Home truths about Australians and teeth whitening

Released to mark this year's World Oral Health Day, new consumer findings uncovered by the Australian Dental Association (ADA) has revealed some home truths about Australians and teeth whitening.

Of a survey sample of 25,000 Australian adults conducted for the ADA, the peak dental body found that 22% of us have whitened our teeth - an 8% increase since it first started recording this data in 2017.

More than twice as many women than men have teeth whitened, and it's most popular in the 24-34 year-old age group.

But as of 2021, whitening treatments done by dentists is a downward trend with unfortunately only 1 in 3 adults whitening their teeth under the supervision of a dental professional – with 19% of respondents using take-home kits and 14% opting for in-clinic whitening.

The other two thirds of Australians teeth whitened by other means, with all three of these methods on the rise:

- 39% bought a teeth whitening kit online,

- 16% bought an over-the-counter product like strips or gel from a pharmacy or supermarket, and

- 9% used whitening services provided by someone other than a dental professional.

Home truths about teeth whitening

"The theme for WOHD is 'Be Proud of Your Mouth', and people seem to be trying to do this by undertaking cosmetic procedures to lighten their teeth," said Dr Mark Levi, ADA spokesperson and Sydney dentist who focusses on whitening procedures.

"But as people do so, the ADA has unmasked some home truths about teeth whitening based on tracking of consumer oral health habits.

"The problem with home treatments that are not supervised by a dental professional or being treated by someone other than a dental professional is that you're exposing yourself to a range of injuries including soft tissue burns from peroxide, extreme pain if the bleach gets into a crack or hole, blotchiness and damaged enamel - and even swallowing the bleach.

"A high percentage of my patients who've tried to whiten their teeth themselves report pain - but when done correctly, there shouldn't be any pain. That's why seeing a dentist for teeth whitening is best."

He added: "People need to get their oral health assessed first to ensure there are no cracks in teeth, untreated dental decay, leaking fillings or other unresolved dental issues that could cause pain, discomfort, damaged nerve pulp - or even more serious problems down the track."

Issues with off-the-shelf treatments

One problem with buying off-the-shelf products is that you may not know how effective that product will be. As Emeritus Professor Laurie Walsh from UQ's School of Dentistry reports, "the blue light sold with peroxide whitening gels speeds up the tooth whitening process by warming the gel or even better, by using special light-based chemistry.

"But there are some peroxide products on the market where the gel does not include chemicals that these lights will work on, so they're essentially being sold as a gimmick."

Another issue is that in some products the bleach trays are not customised to mouth shape so with a one-size-fits-all tray, peroxide from the bleach can escape and burn the mouth's soft tissue, or worse, be ingested.

"Sometimes too high a concentration of peroxide in the bleach is used and many of the online and off-the-shelf products are unregulated so it's a bit of a wild west and you take a chance with them as you just don't know how well they will work," said Dr Levi.

A further concern is that online and over-the-counter products sometimes make claims of using 'all natural' ingredients, which do not stand up to scrutiny - some products contain sodium chlorite, an industrial chemical also used in swimming pool cleaning.

Dr Levi added: "Nor do many people know that whitening doesn't alter the shade of existing fillings, veneers, crowns or artificial teeth such as dentures which are already in the mouth. Yet there are no clear warnings of this lack of effect visible on sale websites or on over-the-counter products.

"The safest option recommended by the ADA is to see a dentist to assess your mouth first, to see if it is suitable for whitening and for any problems to be fixed. Then you can decide with your dentist on a course of action to ensure you get the best outcome."

The ADA has long held serious concerns about this unregulated space and has written to the ACCC on several occasions about the availability of teeth whitening products that contain illegally high concentrations of hydrogen peroxide or carbamide peroxide which have no safety warnings, as well as concern over false advertising claims about the nature of product ingredients, the extent of the whitening effect consumers can expect, and the claimed expertise of non-dental practitioner teeth whitening service providers.

As the peak dental body, the ADA has asked that the ACCC and its regulators act to better protect Australian consumers by enforcing compliance with relevant Australian laws and educating consumers about the health risks associated with undergoing teeth whitening procedures without first seeking the advice of a dental professional.

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