Being a dentist and owning a professional whitening system company, most automatically assume that I’m firmly against the use of OTC whitening strips. But that’s not really true…with a disclaimer.
Any dentist experienced in professional teeth whitening knows that OTC (over the counter) white strips just don’t work all that well for the majority of consumers. The exception to this is the adult patient whose teeth tend to be extremely susceptible to the whitening effects of peroxide. These adult patients may achieve a very “decent” result.
Also, we know that the younger a person is (such as a teenager age 14-16), the more easily and quickly their teeth will whiten. These younger patients also may achieve a very “decent” result.
And of course, for all other people, my recommendation to my own patients, when they’ve asked if I object to their use of OTC whitening strips has always been – Sure, give it a try! It couldn’t hurt, it may help a little, and it may not.
You can probably see that I’m not at all pushy with my patients. For the past 20+ years I’ve used a cosmetic questionnaire that I created for my new patients to fill out, as well as ongoing patients at their recall visits. If they indicated they’re not interested in cosmetic treatment or professional teeth whitening, I’m certainly not going to push the point.
But here’s where I do have a great big gripe about OTC whitening strips. Some people, including teenagers, tend to over-use them. Not good, not good AT ALL! So I very carefully and very strongly warn my patients about over-usage.
Here’s the problem: Hydrogen peroxide (the bottom line end active ingredient in all peroxide based whitening gels, including carbamide peroxide) is a very unstable chemical. That’s good and bad. It’s good in that it’s so unstable that it can break down quickly in the mouth and whiten teeth. But it’s bad in that it will break down significantly during storage and shipping before it can be used by the patient – especially an OTC product.
OTC products go through Hell. They are stored in warehouses that tend to be quite warm or even hot. Then they go into those huge freight trucks, most often for many days, where it can get up to a sweltering 165 degrees Fahrenheit. And then, into the store’s storage areas and finally onto the store shelf, where it can sit for a prolonged time without refrigeration.
The bottom line is that companies that make whitening strips must use a LOT of chemical stabilizer to prevent as much premature breakdown. Afterall, when these strips have already broken down, they just won’t work at all when the patient uses them.
But the problem is that, with all that chemical stabilizer, when the patient places the whitening strips on their teeth, the chemicals are not unstable enough to break down all that well – so not all that much whitening effect is present.
But here’s my major gripe – the most common chemical stabilizer is none other than phosphoric acid. And if that’s not bad enough, as peroxide breaks down, one of the byproducts it releases is hydrogen ions. And hydrogen ions ARE acid (remember that pH means “potential of hydrogen”). So those whitening strips can be LOADED with acid before the patient even places them on their teeth. And yes, this is exactly how I explain my warning to my patients.
But the fact is, if you use OTC whitening strips and closely follow the directions…AND if you don’t keep buying more boxes to use, just that one-time treatment over a few days isn’t going to cause any meaningful damage to the tooth structure. But chronic use – you can bet that there will be acid erosion damage.
This is just one of the several reasons why at KöR Whitening, we use refrigeration instead of any chemical stabilizers. Not only does that mean that we use ZERO phosphoric acid, but the constant refrigeration prevents any premature breakdown, so hydrogen ions have not been released by the gels prior to patient use. And we even use buffering systems in our gels to instantly neutralize any hydrogen ions that are produced when the gels are on the patient’s teeth.
Here’s the icing on the cake – since we don’t use any chemical stabilizers, and we fully stabilize the gels with constant refrigeration, when the gel is placed on the patient’s teeth, it is VERY unstable…so it breaks down like crazy, whitening teeth like crazy.
But hey, if you want to give OTC white strips a try without abusing and over-using them, I’m totally fine with that.