Potential Side Effects of Teeth Whitening Procedures
The most common side effects of teeth whitening procedures are tooth sensitivity and gingival irritation, which are usually mild to moderate and transient in nature, typically resolving when treatment is discontinued. 1
Common Side Effects
Tooth Sensitivity
- Occurs in approximately 54% of patients using peroxide-based whitening products 2
- Severity breakdown:
- Mild sensitivity: Most common (54% of users)
- Moderate sensitivity: Affects about 10% of users
- Severe sensitivity: Affects approximately 4% of users 2
- Usually temporary and decreases with time:
- Severe sensitivity typically resolves within 1-2 weeks
- Moderate sensitivity typically resolves within 4 weeks 2
- Risk factors:
- Gingival recession significantly increases the likelihood of experiencing sensitivity 2
Gingival Irritation
- Common side effect alongside tooth sensitivity
- Usually mild to moderate
- Transient in nature, resolving when treatment is discontinued 1
Less Common Side Effects
Effects on Tooth Structure
- Tooth surface roughening and softening
- Increased potential for demineralization 3
- Decreased corneal sensitivity 4
Effects on Dental Restorations
- Degradation of existing dental restorations
- Unacceptable color change in dental restorations 3
Other Potential Side Effects
- Visual symptoms including glare or starburst/halo effects
- Decreased contrast sensitivity
- Induced regular or irregular astigmatism 4
- Corneal haze or scarring (early or delayed onset) 4
Risk Factors for Side Effects
- Gingival recession is significantly correlated with increased sensitivity 2
- Inappropriate application methods
- Abuse of whitening products
- Use of inappropriate or non-dental professional supervised products 1
- Extended use beyond manufacturer's recommendations
Managing Side Effects
For Tooth Sensitivity
- Potassium nitrate application:
- Applied by brushing before initiating whitening
- Or applied via tray during whitening 5
- Temporary discontinuation of treatment
- Reduced frequency of application
- Use of fluoride-containing products 6
For Gingival Irritation
- Proper tray fit to minimize gel contact with gingival tissues
- Wiping excess gel from gingival tissues
- Temporary discontinuation if irritation becomes uncomfortable
- Anti-inflammatory rinses such as 0.1% chlorhexidine 4
Important Considerations
- Most side effects are transient and resolve when treatment is discontinued 6
- There is no evidence of significant long-term health risks associated with properly used peroxide-based tooth whitening 1
- Risks increase with inappropriate application, abuse, or use of inappropriate products 1
- Patients with pre-existing conditions like gingival recession should be monitored more closely 2
Best Practices to Minimize Side Effects
- Use dentist-supervised whitening procedures rather than over-the-counter products 6
- Follow manufacturer's instructions precisely
- Discontinue use if moderate to severe side effects occur
- Use products containing 10% carbamide peroxide, which has demonstrated safety in research 6
- Monitor for any adverse effects during treatment
- Consider pre-treatment with desensitizing agents for patients with known sensitivity 5