Teeth Whitening in Dental Care Practices

Donna Jalai, Aimee Park, Trinity Low

Project Smile Global

23 July 2025

Dentistry encompasses a wide variety of treatments, ranging from purely health-centred to purely cosmetic, and oftentimes, both. Teeth whitening is one of the most commonly sought-after cosmetic dental procedures. Teeth whitening is the process of whitening tooth enamel to give the overall tooth a whiter appearance, and it is a booming industry within the dental field. There are different avenues to teeth whitening, which can provide accessibility to many communities, including those struggling with dental disparities. Teeth whitening can be performed professionally in dental offices, using prescription-strength products, over-the-counter products intended for home use, and various natural remedies from multiple cultures (Carey 72). This article examines various methods of teeth whitening, including the advantages and disadvantages of undergoing whitening treatments, as well as strategies for maintaining a whiter smile.

Teeth whitening, unlike other dental procedures, is purely cosmetic. However, while there are no physical health benefits to teeth whitening, there are mental health benefits, as whiter teeth are often deemed more attractive and can boost self-confidence. Just as having straighter teeth is considered ideal in the dental world, having a whiter smile is also considered ideal, which aligns with beauty standards in most societies. Professional teeth whitening procedures, typically only done in a dentist’s office, are the most effective but come with some caveats. Many patients have reported increased sensitivity after professional tooth whitening procedures. At the same time, this typically resolves after a short while; however, some patients have reported experiencing prolonged sensitivity after an in-office professional whitening procedure (Pitz et al. 119). For those with especially sensitive teeth, at-home whitening procedures may be a more beneficial approach to avoid further sensitivity and still achieve a bright smile. While at-home treatments are not quite as effective as a two-hour procedure done in office, consistency in at-home products like whitening strips and UV light products can achieve similar results over a more extended period, and this is especially true as dental technology expands and advances, with brands like Crest releasing new whitening products almost every year (Santos 4). 

Furthermore, at-home teeth whitening treatments can offer more attainable solutions for individuals with yellow teeth. Office whitening treatments can be expensive and are often not covered by most insurance plans, so many people opt for over-the-counter whitening products from dental companies or use home remedies to achieve a brighter smile. One study evaluated the effectiveness of office whitening procedures or at-home whitening kits with shorter treatment durations compared to products with longer treatment durations, such as whitening toothpastes or at-home remedies. The study found that take-home products achieved longer-lasting and more sustainable results than in-office treatments; however, the take-home products had to be used between 7 and 140 hours, which is a significantly longer time frame to achieve these results (Zhao et al. 1139). This study highlights the effectiveness of consistency with teeth whitening and indicates that in-office treatments are unnecessary to achieve a whiter smile. These conclusions from the study can help educate individuals on dental whitening and informing patients that they can achieve their whitening goals at home, aiding both their finances and their overall satisfaction with the results, as well as making the treatment more accessible to people of lower incomes and allowing patients to have autonomy of the level of whiteness they wish to achieve. 

The natural colour of teeth can vary from gray-white to yellow. Tooth discoloration can develop for several reasons, with the two leading causes being extrinsic and intrinsic discoloration. Extrinsic discoloration affects the outermost surface of teeth, the enamel, and is attributed to environmental factors such as certain foods and beverages. Foods with high acidity or intense pigments tend to stain the teeth more easily due to their ability to penetrate and discolour the enamel. Some examples include coffee, tea, and tomato sauce. This is why eating certain foods is highly discouraged after teeth whitening, because it may have adverse effects and reverse the whitening process. Intrinsic discoloration begins inside the tooth, affecting the dentin layer underneath your enamel (Cleveland Clinic). The causes may stem from dental trauma or specific medications. Tetracycline is an antibiotic that was widely administered in the 1950s to treat various infections. Children exposed to antibiotics during pregnancy or the early years of tooth development may experience discoloration, resulting in permanent gray, brown, or yellow stains below the gum line. The enamel becomes stained as tetracycline binds with calcium during the mineralization and calcification process. Sunlight also affects tooth colour, so it is not uncommon for anterior teeth to have greater discoloration (Archibald).

Teeth whitening most commonly involves the use of carbamide peroxide and hydrogen peroxide. Bleaching is chemically induced when reactive oxygen molecules derived from hydrogen peroxide interact with the coloured compounds within the enamel and dentin through an oxidation process. This process addresses intrinsic stains because hydrogen peroxide diffuses through the enamel, allowing passage to the pulp within 15 minutes of exposure (American Dental Association). The effectiveness of whitening depends on factors such as the method used, the severity of the stains, and the individual’s tooth structure (Carey 74).

While teeth whitening is effective, several safety issues should be considered, particularly with peroxide-based materials (Li et al. 29). As mentioned earlier, most dental practices and commercial products utilize hydrogen peroxide. Although it has been proven to be generally safe and effective when used properly, common side effects include tooth sensitivity and gingival irritation (Li et al. 33). Studies have shown that there are no associated health risks with the procedures. However, patients and commercial manufacturers should use hydrogen peroxide appropriately rather than abusing it (Carey 73). 

In conclusion, teeth whitening has become a popular cosmetic procedure, yielding promising results for many. Accessible through dental procedures or at-home methods, both are fast and effective. Store-bought, commercial products offer an alternative way for more patients to access the procedure, especially for individuals with financial concerns. While teeth whitening has been proven to be generally safe, the use of excessive peroxide-based materials should be cautioned. Ultimately, teeth whitening is a testament to the ever-evolving field of dentistry, demonstrating how dental procedures are continually improving to be more affordable and effective.

References

Archibald, Jennifer. “Tetracycline Teeth: Staining Effects & How to Re-Whiten.” Healthline, 15 June 2021, https://www.healthline.com/health/tetracycline-teeth. Accessed 14 June 2025.

Cleveland Clinic. “Tooth Discoloration: Causes, Treatment & Prevention.” Cleveland Clinic,  24 05 2024, https://my.clevelandclinic.org/health/symptoms/10958-tooth discoloration. Accessed 7 June 2025.

Carey C. M. (2014). Tooth whitening: what we now know. The journal of evidence-based dental practice, 14 Suppl, 70–76. https://doi.org/10.1016/j.jebdp.2014.02.006

Li, Y., & Greenwall, L. (2013). Safety issues of tooth whitening using peroxide-based materials. British dental journal, 215(1), 29–34. https://doi.org/10.1038/sj.bdj.2013.629

Pitz, Kristel, et al. “Comparison of In-Office and at-Home Tooth-Whitening Products Cytotoxicity.” Annals of Medicine (Helsinki), vol. 53, no. S1, 2021, pp. S119–S119, https://doi.org/10.1080/07853890.2021.1895580.

Santos, Mariana Evangelista, et al. “At-Home Bleaching versus Whitening Toothpastes for Treatment of Tooth Discoloration: A Cost-Effectiveness Analysis.” Journal of Applied Oral Science, vol. 32, 2024, pp. e20230336–e20230336, https://doi.org/10.1590/1678-7757-2023-0336.

Wallace, S. “Teeth holding shade guide.” Stephen Wallace Dental Excellance. https://www.stephenwallacedds.com/services/teeth-whitening/ Accessed 15 July 2025.

Zhao, Xiaoyi, et al. “Treatment Durations and Whitening Outcomes of Different Tooth Whitening Systems.” Medicina (Kaunas, Lithuania), vol. 59, no. 6, 2023, pp. 1130, https://doi.org/10.3390/medicina59061130.