.

Tooth sensitivity may help guard against the overuse of whitening products. Consumers may be more apt to remove a product at the instructed time if teeth or gums begin to ache. Overuse of whitening products can be detrimental. In an article on WebMD, Van Haywood, DMD, a professor in the Department of Oral Rehabilitation at the Medical College of Georgia, states that, with extreme use, teeth may become transparent.

However, when used properly, almost all data on tooth-whitening attests to its safety. A 2006 literature review published in the Journal of Esthetic and Restorative Dentistry finds no correlation between hydrogen peroxide tooth whitening products and oral cancer. Many studies at the 2007 IADR examine whether whitening can damage the structure of the tooth, including the enamel. One study shows that the three products tested (NiteWhite ACP, Opalescence PF and Tres White) decrease enamel hardness and density. Most studies show no harmful effects, although long-term data is not presented. Data from a report presented at the 2005 Materials Research Society suggests that whitening can reduce the hardness of tooth enamel. In testing on extracted teeth, a carbamide peroxide solution of 10% reduces enamel hardness by 22%. A 35% carbamide solution reduces enamel hardness by 82%. There is little evidence that occasional whitening treatments cause damage, but a few studies do note that some people find teeth-whitening psychologically addictive.

An article in WebMD notes that some people should not undergo tooth-whitening. Bleaching is not recommended in children younger than 16 because the pulp chamber, or nerve of the tooth, is enlarged until this age. Teeth-whitening could irritate the pulp or cause it to become sensitive. Pregnant or lactating women should also forgo teeth-whitening. People who have gum disease or teeth with worn enamel are usually discouraged from undergoing a tooth-whitening procedure. Cavities should be treated before any whitening procedure.

Important Features: Teeth whitening products

Experts say to remember the following when choosing a tooth whitener:

• The ADA recommends discussing the options with your dentist and choosing a dentist-supervised whitening plan.

• Bleaching effectiveness is directly related to the percent of peroxide and length of time it's in contact with your teeth. Over-the-counter tooth-whitening products generally contain no more than 10% peroxide. Professional teeth-whitening processes can use up to 43% peroxide.

• Bleaching works best for yellow teeth, not as well for gray teeth.

• Crowns, fillings and dental veneers are not affected by lightening products -- something to keep in mind if you have a prominent crown or bridge.

Our Consensus Report shows how many times products are top-ranked by reviewers included in our
All The Reviews Reviewed chart.

# of Picks	Model with retailer link	Detail from Amazon.com
11	Professional Whitening (BriteSmile, Zoom!, dentist supervised home kits)$300 to $800	-
8	Crest Whitestrips Premium (*est. $35)	details
8	Crest Whitestrips Classic (*est. $25)	details
5	GoSmile Advanced Formula B1 (*est. $90)	details
4	Crest Night Effects (*est. $15)	details
3	Aquafresh White Trays (*est. $35)	details
3	Listerine Whitening Strips (*est. $30)	details
2	Crest Premium Plus (*est. $40)	details
2	Crest Daily Multicare (*est. $40)	details
1 each	Oral-B Rembrandt Whitening Strips , Ranir Whitening Strips, Rembrandt Advanced , BriteSmile To Go , Trident White Chewing Gum , Ultrabrite toothpaste, Colgate Max Fresh toothpaste , Colgate Luminous toothpaste , Colgate Baking Soda and Peroxide toothpaste , Crest Baking Soda and Peroxide toothpaste , Colgate Sensitive Multiprotection toothpaste, Arm and Hammer Advanced White toothpaste

All experts agree that professional teeth-whitening, while the most expensive, is the way to go if you want dramatic, long-lasting results and convenience. Crest Whitestrips Premium and Classic win good reviews for over-the-counter effectiveness and convenience. Some testers notice better results with overnight products that are left on the teeth longer, like Crest Night Effects. Whitening chewing gums, like Trident White and Aquafresh Whitening Gum, may be an option if you already enjoy chewing gum, but they're not nearly as effective as bleaching agents. GoSmile is expensive, but testers like that the paint-on formula can get to areas that strips can’t reach. GoSmile has an advantage in that the gel does not have to be removed.

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