Whitening toothpaste damages enamel

Whitening toothpaste damages enamel?
Okay, so I’ve been using whitening toothpaste for a while now – maybe six months? I really want to get my teeth a few shades lighter, and it seemed like the easiest option. I’ve noticed my teeth are feeling a little more sensitive lately, especially to cold drinks. Is it possible that the whitening toothpaste is actually damaging my enamel? I’ve heard that some of them are really abrasive. I’m using [Name of toothpaste, if known, otherwise say a common brand like Crest Whitening or Colgate Optic White] right now.
Does anyone know what ingredients in whitening toothpaste are most likely to cause damage? Are there certain types I should avoid? Are there any other options for whitening my teeth at home that are gentler on the enamel? I don’t want to end up with permanently sensitive teeth just to have them be a little whiter! Should I just switch back to regular toothpaste?

Answer

Whitening toothpastes do not typically "damage" enamel in the sense of causing significant structural weakening or irreversible loss of enamel in the short term, like dental erosion from acid. However, the use of whitening toothpastes can, over time and with improper use, contribute to enamel wear and increased tooth sensitivity.

Here’s a detailed breakdown of how whitening toothpastes interact with enamel and the potential risks involved:

How Whitening Toothpastes Work:

Whitening toothpastes primarily work through two mechanisms:

• Abrasives: The majority of whitening toothpastes rely on abrasive particles to physically scrub away surface stains (extrinsic stains) caused by coffee, tea, tobacco, food pigments, and other substances. Common abrasives include hydrated silica, calcium carbonate, dicalcium phosphate, and alumina.
• Chemical Action: Some whitening toothpastes contain chemical agents, most commonly peroxide compounds such as hydrogen peroxide or carbamide peroxide. These chemicals help to break down stains on the tooth surface. However, the concentration of peroxide in over-the-counter whitening toothpastes is significantly lower than that used in professional dental whitening treatments.

Potential Effects on Enamel:

• Abrasion and Enamel Wear: The abrasive particles in whitening toothpastes, while necessary for stain removal, can gradually wear down the enamel surface with repeated, aggressive brushing. The level of abrasiveness is measured by a scale called Relative Dentin Abrasivity (RDA). Toothpastes with higher RDA values are more abrasive. Prolonged use of highly abrasive toothpastes, especially with excessive brushing force or hard-bristled toothbrushes, can lead to enamel thinning over time. This thinning can expose the underlying dentin layer, making teeth more susceptible to sensitivity and further damage.
• Sensitivity: Enamel wear caused by abrasive whitening toothpastes can lead to increased tooth sensitivity. When the protective enamel layer is thinned, the dentin tubules (microscopic channels leading to the nerve of the tooth) become more exposed. This allows hot, cold, sweet, or acidic stimuli to reach the nerve more easily, triggering a sensation of pain or discomfort. Some whitening toothpastes also contain ingredients that can contribute to sensitivity, even without significant enamel loss.
• Acidity: Some whitening toothpastes may have a slightly acidic pH. While the acidity is typically buffered by saliva, prolonged exposure to acidic toothpastes, particularly in individuals with already compromised enamel or reduced salivary flow, could potentially contribute to enamel softening or demineralization.
• Effectiveness: It’s also important to note that whitening toothpastes primarily address surface stains. They are generally not effective at removing deeper, intrinsic stains that are embedded within the tooth structure. To achieve more significant whitening results, professional dental treatments, such as bleaching with higher concentrations of peroxide, are typically required.

Minimizing Risks:

To minimize the potential risks associated with whitening toothpastes, consider the following:

• Choose a toothpaste with a lower RDA value: Look for toothpastes that are specifically labeled as "low abrasion" or have an RDA value within the recommended range.
• Use a soft-bristled toothbrush: A soft-bristled toothbrush is gentler on enamel and gums than a medium- or hard-bristled brush.
• Brush gently: Avoid applying excessive pressure when brushing. Use a circular motion and focus on cleaning each tooth surface thoroughly but gently.
• Limit the frequency of use: Consider alternating between a whitening toothpaste and a regular fluoride toothpaste. Use the whitening toothpaste only a few times a week, or as directed by your dentist.
• Consult your dentist: If you have concerns about tooth sensitivity or enamel wear, consult with your dentist. They can assess your oral health, recommend appropriate toothpaste, and provide personalized advice on brushing techniques.
• Consider professional whitening: If you desire more significant whitening results, talk to your dentist about professional whitening treatments, which are typically more effective and can be performed under controlled conditions to minimize the risk of enamel damage.
• Fluoride Toothpaste: Always ensure the whitening toothpaste contains fluoride, as fluoride helps strengthen enamel and protect against decay.

In summary, while whitening toothpastes can contribute to enamel wear and sensitivity with improper use, they don’t typically cause major structural damage to enamel in the short term. The key is to use them judiciously, choose less abrasive options, employ proper brushing techniques, and consult with a dentist if you have any concerns.