Teeth Bleaching Safety in Healthy Adults
Teeth bleaching is safe for healthy adults when performed under dental supervision, though it commonly causes transient tooth sensitivity and gingival irritation that resolve after treatment cessation. 1, 2
Evidence for Safety
The safety profile of professionally-supervised bleaching is well-established:
10% carbamide peroxide solutions used in nightguard vital bleaching have demonstrated tissue-healing properties and reduction of plaque and gingivitis in clinical studies, with no detrimental side effects reported. 2
Multiple studies examining dentist-prescribed home bleaching with carbamide peroxide (10%) or hydrogen peroxide found no evidence of toxicity or damage to hard or soft tissues when administered properly under dental supervision. 2, 3
The bleaching agents effectively whiten teeth over short time periods (2 weeks to 6 months) compared to placebo, though the certainty of evidence is low to very low. 4
Common Side Effects (Transient and Mild)
Tooth sensitivity and oral irritation are the most common side effects, occurring more frequently with higher concentrations of bleaching agents, but these effects are mild and transient. 4
Sensitivity typically resolves after discontinuation of treatment. 1
Gingival irritation is concentration-dependent and self-limiting. 4
These side effects do not constitute permanent harm to dental structures. 2
Critical Safety Requirements
Bleaching requires proper examination, diagnosis, and treatment planning by dental professionals to maximize efficacy and minimize potential risks. 1
Dentist-supervised bleaching is safer than non-professional alternatives available at mall kiosks, salons, spas, and cruise ships. 1
Professional oversight ensures appropriate concentration selection, proper application technique, and monitoring for adverse effects. 3
A properly fitted delivery prosthesis (tray) is essential for controlled application. 3
Potential Concerns (Theoretical)
While current evidence supports safety, some theoretical concerns exist:
Hydrogen peroxide may potentiate carcinogenic effects of known carcinogens, though clinically relevant long-term studies are lacking. 5
Bleaching agents may have transient effects on tooth structure and some dental restorative materials. 5
Soft tissues exposed to hydrogen peroxide for prolonged periods show changes consistent with inflammation or hyperplasia. 5
Clinical Recommendations
When bleaching is performed with dentist-prescribed, home-applied products using proper examination, correct diagnosis, properly fitted prosthesis, and appropriate monitoring, it is as safe as other accepted dental procedures. 3
Use 10% carbamide peroxide as the standard concentration for home bleaching, as this has the most established safety profile. 2, 3
Avoid over-the-counter products without professional supervision, particularly those with unclear concentrations or application protocols. 1
Monitor patients during treatment for sensitivity or irritation and adjust concentration or frequency as needed. 1
Common Pitfalls to Avoid
Using non-professionally supervised bleaching products increases risk without proper diagnosis or monitoring. 1
Applying higher concentrations than necessary increases side effects without proportional benefit. 4
Failing to assess for contraindications (existing tooth sensitivity, gingival disease, defective restorations) before initiating treatment. 1
Prolonged or excessive use beyond recommended treatment duration. 5