To Bleach or Not to Bleach?

We see it all over television and magazines. Celebrities with bright, white, sparkling smiles. We also see our friends showing off their pearly whites in a selfie on social media. A healthy, white smile is very attractive and can give someone the confidence they need to boost their self-esteem.  So, it is no surprise to me, when I see an increase in the types of bleaching products out in the market. More and more parents are requesting information about dental whitening products for their adolescents.

According to the American Academy of Pediatric Dentistry, “a negative self-image due to a discolored tooth or teeth can have serious consequences on adolescents and could be considered an indication for bleaching.” There are many reasons a tooth could be discolored. These reasons include, but are not limited to, trauma or injury to the tooth, irregularities in enamel formation, staining or a mismatching filling material. Not every discoloration can be treated with a whitening product, so it is important to be evaluated by your dental professional to see if your smile would benefit from a whitening product. Also, it is very important to take in to account the stage of dental development that your child is in. There are 3 main sets of dentition your child can have.  You may be asking what is Dentition?  Dentition is the arrangement of your teeth. Better said, it is a set of teeth.

3 Main Sets of Dentition:

  1. Primary dentition: all baby teeth (typically between the ages of 0-6 years old)
  2. Mixed dentition: mixture of baby and adult teeth (typically between the ages of 6-12 years old)
  3. Permanent dentition: all adult teeth (typically 12 years old and above)

When your child is in mixed dentition stage, they have both baby and adult teeth in their mouth. At this time, you can compare the different shades of white between the baby and adult teeth and you may feel that their adult teeth are more yellow. This is not a figment of your imagination. This is mainly due to the difference in the thickness of enamel between the baby and adult teeth.  This is normal and does not typically warrant bleaching the adult teeth.

If your dental professional recommends bleaching, it will most likely be once your child has all their permanent teeth in their mouth. Typically, a peroxide containing agent is used to whiten your teeth. The peroxide containing products can range in concentration, depending on the method of whitening being used.

There are different ways that bleaching can be accomplished:

  1. Over the counter: least expensive, contains lowest concentration of peroxide-containing whitening solution and produce gradual results
  2. Custom trays made by a dental professional for at home use: more expensive, higher concentration of peroxide containing whitening solution, faster results
  3. In office bleaching by dental professional: most expensive, higher concentrations of peroxide-containing whitening solutions, fastest results

You must also be aware that bleaching can have side effects and that most of the research that has been obtained about whitening products have been performed on adults.  For these reasons, and because side effects are not tolerated well by children, I do not regularly recommend whitening products to my patients. The most common side effects include:

  • Teeth sensitivity and gum irritation (reported in 8% to 66% of patients) are normally reported at the start of treatment and typically subside once treatment is complete
    • Gum irritation can be largely avoided by using a well fitted, custom tray made by a dental professional
  • Increased marginal leakage of existing restorations which can lead to fillings needing to be replaced
  • Byproducts of hydrogen peroxide can cause periodontal tissue damage and root resorption

Pro Tips:

  • Visit your dentist to have them assess if whitening products will address your concerns
  • If whitening products are necessary, use the lowest effective concentration of peroxide containing whitening products
  • Consider the side effects that can occur, especially on your little one.
  • Remember baby teeth normally look brighter than our children’s new adult teeth.
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