Whitening products contain hydrogen peroxide or carbamide peroxide as the active ingredient. Tooth sensitivity has been commonly reported in clinical studies; its cause is not fully known (Sakaguchi & Powers, 2012). Safety data have been evaluated in reviews (Dahl & Pallesen, 2003; Li, 1998).

Conditions that affect sensitivity

• Exposed root surfaces and gum recession (see gum recession)
• Cracked or worn enamel
• High concentration and long application time

Safety notes

Safety questions have been addressed for applications with night guards (Haywood & Heymann, 1991; Dadoun & Bartlett, 2003). The gum can show chemical irritation; therefore tray fit and protection are important. Long-term low-dose effects are not fully known (Sakaguchi & Powers, 2012).

What can be done?

• Desensitizing products recommended by the dentist
• Temporarily avoiding very hot/cold foods
• If the complaint continues, pause the application and see the dentist

Why does sensitivity occur?

Peroxide can pass through enamel and dentin tubules to the pulp and cause temporary sensitivity in the tooth. Although the exact mechanism of sensitivity is not known, it is commonly reported in clinical studies (Sakaguchi & Powers, 2012; Dahl & Pallesen, 2003). This sensitivity is mostly temporary and decreases after the application ends.

People at risk

Complaints can be more marked in people with previous sensitivity, thin enamel, cracked or worn teeth and exposed root surfaces. In patients with gum recession, a dentist’s evaluation before whitening is especially important.

What can be done to reduce sensitivity?

• Desensitizing products (with potassium nitrate or fluoride) recommended by the dentist
• Shortening the application time or doing it at intervals
• Preferring low-concentration products
• Temporarily avoiding very hot and very cold foods

Gum and safety

Peroxides can cause chemical irritation in the gum; therefore trays must be prepared correctly and the gum protected (Sakaguchi & Powers, 2012). Reviews on safety have discussed the risks of uncontrolled, long-term use (Dadoun & Bartlett, 2003; Li, 1998). That is why it is recommended that products be used under dentist control.

Frequently asked questions

How long does sensitivity last?

It is mostly temporary; duration varies from person to person.

Is whitening done during pregnancy?

Consulting your dentist is recommended.

Is buying a product for home enough?

For safety, applications under dentist control are recommended; for basic information see our article on in-office whitening.

Does sensitivity become permanent?

In most cases it is temporary; if it persists a dentist check is needed.

Should I use a painkiller for sensitivity?

Do not use medication except on the dentist’s advice.

What should I do if there is pain during whitening?

Stop the application and see your dentist.

You can book an appointment or browse the other articles in our Dental Health section. You can reach us from Bahçelievler, Bakırköy, Güngören, Haznedar, İlkyuva, Basınsitesi and the European side.

References

• Sakaguchi, R. L., & Powers, J. M. (Eds.). (2012). Craig’s restorative dental materials (13th ed.). Elsevier Mosby.
• Dahl, J. E., & Pallesen, U. (2003). Tooth bleaching: A critical review of the biological aspects. Critical Reviews in Oral Biology & Medicine, 14(4), 292–304. PubMed ↗
• Haywood, V. B., & Heymann, H. O. (1991). Nightguard vital bleaching: How safe is it?. Quintessence International, 22(7), 515–523. PubMed ↗
• Dadoun, M. P., & Bartlett, D. W. (2003). Safety issues when using carbamide peroxide to bleach vital teeth: A review of the literature. European Journal of Prosthodontics and Restorative Dentistry, 11(1), 9–13. PubMed ↗
• Goldstein, G. R., & Kiremidjian-Schumacher, L. (1993). Bleaching: Is it safe and effective?. Journal of Prosthetic Dentistry, 69(3), 325–328. PubMed ↗
• Li, Y. (1998). Tooth bleaching using peroxide-containing agents: Current status of safety issues. Compendium of Continuing Education in Dentistry, 19(8), 783–792. PubMed ↗

Note: Book chapter references follow the page ranges of the publisher’s edition; article links open the matching PubMed record.

This article is for information only and is not medical advice. See your dentist for diagnosis and treatment; no outcome is guaranteed.

This page was reviewed by Dr. Dt. Mehmet Fuat Bozaba, periodontist.