A Comprehensive Guide to Teeth Whitening

Clinical Content Reviewed by Dr. Jay Khorsandi, DDS
Last Modified:

Table of Contents

  1. Teeth Whitening
  2. Why Teeth Change Color
  3. Who is a Candidate?
  4. Types & Systems
  5. At-home vs Professional
  6. Risks
  7. Safety Tips
  8. Top-rated Brands

A bright, white smile can be key to positive self-image and mental health. Teeth whitening can get you the smile you want.

No matter how much you brush and floss your teeth, they can still change color with age, environmental exposure, and trauma. Teeth can shift from white to yellow, brown, or gray. Teeth whitening products and procedures can help to return them to a whiter color.

There are a wide variety of teeth whitening options on the market today, including home remedies, over-the-counter (OTC) products like toothpastes and gels, and professional in-office teeth whitening procedures done by your dentist.

There are some potential complications and risks for teeth whitening. Before starting any kind of treatment, be sure to talk to your dentist to determine if you are a candidate and what will be your best option.

Teeth whitening

Studies show that nearly half of people state that their smile would be the first thing they would change about themselves. People commonly hate their smile and regularly try to hide it. Often, this is related to tooth discoloration.

The American Association of Orthodontists reports that almost 90 percent of patients request teeth whitening procedures. In 2020, approximately 37 million Americans used teeth whiteners.

Teeth whitening products contain a form of bleach (either carbamide peroxide or hydrogen peroxide) in a variety of strengths and methods of application. Your teeth can become discolored as you age for a number of reasons. Bleach can work to lighten your teeth.

The process is typically simple. It can be done either at home or under the direction and supervision of a dental professional.

Why teeth change color

Your teeth can stain by coming in contact with certain things directly or as a result of changes to the makeup of your teeth. These are common causes of tooth discoloration:

  • Aging: Your enamel (the hard, white outer layer of your teeth) thins as you age, which can expose the more yellow dentin underneath.

  • Trauma: Injury to the teeth can cause them to become darker, either due to more dentin being produced or due to a lack of blood flow to the tooth, resulting in tooth death.

  • Food and drinks: Red wine, coffee, tea, and certain foods with intense color pigments can stain the teeth, as the chromogens attach to your enamel.

  • Certain medications: High blood pressure medications, antihistamines, and antipsychotics can cause tooth darkening. Antibiotic exposure in young children whose teeth are still forming can also cause teeth darkening.

  • Tobacco products: Both tar and nicotine, which are contained in tobacco products, can stain teeth yellow.

Your teeth can get darker regardless of how well you keep up with good oral hygiene practices, including teeth brushing and flossing. This may make you want to consider a tooth whitening option.

Who is a candidate for teeth whitening?

If you are over the age of 16, not pregnant or lactating, and have healthy gums and teeth that are yellowish in color, you could be an ideal candidate for tooth whitening.

Teeth that are darkly stained or more grayish in color can be harder to get white. If you have tooth decay, cavities, exposed roots, or gingivitis, you need to get treatment for these dental issues before attempting a tooth whitening program.

You should not get your teeth whitened if you are allergic to the bleach or have sensitive teeth already. Discuss your options and goals with your dentist before getting your teeth whitened. You will need to have realistic expectations for the whitening process if you are a good candidate.

Only your natural teeth can be whitened. Whitening products do not work on crowns or fillings. If you have crowns, fillings, or veneers, your dentist can help you come up with a plan to get the brightest smile possible.

Types & system

Teeth whitening systems use a bleaching agent that has a chemical reaction on and in your teeth to lighten the color. There are many different kinds of teeth whitening products and systems, both professional in-office treatments and OTC and at-home ones.

Whitening toothpastes typically aim to target extrinsic stains (on the surface of the teeth) using abrasive and mechanical methods. Some whitening toothpastes also contain a low level of bleach as a whitening agent as well.

Whitening toothpastes are generally inexpensive. You will continue to brush your teeth two times per day as usual.

Whitening toothpastes are less invasive and carry less risk than using concentrated peroxides. Instead, they rely on abrasives, enzymes, adsorbent particles, peroxides in low concentrations, or optical effect agents.

Studies show that those using blue covarine and microbead abrasives have the best tooth whitening aesthetic effect.

Whitening toothpastes can help to remove stains from teeth, but they can take longer to work than other whitening agents. They also have a less drastic impact on tooth color.

Whitening strips contain a low level of hydrogen peroxide, usually 10 percent or so. You place them on your teeth for about 30 minutes once per day.

These strips contain a bleaching gel that aims to remove stains from the outside of the teeth. They do not come in custom trays, however. They can come into contact with your gums, which can irritate them and make them more sensitive.

Teeth whitening strips are shown to be more effective than other OTC methods, including paint-on gels. The ADA accepts three whitening strip products from Crest.

OTC teeth whitening gels are painted on to your teeth with a small brush two times per day, usually for a period of two weeks. They can lighten teeth a shade or two, but it is harder to get an even application on the teeth, and your saliva can wash it away too fast.

Both gels and strips generally cost between $30 and $50 per kit.

Whitening rinses use a low concentration of hydrogen peroxide to bleach the teeth. You will usually rinse two times per day for 60 seconds each time.

It can take several months to see a noticeable difference in the color of your teeth. While these whitening mouthwashes can lighten your teeth with repetitive use, they are less effective than other bleaching agents. Whitening rinses can range between less than $5 up to $15 or so per bottle.

Teeth whitening pens can improve the color of your teeth nearly immediately, working on extrinsic stains using either hydrogen peroxide or carbamide peroxide. These pens are compact and can be easily taken on the go for a quick and easy application.

For best results, use one to two times per day. Refrain from rinsing your mouth or eating or drinking for an hour or two after use.

Whitening pens can be a good touchup option after a professional whitening procedure. They can also be used on their own to lighten teeth up to a few shades.

Typically, hydrogen peroxide-based whitening pens will produce a quicker maximum whitening effect over carbamide peroxide-based solutions. These pens generally cost around $20 on average.

Teeth whitening systems using a tray can be either professional, coming from your dentist, or purchased over the counter. The trays contain a bleaching agent — 10 percent carbamide peroxide is shown to be most effective with the least amount of adverse effects.

These trays are fitted to your teeth. Your dentist can make you custom ones. They are often worn overnight or at least two to four hours per day for optimal results.

Tray-based teeth whitening systems can lighten your teeth one to two shades in just a few uses. The bleaching agent can make your teeth and gums more sensitive.

Whitening trays can cost between $100 and $500 on average, depending on what type and whether or not you are using a professional or OTC system.

There is some anecdotal evidence that using an LED light along with a tooth whitening tray can speed up the chemical process and lead to brighter and whiter teeth. While using an LED light during professional teeth whitening can be initially effective, long-term at-home use does not seem to be much different than regular tray-based whitening systems.

Research is unclear on if adding a light-activating source to a tooth whitening system will produce better results than the whitening system on its own.

An in-office professional teeth whitening procedure uses a higher concentration of the bleaching agent than over-the-counter products can contain. It therefore only takes one or two sessions to see brighter and whiter results.

A dental professional will apply the whitening agent, often with a syringe, to your teeth. They will leave it on for periods of 15 to 30 minutes at a time, for up to 1.5 hours total. A high-intensity light may be used to speed up the process.

In-office/professional teeth whitening procedures are highly effective, but they may cause your teeth to become more sensitive and can irritate your gums.

An in-office professional whitening treatment costs an average of $800 to $1,000 per treatment. While more expensive, it is also more effective than OTC whitening products.

There are many home remedies related to whitening your teeth without specific whitening products. Using hydrogen peroxide mixed with baking soda as a toothpaste is a popular choice. You can also use baking soda on its own to make a paste to brush with.

Apple cider vinegar is another home remedy for tooth whitening. However, this is an extremely acidic compound that can damage the enamel of your teeth and actually cause them to look darker, not whiter.

When used sparingly, these remedies can potentially reduce some of the light stains on your teeth. They will not have as drastic an effect as professional and OTC whitening options.

At-home remedies are not going to be as effective as a professional tooth whitening procedure.

At-home vs. professional/dentist-supervised

At-home whitening systems can be less expensive than professional and dentist-supervised procedures. They also often use a lower concentration of the bleaching agent, which can have pros and cons.

The upside is that a lower level of bleach will have fewer potential side effects and risk factors. The downside is that it will also be less effective and take longer to see results.

With a professional whitening procedure, you will likely only need one, or two, sessions to achieve that whiter smile. At-home products can take much longer to achieve the desired results. When a dentist is involved in your whitening process, they can help to make sure your teeth are safe and that the product works best for you.

Risk & complications

One of the most common side effects of teeth whitening is tooth sensitivity. Your teeth can feel sensitive to hot and cold temperatures for several days after treatment. The more concentrated the bleach solution, the more sensitive your teeth can feel; however, it is typically a temporary sensation.

If the whitening agent comes in contact with your gums, this can cause gingival irritation and a burning sensation. This is also temporary and goes away after a few days. It is most likely caused by an improper application of the whitening product or trays that are not fitting correctly.

Teeth whitening products that are sold over the counter and not directly supervised by your dentist can be harder to regulate. They can possibly interact negatively with your teeth. Concentrations on these products varies widely.

Teeth whitening products can potentially cause the following:

  • Enamel erosion and softening of the teeth

  • Mouth infections

  • Gingival recession

  • Burns and blisters on the gums

  • Tooth nerve damage

Teeth whitening products can also sometimes have the opposite effect, making your teeth darker instead of lighter.

Teeth whitening safety tips

It is always best to talk to your dentist before starting any kind of teeth whitening plan. Certain products can be better for your specific teeth than others. If you have any dental issues or restorations, you will need to discuss treatment options and expectations with your dentist prior to whitening.

For best results with teeth whitening, be sure to read and follow all instructions from the manufacturer. Use the product exactly as directed.

Try to keep the whitening gel off your gums. Do not overuse whitening products, as this can cause damage to your gums and teeth.

Most popular & top-rated brands

Disclaimer: This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to serve as dental or other professional health advice and is not intended to be used for diagnosis or treatment of any condition or symptom. You should consult a dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.