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Are Teeth Whiteners Safe?

Over the past decade, sales of at-home teeth-whitening products have exploded in the United States. These products generally contain either hydrogen peroxide or carbamide peroxide, and are usually painted or brushed on, or applied in strips directly to the teeth. They are milder versions of whiteners that are used in the dentist's office, which may contain up to 35% active ingredients.

While studies have shown that these products do whiten teeth, there is some lingering concern about their safety. For example, studies have shown that peroxide from at-home whitening products penetrates the tooth enamel into the pulpy interior of the teeth (Gokay 2005). In studies of human molars, these products have also been shown to adversely affect the hardness of enamel (Leonard 2005; Basting 2005).

So far, however, no systemic adverse effects have been demonstrated with the use of teeth whiteners containing 10% carbamide peroxide (Li 2003). The most common side effects are moderate tooth sensitivity and mild gum irritation that usually discontinues when the product is no longer being used (Li 2003).

Because stronger at-home solutions containing up to 18% carbamide peroxide have not yet been extensively tested in humans, it may be advisable to use a milder at-home tooth-whitening product under a dentist's supervision.