Teeth whitening treatments contain hydrogen peroxide that removes stains and tooth discoloration caused by smoking, coffee, poor dental hygiene, age, and other issues. The process can be done at your dentistâs office or at home, using trays provided by your dentist or over-the-counter products (OTC) like whitening strips.
Here, we break down how teeth whitening works and compare the most popular options.
Pros
Cons
RealSelf Tip: Always go to an accredited doctor of dental surgery (DDS) for a teeth whitening treatment, not a medispa or other practice with no DDS presence.
Your cost will depend on which whitening method you choose, your provider's level of experience, and a few other key factors.
The teeth whitening photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.
People with good oral health, including healthy teeth and gums, are likely to be good candidates for teeth whitening procedures. If your teeth look yellow, youâre more likely to respond to treatment as well.
Avoid professional teeth whitening if:
Your provider should also do a patch test to ensure youâre not allergic to the bleaching agent used.
Some restoration dental work can impact the overall quality of whitening. Fillings, implants, crowns, and bridges donât whiten the way natural teeth do, so you could end up with uneven color. Your dentist can develop a strategy to provide you with uniform whitening, which could mean new fillings or crowns in a brighter shade.
Almost everyone, including children, can use OTC whitening toothpastes and rinses because theyâre so gentle. Dentists recommend kids only use a pea-size amount of toothpaste under parental supervision. They shouldnât eat or swallow either product, or they risk stomach upset.
The primary difference between professional and OTC whitening treatments is the amount of hydrogen peroxide in the formula.Â
Hydrogen peroxide penetrates your tooth enamel and breaks down discolored molecules, leaving teeth whiter. OTC treatments typically contain less than 10% hydrogen peroxide, so theyâre weaker than professional treatments like Zoom, BriteSmile, Opalescence Boost, and Glo Professional, which contain higher levels of hydrogen peroxide and have more dramatic whitening power.Â
âIn-office whitening makes the teeth white the fastest, mainly due to the fact that it contains a higher percentage of hydrogen peroxide,â says Dr. Maddahi. âIn the office, the gums can be protected by a barrier, but at home, this canât be done. Without the barrier, the higher percentage of hydrogen peroxide would burn the gums.âÂ
Professional whitening methods are regulated by the U.S. Food and Drug Administration (FDA), whereas nonprescription, OTC toothpastes, strips, and trays that have been deemed âcosmeticâ are granted a seal of safety and efficacy by the American Dental Association (ADA).
In-office bleaching (aka professional whitening)
You can expect the most dramatic results from a professional teeth whitening treatment.Â
Youâll start by meeting with your dentist, who will examine your teeth and gums and ask you about your oral hygiene, lifestyle, and whitening goals. Youâll go through a full dental exam and evaluation, to determine which treatment is best for you.Â
âStaining can be caused by problems like decay or hardened plaque on your teeth. An evaluation by a dentist is crucial, to make sure you don't have any bigger underlying problems that are causing your teeth to darken,â says Chicago dentist Dr. Kaori Ema in a RealSelf Q&A.Â
You may have specific instructions to follow before your whitening appointment. For example, some dentists recommend using Sensodyne toothpaste twice daily for two weeks prior, to diminish sensitivity.Â
Before the whitening solution is applied, your gums will be carefully covered to prevent burns from the hydrogen peroxide. Then your provider will apply the whitening gel to the tooth surface.Â
During any in-office whitening treatment, youâre encouraged to sit back and relax, listen to music, or watch TV. The process shouldnât be painful, but you may experience occasional pangs of discomfort. âI felt the âzingerâ they said may happen toward the last few parts of the treatment only once, but it wasnât bad enough to end the treatment early,â says one RealSelf member.Â
Take-home whitening systems
There are prefilled whitening trays that are available only from your dentist. You use them at home, so theyâre easy to apply and very convenient.Â
OTC whitening products
Over-the-counter whitening systems vary in efficacy and results.Â
RealSelf Tip: Some teeth whitening products list carbamide peroxide as their active ingredient. In water, carbamide peroxide breaks down into hydrogen peroxide and urea. âThese at home products are typically used overnight in bleaching trays, as the carbamide peroxide takes time to break down into hydrogen peroxide,â explains Dr. Davidowitz. They can be a good option for those with sensitive teeth: the breakdown results in a lower concentration of hydrogen peroxide and accounts for it staying active over a longer period of time, working slowly and steadily.
In-office teeth whitening treatments are considered safe, especially since they should be administered or monitored by a qualified dentist.Â
However, the whitening process (including at-home whitening gels) can be painful, if your teeth or gums are extremely sensitive. Because our teeth are porous, whitening agents go beneath the surface and dehydrate the tooth.Â
âThis dehydration is the reason teeth may be a bit sensitive,â adds Dr. Victoria Veytsman, a dentist in New York City. âThis sensitivity lasts about 24 hours and can be helped with Sensodyne toothpaste and an OTC anti-inflammatory, like ibuprofen.âÂ
To mitigate sensitivity, avoid very hot or very cold foods for the first 24 hours after professional whitening. Your gums may also look a little discolored after treatment, but that usually resolves in a day or two.Â
Houston dentist Dr. Heather Fleschler recommends applying a thin layer of petroleum jelly to your gums prior to the procedure, to prevent gum irritation.
Your results and their longevity will depend on the type of teeth whiteners you get.Â
Avoiding foods and drinks that are likely to stain or consuming them in moderation (i.e. drinking less coffee and red wine) will help prolong your results. The better you care for your teeth after a whitening treatment, the longer your results will last. Dr. Gerilyn Alfe, a Chicago dentist, likens teeth bleaching to visiting a personal trainerâyou canât completely erase years of damage in one session, and you also canât expect one session to prevent things from going south again in the future.
RealSelf Tip: Studies show that using a power toothbrush can maintain the whitening effects longer than using a manual toothbrush.
If none of these bleaching methods get your teeth as white as youâd like, the next step is porcelain veneers or Lumineers. These are permanent alternatives to teeth whitening, and theyâre significantly more expensive, though they can be applied to just one tooth.Â
Another option for whitening a tooth with internal stains (usually caused by trauma or a root canal) is internal tooth bleaching. The process whitens from the inside out; itâs typically done on a tooth that doesnât have an inner core of dental pulp. Internal bleaching restores the natural tooth color.
Updated September 20, 2019