TEETH WHITENING

Pros

• Most whitening treatments will lighten your teeth a few shades—the professional versions just do it better and faster (albeit at a higher cost) than OTC products.
• They carry minimal risks and side effects.
• You won’t need any downtime. 
• Teeth whitening is the most popular and accessible cosmetic dentistry treatment, since it’s available at all price points.
• You can expect the procedure to be simple and minimally invasive. 

Cons

• Teeth whitening can cause tooth sensitivity, especially during the first 48 hours post-treatment. “Using a desensitizing toothpaste for two weeks prior to whitening can help alleviate much of the sensitivity during and after a whitening session,” says Dr. Steven Davidowitz, a cosmetic dentist in New York City.
• While OTC and professional treatments work well on surface stains caused by food and tobacco, they tend not to work as well on internal gray stains, which are typically caused by trauma or medication. These stains are much more difficult to whiten, according to Dr. Kourosh Maddahi, a cosmetic dentist in Beverly Hills, California. 
• Whitening treatments don’t work on crowns or fillings, so if you have a lot of dental work, your results could be spotty. Whenever possible, have professional whitening done prior to dental work.
• Some people respond better to whitening than others. “Just like certain people’s skin tans better than others’, it’s the same with teeth whitening. Some will get an incredible whitening result very fast, and others may undergo numerous bleaching sessions and get a minimal result,” says Laguna Niguel, California, dentist Dr. Norman Huefner.

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.

• Average Cost:
• $600

• Range:
• $250 - $1,000

Your cost will depend on which whitening method you choose, your provider's level of experience, and a few other key factors.

Learn more about the cost of teeth whitening

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, you’re more likely to respond to treatment as well.

Avoid professional teeth whitening if:

• You’re pregnant or breastfeeding
• You have very sensitive teeth
• You have periodontal disease, cavities, or exposed roots

Your provider should also do a patch test to ensure you’re not allergic to the bleaching agent used.

Some restoration dental work can impact the overall quality of whitening. Fillings, implants, crowns, and bridges don’t 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 they’re so gentle. Dentists recommend kids only use a pea-size amount of toothpaste under parental supervision. They shouldn’t 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. 

Hydrogen peroxide penetrates your tooth enamel and breaks down discolored molecules, leaving teeth whiter. OTC treatments typically contain less than 10% hydrogen peroxide, so they’re 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. 

“In-office whitening makes the teeth white the fastest, mainly due to the fact that it contains a higher percentage of hydrogen peroxide,” says Dr. Maddahi. “In the office, the gums can be protected by a barrier, but at home, this can’t be done. Without the barrier, the higher percentage of hydrogen peroxide would burn the gums.” 

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 “cosmetic” 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. 

You’ll start by meeting with your dentist, who will examine your teeth and gums and ask you about your oral hygiene, lifestyle, and whitening goals. You’ll go through a full dental exam and evaluation, to determine which treatment is best for you. 

“Staining 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,” says Chicago dentist Dr. Kaori Ema in a RealSelf Q&A. 

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. 

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. 

• Zoom contains 25% hydrogen peroxide, and an overhead blue plasma light is used to activate the hydrogen peroxide. The gel stays on for 15 minutes, and the process is repeated three times for a total of 45 minutes. 
• Glo Professional contains either 24% or 30% hydrogen peroxide. An LED mouthpiece is slipped over your teeth to activate the hydrogen peroxide formula. Dr. Maddahi likes Glo because he believes it causes less tooth sensitivity. 
• BriteSmile uses a 25% hydrogen peroxide–based gel, activated by a specialized laser. It’s typically a one-hour session, with a series of three 20-minute applications. This laser whitening or “power whitening” treatment is intended to make teeth five to six shades brighter. 
• Opalescence Boost contains a higher amount of hydrogen peroxide (40%). The consistency of the gel is stickier, and a light activator is not used. The gel also contains potassium nitrate (to reduce sensitivity) and fluoride (to prevent cavities). The process takes about an hour.

During any in-office whitening treatment, you’re encouraged to sit back and relax, listen to music, or watch TV. The process shouldn’t be painful, but you may experience occasional pangs of discomfort. “I felt the ‘zinger’ they said may happen toward the last few parts of the treatment only once, but it wasn’t bad enough to end the treatment early,” says one RealSelf member. 

Take-home whitening systems

There are prefilled whitening trays that are available only from your dentist. You use them at home, so they’re easy to apply and very convenient. 

• For Opalescence PF, your dentist makes a mold of your teeth and creates a custom tray based on the impression. You squirt gel (which in addition to hydrogen peroxide, contains potassium nitrate and fluoride) from a syringe into your tray and wear it for a specific amount of time (as little as 15 minutes or as long as overnight) determined by your dentist, based on your whitening needs, for two weeks. 
• Opalescence Go is similar but uses prefilled disposable trays, which you wear for between 15 and 60 minutes for 5–10 days.
• BriteSmile’s line of at-home whitening pens is called BriteSmile To Go. It produces results similar to those of whitening strips or lower-strength bleaching trays. The instructions recommend applying the gel twice a day for two weeks, then as needed to maintain results.

OTC whitening products

Over-the-counter whitening systems vary in efficacy and results. 

• Whitening strips are the most common (and most popular) option. These clear, disposable strips are applied to the teeth and worn for about 30 minutes a day (in the case of 3D Crest Whitestrips) for two weeks. They’re good for tackling mild stains but really reach only the front six to eight teeth, often called the “smile zone.” 
• OTC kits that use blue LED light (such as Glo Lit Teeth Whitening Device tech kit, AuraGlow, iSmile, or Zero Glow Teeth Whitening Kit) use an LED mouthpiece to help jump-start the chemical (either carbamide peroxide or hydrogen peroxide) that whitens your teeth. 
• Other OTC products, such as whitening toothpaste, floss, and mouthwash have flooded the market recently. Unfortunately, clinical trials suggest that you won’t have significantly whiter teeth compared to their in-office counterparts. 

RealSelf Tip: Some teeth whitening products list carbamide peroxide as their active ingredient. In water, carbamide peroxide breaks down into hydrogen peroxide and urea. “These at home products are typically used overnight in bleaching trays, as the carbamide peroxide takes time to break down into hydrogen peroxide,” 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. 

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. 

“This dehydration is the reason teeth may be a bit sensitive,” adds Dr. Victoria Veytsman, a dentist in New York City. “This sensitivity lasts about 24 hours and can be helped with Sensodyne toothpaste and an OTC anti-inflammatory, like ibuprofen.” 

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. 

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. 

• Professional whitening treatments yield immediate results that typically last a year, sometimes more, before you’ll need a maintenance treatment. 
• Professional at-home treatments (trays and gels) take a few weeks to create your desired results. Then you can rewhiten once a year, going through the full at-home process again.  

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 trainer—you can’t completely erase years of damage in one session, and you also can’t 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 you’d like, the next step is porcelain veneers or Lumineers. These are permanent alternatives to teeth whitening, and they’re significantly more expensive, though they can be applied to just one tooth. 

• Veneers are custom-made, tooth-colored shells that are applied directly over your existing teeth. While they’re thin, the natural teeth are usually shaved down so the veneers don’t look too thick and unnatural. 
• Lumineers are similar, but they’re thinner and don’t require as much (if any) shaving. All veneers are stain-resistant and can disguise gaps, chips, and crooked teeth as well as discoloration. 

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; it’s typically done on a tooth that doesn’t have an inner core of dental pulp. Internal bleaching restores the natural tooth color.

American Dental Association, (ADA). “ADA Oral Health Topics: Whitening.” Whitening, 2019.

Demarco, et al. “Over-the-Counter Whitening Agents: a Concise Review.” Brazilian Oral Research, Sociedade Brasileira De Pesquisa Odontológica. 2009.

Jorgensen, Michael G, and William B Carroll. “Incidence of Tooth Sensitivity after Home Whitening Treatment.” Journal of the American Dental Association (1939), U.S. National Library of Medicine, Aug. 2002.

Oral Health Foundation; Dentalhealth.org. “Tooth Whitening.” 2020.

Pace Brinker, Shannon. “Is Light-Accelerated Whitening Worth the Pain?” AACD, Aug. 2017.