Natural Beauty—Worry-free Tooth Whitening

By Sharon Epel

It’s the end of the day, and I’m standing in front of my bathroom mirror, painting my teeth. I dip a dainty brush into a small bottle and carefully stroke each yellowing incisor. The almost tasteless white gel fizzes up over my bared teeth, and just as quickly dissipates. I resist the urge to rinse—per the instructions on that petite bottle. But just before I switch off the bathroom light, it occurs to me that I have no idea what I’ve left to sit overnight on my teeth.

I grab the bottle again, seeking reassurance, but what I read on the label offers none: glycerin, carbopol, sodium phosphate, phosphoric acid, and—wait a minute—hydrogen peroxide. Isn’t that a free radical, one of those dangerously unmoored molecules linked to cancer and many other diseases? Could I be unwittingly releasing toxins into my body? I quickly rinse my defenseless teeth, directions be damned. Forget cleaner, brighter teeth—what am I doing to my health?

The answer surprised me. Sure, the mainstream American Dental Association okays the use of brighteners, citing research on their safety and effectiveness. But the happier news is that holistic dentists, whom you’d expect to be wary, are bullish on them, too. Not only is it absolutely safe to use teeth-bleaching products as directed, they say, but most of these dentists offer their patients the same whitening procedures.

“A lot of people are so darn skeptical of so many modalities in dentistry, and by all rights they should be,” says James Medlock, a holistic dentist in West Palm Beach. “But bleaching is one technique you don’t need to worry about. It’s hypoallergenic and very safe, too.” Victor Zeines, the holistic dentist who created the Natural Dentist line, agrees. He finds peroxide-based whiteners so effective and safe that he hasn’t bothered to develop an alternative. “Bleaching is one of the few harmless things that have come out of conventional dentistry,” he says.

Here’s why: That odd fizzing on my teeth was the hydrogen peroxide breaking down into oxygen and water. The oxygen immediately penetrated my tooth enamel and bonded to the stain molecules, lifting them and whitening my teeth. The whole process takes no longer than an instant, which explains why most peroxide-based bleaching systems require repeated applications to be effective. But the speed also explains why they’re harmless—the peroxide oxidizes and dissipates too quickly to enter the bloodstream.

“Hydrogen peroxide doesn’t remain a free radical for long because it binds so quickly with the stain molecules,” says Walter Jess Clifford, of Clifford Materials Reactivity Testing, a Colorado Springs firm that tests dental materials for immune and allergic reactions. “The mouth doesn’t absorb enough of these very weak free radicals to make a hill of beans of a difference.”

This is good news, even for those who don’t stay up at night reading ingredient labels. In the last five years, tooth whitening in this country has increased by more than 300 percent, according to the American Academy of Cosmetic Dentistry. I can see why. I started noticing the effects of my 20-year-old coffee-and-tea-drinking habit last summer, and have felt mildly self-conscious about my dimming smile ever since. It doesn’t help that practically everyone I meet these days seems to be flashing brighter smiles. “Whiter teeth present an aura of confidence and health,” says Medlock. Apparently, lots of people agree.

If you’re ready to take the peroxide plunge, it’s easy to feel overwhelmed by all the options. Many dentists offer custom bleaching, which includes fitted trays, bleaching gels, and often a laser light or heat-light treatment that speeds up the process. And you can find a vast array of other choices in almost any drugstore.

A general rule of thumb is that the more money you spend, the faster and more effective the whitening experience. But because this purely cosmetic procedure is not covered by insurance, many people opt for the over-the-counter route instead. And why not? I was reasonably happy with the results of my cheap paint-on job, and most other options seem to work fine, too—if you’re willing to put in the time.

Be warned that whiteners—whether administered by you or your dentist—may not work for everyone: They probably won’t lighten dental work like crowns and veneers, nor will they brighten gray or patchy stains caused by tetracycline or fluoride. But if it’s common stains you’re tackling, even the least expensive option can offer some improvement.

To help you sort through the various whiteners, we asked the staff of Alternative Medicine and a holistic dentist to put them to the test.

In the Dentist’s Chair
Product:
Whitening gel activated by laser, heat-light, or “blue” light
Cost: $400-$600

Description: The quickest—but costliest—bleaching method administered by dentists. First, the dentist places two carbamide-peroxide-gel-filled trays on your upper and lower teeth; then he or she uses heat-generating laser or plasma-arc lights to activate the bleaching process. Dentists who use a procedure patented by a company called BriteSmile apply bleaching gel directly to your teeth, without using any trays. With either method you’ll have whiter teeth in about an hour.

If you go the tray route, you’ll then take home the trays and extra gel so you can do touch-ups at home. To maintain a BriteSmile grin, you’ll need to use their whitening toothpastes, mouthwash, and a Sonicare rechargeable toothbrush (a starter kit, including toothbrush, adds $180 to the total cost).

A dentist weighs in: “You’re paying a premium for the speedy brightening,” says David Biles, a holistic dentist in Santa Cruz, California. And unless you go with BriteSmile you still need to continue using trays to keep your teeth white. Though BriteSmile notes that coffee, teas, and colas may darken teeth again, it claims that with regular dental cleanings and the use of its maintenance whitening products, your teeth should stay white for up to two years.
Our take: May be worth it if you suddenly need whiter teeth (say you’ve decided to attend your high-school reunion at the last minute). Otherwise, it would be cheaper to go with our next option, custom-fitted dental trays.

Product:
Custom-fitted dental trays and whitening gel
Cost: $300-$450

Description: Your dentist takes a mold of your teeth and creates upper and lower fitted dental trays. You fill them with professional-strength carbamide peroxide gel and wear them for one hour every day for a couple of weeks. (You’ll get faster results if you wear them all night while sleeping.) You can buy more gel, as needed, from your dentist and reuse the trays to touch up your teeth for years to come.
A dentist weighs in: “Wearing the trays for a few weeks gives you the same results as the more expensive laser-light method,” says Biles.
Our take: Whitens teeth beautifully and gives you the tools you need to perform at-home touch-ups. It’s also more economical than the laser-light method. “Once you go through the hassle of getting the mold made, keeping up with the bleaching process is easy,” says the husband of one staffer. He keeps his teeth bright by wearing the dental trays nightly one week every year.

Over the Counter
Products:
Gel in strips, one-size-fits-all dental tray, or a paint bottle
Cost: $15-$45

Description: These products whiten teeth with peroxide suspended in a benign gel; the difference lies in how you apply that gel to your teeth. Some deliver it through a plastic, Band-Aid-like strip that you wear on your teeth for up to 30 minutes each day for two weeks. Others offer a two-week supply of disposable one-size-fits-all dental trays and bleaching gel; you fill a tray and then wear it on your teeth for 20 minutes a day for two weeks. A third method gives you a bottle of bleach and a brush and requires you to paint the bleach on your teeth once or twice a day, post-brushing, for a couple of weeks.
A dentist weighs in: They all have the same ingredients and theoretically ought to work. The trouble is, they’re time-consuming and most people don’t follow through, says Biles. “Still, if some people want to whiten their teeth economically, this is where I’d steer them.”
Our take: Overall, we preferred the teeth painting method because it was easiest to use. While the strips earned one devoted fan (“I’m using these again!”), other testers found that they could be cumbersome and occasionally messy, as was the one-size-fits-all tray. The biggest complaint was finding the time to use them. “No way could I carry on a conversation,” said one tray-user. But everyone who stuck with them got good results—from all three.

Product:
Toothpastes
Cost: Approximately $3-$7 for a 6-ounce tube

Description: The pastes and gels use mildly abrasive ingredients, such as silica, baking soda, and bamboo powder, or a low concentration of hydrogen peroxide, to remove external stains.
A dentist weighs in: “Over a long period of time they may give you some benefits, but most patients don’t find a whole lot of change with whitening toothpastes,” says Biles. “The material isn’t at a very high concentration, and merely brushing teeth a minute or two [a couple of times a day] isn’t enough time for the exposure.”
Our take: The cheapest but least satisfying route. We found that brushing with the pastes for a few weeks didn’t result in any noticeable difference. But a couple of staffers who’ve used whitening toothpastes for a few years swear by them. As with any of the over-the-counter products we looked at, the more time you put into using it, the pearlier your whites will be.