Tooth sensitivity and gum irritation are the most common whitening side effects.
Any whitening system has the potential to produce side effects and tray teeth whitening is no exception. The two most common side effects associated with this technique are tooth sensitivity and gum irritation. Less frequently reported side effects are: sore throat, tingling of the oral tissues, headaches and uneven whitening.
A) Tooth sensitivity - thermal sensitivity, air sensitivity, tooth pain.
Having sensitive teeth is the most frequent reported whitening side effect.
Easily half of all patients who bleach their teeth notice some type of tooth sensitivity. It may take the form of 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 simply generalized tooth discomfort.
While there is no way to predict who will develop tooth sensitivity (or to what degree) there are some indicators. Those people who prior to whitening already noticed some sensitivity to hot and cold extremes and those people who notice thermal sensitivity after getting their teeth cleaned are more likely to experience tooth sensitivity when they bleach their teeth.
If you develop tooth sensitivity, consider stopping your whitening treatments for a while.
If your tooth sensitivity has been caused by your bleaching treatments, it is quite possible that by simply halting your whitening activities for a few days your symptoms will resolve on their own.
Then, once things have returned to normal, consider resuming your whitening treatments but with a scheduling that lessens your exposure to the whitener (by either reducing the duration of your whitening sessions or performing them less frequently).
Yes, this reduced scheduling will mean that your whitening process will take longer to complete (and probably require more whitener). But if that is what it takes to keep your bleaching experience uneventful, then so be it. Despite this change in the way your treatments are performed it should still be possible to reach the same whitening end point.
Using a toothpaste "for sensitive teeth" may help.
For many people, the sensitivity caused by their teeth bleaching treatments can be kept under control by way of using "anti-sensitivity" toothpaste.
This type of product, typically labeled as "toothpaste for sensitive teeth," can be found on the dental isle of just about any store that sells dental goods. Usually the active ingredient in this type of toothpaste is potassium nitrate or less frequently fluoride.
The idea is that you use the anti-sensitivity toothpaste in place of your regular toothpaste for days, or even weeks, as it creates its palliative effect. Prescription-strength fluoride toothpaste or gel can be used in similar fashion.
Some dentists recommend using anti-sensitivity toothpaste for one or two weeks before initiating teeth whitening treatments as a way of minimizing the potential for side effects.
OTC anti-inflammatory medicines can help to control tooth bleaching sensitivity.
Many dentists 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). The reasoning for this is as follows.
As the components of a whitener penetrate into a tooth they can cause a temporary inflammation of the tooth's nerve tissue (thereby causing tooth sensitivity). 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 effect takes place.
It's never a bad idea to discuss your tooth sensitivity with your dentist.
When experiencing any type of tooth sensitivity, it's not a bad idea to get your dentist involved. Transient whitening tooth sensitivity, as described above, is commonplace. But for peace of mind, and especially in those cases where the sensitivity persists or intensifies, it might be best to let them pass judgement on the matter.
B) Gum irritation - gingival irritation.
It is possible that during the whitening process a person's gum tissue will become irritated by either the whitener they are using or else the bleaching tray itself.
Whiteners that have a high peroxide content tend to irritate gum tissue.
It is generally thought that a person's potential for experiencing gum tissue irritation is directly related to the concentration of peroxide found in the whitening gel they are using. (This is one of the reasons why on our pages we only discuss the use of tray teeth whitening systems that utilize a 10% carbamide peroxide whitening gel.)
Custom-made bleaching trays help to minimize gum tissue irritation.
Gum irritation can be kept to a minimum when "custom" bleaching trays are used. (Dentist-dispensed teeth whitening systems typically involve the use of this type of tray.)
Custom whitening trays are simply bleaching trays that have been fabricated specifically for the person who will wear them (from models of their teeth).
They are trimmed so they fully cover over the surface of each tooth yet their edge lies just short of touching the person's gum tissue. This type of edge contouring helps minimize the contact of whitening gel with the gums. It also helps to prevent mechanical gum tissue irritation caused by the tray itself.
( Learn more : How custom-made bleaching trays help to maximize whitener effectiveness and minimize side effects. )
Wipe away any excess whitening gel that escapes from the tray.
Another factor that can help to reduce the potential for gum irritation is simply wiping away any excess whitening gel that escapes from the tray after it has been inserted. You can do this with either your finger or a toothbrush. (Rinse your hands or toothbrush off after doing so.)
C) Throat irritation.
It is inevitable that during every whitening session some whitener will escape from the bleaching tray and be swallowed. Possibly this phenomenon occurs to a greater extent when whitening treatments are performed overnight as opposed to during waking hours.
When whitener is swallowed it has the potential to irritate the mucosal tissues of the throat. This irritation is only transitory in nature and should resolve on its own without treatment.
D) Uneven or spotty whitening.
There can be a phenomenon that occurs where the teeth being bleached develop a splotchy-white appearance. This effect is typically associated with the use of whiteners that have a relatively high peroxide content. (Yet another reason why we think that a 10% carbamide peroxide whitening gel makes a good choice). 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 whitening treatments are continued.
How intense can whitening side effects be?
Those side effects that a person experiences during their tray whitening treatments can be intense enough that their bleaching process must be discontinued. But this is the exception not the rule. In most cases the side effects that a person encounters are only minor in nature.
One study evaluating the side effects associated with tray teeth whitening technique (Leonard, 1998) asked participants to rate the level of discomfort caused by their bleaching side effects on a scale from 0 to 10, 10 being the most painful. Most respondents rated their side effects experience as being a 1 or 2.
For most people, whitening side effects are a non-issue.
The side effects that most people experience are never significant enough to interfere with their teeth whitening activities. And those mild side effects that do crop up typically subside within a few days once their whitening treatments have been completed.
Some people need help controlling their whitening side effects.
In those cases where the side effects a person experiences are more severe in nature, a dentist's attention may be needed. If they find no dental pathology is involved, the dentist may simply recommend the use of "anti-sensitivity" toothpaste (as discussed above).
In other cases a dentist might feel that a person's whitening treatments should be reduced in scope (such as bleaching every other day or using shorter sessions). This new whitening regimen is then continued until the person's side effects have substantially subsided or, if needed to keep them symptom free, for the remainder of their teeth whitening activities.
