Teeth whitening has become one of the most popular cosmetic procedures, but some people may be overstepping the line in their quest for the perfect smile.
According to recent news reports, the public's obsession with pearly whites has led to excessive teeth whitening -- a condition some call "bleachorexia."
Bleachorexia is not a dental term, nor is it a new problem, said Matthew Messina, DDS, a spokesperson for the ADA. It refers to people who whiten their teeth more than recommended and risk damaging their teeth in the process.
According to Kellee Stanton, DDS, spokesperson for the American Academy of Cosmetic Dentistry (AACD), the term means overuse of bleaching and whitening agents and refers to people with an unrealistic idea of how white teeth should be.
— Matthew Messina, DDS, ADA
spokesperson
"Anytime you do anything in excess, you lose track of reality," she said. "With some patients, their teeth will be as white as possible, as white as the whitest dental ceramic materials or as the purest white found in nature, but they will still feel their teeth are yellow."
According to Dr. Messina, when it comes to aesthetics, some people can get a psychological attachment. People whiten for all kinds of reasons, such as a date or a job interview, but for some it becomes habitual and they go into excessive bleaching, he said.
"It's useful to remind people that even though teeth whitening is safe and effective, it should not be done all the time," he stressed.
Too much accessibility to over-the-counter products, such as whitening gum, strips, toothpastes, and mouth rinses, has made it easy for people to bleach their teeth excessively, Dr. Stanton added.
Signs of overbleaching
Excessive bleaching can irritate periodontal tissue, which can become red, inflamed, and sore, Dr. Messina noted. Trays that haven't been custom fitted can move around and cause issues such as gum recession. Also, too much bleaching can damage enamel and teeth can become translucent and start appearing almost blue in color.
According to Dr. Messina, if patients' teeth are blue, they'll want to whiten them more, but that will only make the situation worse. It is important to tell patients that they need to stop bleaching if they want to restore color.
"Talk about their whitening history and get them to be honest," he explained. "Apprise them of the dangers of overbleaching, and if they are showing signs of overbleaching, point out the problem."
Dr. Stanton also warns of side effects that come with excessive bleaching. Sometimes peroxide can irritate the gums and they can have small burns on them, she said. In addition, excessive bleaching can expose the under layer of the tooth because of enamel thinning, making the teeth look even more yellow. Also, dentists should be alert for patients whose teeth are smooth and shiny because natural teeth have ridges, she noted.
"I would talk to the patients about what I see and tell them where their teeth would end up if they keep doing this," Dr. Stanton said. "Ask them what they are using and ask them to do it less and cut back."
For initial whitening, it is safe to bleach for seven to 10 days, according to Dr. Messina; after that, once and not more than twice a month. This applies to both at-home and in-office bleaching, he noted.
"Patients can touch up ever six months if they have good oral habits and are not staining teeth," Dr. Stanton said.
She advises careful maintenance instead of constant bleaching. She also recommends avoiding foods and beverages that cause staining, such as coffee, and wine, as well as smoking. For some patients, dentists can even shorten their cleaning schedule from six months to three months to remove the stains without bleaching, she added.
"Advise patients against smoking or too much red wine and sodas -- basically anything that you will get upset about getting on your white tablecloth," Dr. Messina concluded. "That's the part they don't want to hear."
