Common side effects associated with tray-based at-home teeth whitening products and whiteners.

Side effects can and do occur when using a 10% carbamide peroxide whitener in conjunction with an at-home tray-based teeth whitening system. The two most common side effects are tooth sensitivity and gum irritation. Other, less frequently reported, side effects are: sore throat, tingling of the oral tissues, and headaches.

While the side effects that a person encounters during their whitening treatments can be intense enough that the bleaching process must be discontinued, they are usually only minor in nature. One study asked participants to rate the level of discomfort associated with their side effects on a scale from 0 to 10, 10 being the most painful. Most respondents rated their side effects as a 1 or 2. In all cases however, if you do notice any side effects during the bleaching treatments you should report them to your dentist.

For most people the side effects that they experience are never significant enough to interfere with their whitening activities. Typically those mild side effects that a person has tolerated during the whitening process will subside within a few days once they have completed their treatments. In those cases where the experienced side effects are severe, a dentist may feel that palliative treatments, usually quite simple in nature, are indicated or else that the teeth whitening process should be stopped altogether.

If only minor side effects have presented themselves, a dentist will usually make the simple recommendation that the person reduce the total number of hours they wear their bleaching trays each day, or else only performed whitening treatments on alternating days. In some cases it might be best to cease the whitening treatments all together until the side effects have resolved and then resume bleaching using a reduced schedule.

A) Tooth sensitivity (hot and cold sensitivity, air sensitivity, tooth pain).

Probably the most common side effect that people notice when performing at-home teeth bleaching treatments is increased tooth sensitivity. This sensitivity can take a variety of forms. It can be thermal sensitivity (a response to hot and cold temperature variations such as those produced by foods and beverages), sensitivity to air (such as when a person breathes through their mouth), or just tooth pain. Easily half of all patients who bleach their teeth do notice at least some transient tooth sensitivity.

While there is no way to predict specifically who will develop this complication, there are some general indicators. Those people who prior to bleaching already noticed some sensitivity to hot and cold extremes and also those people who notice that they experience thermal sensitivity after getting their teeth cleaned can anticipate that they may experience tooth sensitivity when they bleach their teeth.

Solutions for tooth sensitivity caused by whitening treatments.

If you do notice tooth sensitivity in conjunction with your whitening activities you should feel free to report it to your dentist. In most cases they can help you control the degree to which you experience the sensitivity by either suggesting that you reduce the amount of time that you wear your bleaching trays each day or by recommending some simple palliative measures.

One of these palliative measures can be the use of an anti-sensitivity toothpaste. Several companies make toothpaste "for sensitive teeth" and they are easily found wherever dental products are sold. Anti-sensitivity toothpastes typically list potassium nitrate as their active ingredient. The idea is that you use the anti-sensitivity toothpaste in place of your regular toothpaste for days and even weeks as it produces its palliative effect. Along these same lines, some dentists will recommend to their patients that they use an anti-sensitivity toothpaste for two weeks or so prior to initiating their whitening treatments as a way of minimizing their potential for experiencing tooth sensitivity. Prescription-strength fluoride toothpaste or gel (as prescribed by the treating dentist) can be used in a similar fashion.

Some dentists will suggest to their patients that they take a non-steroidal anti-inflammatory (NSAID) medication such as ibuprofen prior to performing their whitening treatments (in those cases where this drug is appropriate for the patient's use). As the components of the whitener penetrate into a tooth they can cause a temporary inflammation of the tooth's nerve, thus creating the tooth sensitivity that the person experiences. The presence of an anti-inflammatory drug in the person's system prior to performing whitening treatments can help to minimize the degree to which this takes place.

B) Gum irritation (gingival irritation).

During the teeth whitening process a person's gum tissue can become irritated by the bleaching gel being used. It is generally thought that the potential, at least in part, for developing gum irritation is directly related to the concentration of the peroxide found in the whitener. This is one of the reasons why a whitener with a 10% concentration of carbamide peroxide, rather than a higher one, has become the standard for at-home tray-based teeth whitening.

As a means of minimizing or remedying the problem of gum irritation, a dentist will usually fabricate a person's bleaching trays in a fashion where they fully cover over each tooth being bleached, but rest just short of touching the person's gums. Additionally, so to help to reduce the potential for gum irritation, when bleaching trays are initially seated a person should wipe away the excess whitening gel that escapes from the tray onto their gums using their finger or a toothbrush.

C) Sore throat.

It is inevitable that during bleaching treatments some whitener will be swallowed. This phenomenon possibly takes place to a greater extent when whitening treatments are performed overnight as opposed to during waking hours. When whitener is swallowed it can cause irritation of the mucosal tissues of the throat. This irritation is only transitory in nature and should resolve on its own without treatment.

Initally the whitening effect may appear uneven or spotty.

There can be a phenomenon that occurs during the whitening process where the teeth being treated develop a splotchy white appearance. This effect is typically associated with the use of whiteners that have a carbamide peroxide content that is greater than 10%. In most cases this uneven coloration will appear during the first week of bleaching and then resolve on its own, typically within a week, as the whitening treatments are continued.