The Q&A

How safe and effective are all those over-the-counter products?

Americans reportedly drop $1.4 billion annually on nonprescription teeth whitening products to bleach away the effects of cigarettes, coffee, red wine or just good-old age.

Certain medications, notably tetracycline, also discolor teeth, say experts.

But is the bite to your wallet worth it?

Mind you, the government doesn’t regulate whiteners and the consensus among dental experts is that many of them are ineffective; on the other hand, some do work. Dr. Meyers weighs in on the discrepancies…

Q: To what degree is losing that pearly white shine unavoidable and natural?

A: Almost universally, teeth will get darker with age. For most people, as they age, their teeth will turn kind of a brownish yellow — not necessarily from smoking, coffee or wine, but by virtue of aging, itself.

Our hair turns white and our teeth turn yellow. It would be nice if it was the other way around. Some teeth turn out to be grayish. There’s a whole spectrum of what is “normal.”

Q: Whatever the cause, are over-the-counter products effective?

 A: There are two types of discoloration: “intrinsic,” which develops over time and is the tooth’s natural, aged color. Then there’s “extrinsic” color, due to deposits on the teeth from smoking or coffee, or other materials or due to medication taken by the patient.

Bleach will not work with a stain from major deposits caused because a patient has not brushed their teeth. If you’re not taking care of your teeth, there’s not going to be any meaningful and effective whitening from any type of product.

The teeth have to be in a healthy condition. If a patient hasn’t been to the dentist for a while, and if there are any cavities or decay — and whitening material gets within the decay — it can cause excruciating pain.

However, if a patient is healthy, with good oral hygiene, then OTC whitening agents can work effectively. The caveat, however, is that the process is not dentist-monitored to insure efficacy.

Many of them don’t do anything. For instance, a mouthwash containing a “whitening” agent, such as hydrogen peroxide, probably won’t be very effective. There are some products that use a light that we flash on our teeth to accelerate whitening. Even the whitening lights that we use in the dental office are no more effective than other ways of whitening teeth.

If you want white teeth, dentists have tried-and-true methods. Some patients have their dentist paint a whitening solution that sits on the teeth for 30-45 minutes while in the dental office. Keep in mind, these solutions are completely different from the OTC products you buy in the drugstore. It’s highly concentrated; the gums actually have to be protected from this material.

Q: Are there any over-the-counter products that you would recommend?

“Crest Whitestrips” work. This product comes with moldable mouth trays that can be custom-fitted by placing them in hot water and then inserted in the mouth to be molded. The accompanying whitening gel seems to be fairly effective. While mouthwashes are, by-and-large, ineffective, if you were to rinse 6-9 times daily — and hold it in your mouth for 2-3 minutes — you will likely see some improvement in color. Look at the label — the effective products will contain some type of peroxide.

Note, with any of the OTC products, there is virtually no oversight by a dentist. But there is no guidance by a dentist to monitor all this. Side effects include irritated gums, over-processing and the danger of exacerbating cavities.

Q: Will the teeth become as white as what is done in the dental office?

A: Probably not as rapidly. It might take two or three months with over-the-counter products, whereas when we use products that can only be purchased in a dental office and those are going to work within as little as 3-4 days, but up to a week, possibly longer.

Q: How often should a person whiten his or her teeth?

In a medical setting, our procedure should last up to two years. For maintenance, it is recommended that patients touch up a bleaching every six months during their regularly scheduled cleanings.

The recommended procedure, and least expensive, is a home bleaching procedure. The dentist takes an impression of the patient’s mouth and from that impression makes a whitening tray. It fits in the patient’s mouth like a mouth guard. Whitening material can be placed inside in a gel form. Some people wear them overnight, while they’re sleeping; other patients wear them during the day because they’re virtually invisible. This should be worn for an hour or two, daily. (It costs around $500 for the initial investment.)

Bottom line: if you want to whiten, you should consult your dentist first and even then, beware that whitening can have problems. While very rare, having your dentist monitor the process will go along way in helping you achieve the desired results in a quick and safe way.