Frequently Asked Questions
How do you remove stains from teeth?
“Tooth enamel [is] a crystal,” Matthew J. Messina, DDS, a board-certified, Ohio-based dentist, and spokesperson for the American Dental Association (ADA), says. “If you were to look at tooth enamel under a really powerful microscope, [the structure] kind of looks like chicken wire” (or wire mesh). He explains that removing stains within the matrix of the tooth enamel is like getting out dirt stuck in chicken wire: “So what happens in whitening is we want to…open the matrix and bubble out that color, the stain, and then close it back up.” That’s where peroxide comes in.
How do teeth-whitening ingredients work?
Dr. Messina says peroxide causes the color bubbling to occur, so the active ingredient in whitening kits you buy will be hydrogen peroxide or carbamide peroxide (a diluted version of hydrogen peroxide). “Carbamide peroxide is used because it’s a comparatively stable compound,” Dr. Hadaegh says. “This helps the manufacturer to ensure product quality and consistency at the consumer’s end.” Dr. Messina notes that aside from the peroxide, over-the-counter whitening products usually contain some additional ingredients to improve the taste.
What are the differences between in-office whitening and over-the-counter whitening treatments?
Peroxide is the main active ingredient in the products dentists use to do in-office whitening in their offices, too. The only difference is the concentration. “If we’re doing something where we can mask off the gum tissue…where the gum tissues are protected, we can use a stronger whitening agent…because it’s only touching the teeth,” Dr. Messina says. “Something you’re using over the counter has the potential to touch the gum tissues or be swallowed. So, we have to use a much lower strength of the active ingredient because…it might burn [the patient’s] gum tissues.”
Dentists carrying out professional treatments, on the other hand, “can take all the necessary precautions to make sure the gum tissue is safe and protected and the whitening agent is only getting on the tooth enamel that we want whiter.” Ultimately, Dr. Messina says that all over-the-counter, peroxide-based whiteners will deliver comparable results as long as you follow the manufacturer’s instructions for use. He says you can use it for 7 to 10 days to start, and then once every other week or so for maintenance.
Any other considerations while shopping for teeth-whitening products?
The most important thing to look for when you’re shopping is ease of use, Dr. Palani says. “Also, you want to make sure that the product you buy has a good shelf life and store the product properly in the refrigerator to last longer,” Dr. Palani adds.
Am I a good candidate for over-the-counter teeth-whitening products?
Consider taking a trip to the dentist for your standard teeth cleaning and consulting with them on your at-home whitening plans. “Tooth whitening is something that should only be done in a healthy mouth situation,” he says. “If somebody has cavities or periodontal disease, or some other reason why their teeth aren’t white, whitening is not the right choice for them—that’s why it’s always good to have a thorough examination done by your dentist before starting a whitening program.”
Another benefit? If you use at-home whitening products after a dentist cleaning, Dr. Messina says you’ll be whitening the tooth enamel rather than the tartar or buildup on top of it—so you’ll achieve better results. Regardless, involving your dentist in the discussion is always a good idea.
Can yellow teeth actually be whitened?
Yellowing teeth are usually due to stains from coffee, tea, or wine, or a side effect of aging, Dr. Huang says. Luckily, these root causes “respond very well to whitening,” she says. Dr. Kairouz agrees with this, adding that graying teeth or teeth with banded staining (meaning horizontal stains that are embedded in the tooth) is a different story. These issues stem from antibiotics use or trauma to the teeth, and are much more difficult to address. Deeper, more stubborn yellow stains or discoloration are also better off being treated at your dentist’s office, Dr. Huang says.
What are the downsides of teeth whitening?
At-home whitening can increase your tooth sensitivity and irritate your gums, Dr. Huang says. It can also exacerbate existing issues, “like exposed roots or [gum] recession, which is why I always recommend making sure your teeth and gums are healthy before starting,” she says. Overuse can add to that sensitizing effect by thinning the enamel on your teeth, Dr. Kairouz notes. It can even “leave teeth looking grayer at the edges instead of brighter,” he adds. After you complete one course of your whitening kit, take a break for a week or two before considering starting another, as Dr. Messina recommended above.
It’s also important to note that teeth whiteners won’t have any effect on veneers, bonding, crowns, or fillings. “Whitening must be done with your current dental work in mind or be part of your new design,” Dr. Huang says.
Meet the experts
- Chrystle Cu, DDS, a board-certified dentist in San Mateo, California, and Cocofloss founder
- Marina Gonchar, DMD, board-certified dentist based in Morristown, New Jersey
- Neil Hadaegh, DDS, board-certified cosmetic and restorative dentist in Beverly Hills, California
- Sharon Huang, DDS, founder of Les Belles NYC Dentistry in New York City
- Clement Kairouz, DDS, cosmetic dentist based in New York and Dubai
- Pia Lieb, DDS, board-certified cosmetic dentist based in New York City
- Matthew J. Messina, DDS, board-certified dentist in Ohio
- Giri Palani, DDS, board-certified dentist in Beverly Hills and Palos Verdes, California
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