The most commonly observed side effects to hydrogen or carbamide peroxide are tooth sensitivity and occasional irritation of the soft tissues in the mouth (oral mucosa), particularly the gums. Tooth sensitivity often occurs during early stages of bleaching treatment. Tissue irritation, in most cases, results from an ill-fitting tray rather than the tooth-bleaching agents. Both of these conditions usually are temporary and stop after the treatment. On rare occasions, irreversible tooth damage has been reported. Due to the discontinuation of the professional component of the Seal Program on December 31, 2007, professionally applied bleach whiteners are not eligible for the ADA Seal.
The ADA advises patients to consult with their dentists to determine the most appropriate treatment. This is especially important for patients with many fillings, crowns, and extremely dark stains. A thorough oral examination, performed by a licensed dentist, is essential to determine if bleaching is an appropriate course of treatment. The dentist then supervises the use of bleaching agents within the context of a comprehensive, appropriately sequenced treatment plan. Whitening can often open naturally occurring pores within teeth. These open tooth pores can cause temporary sensitivity to air as well as hot and cold food and drinks, a common side effect from tooth whitening.
Dentists are trained to handle any side effects or maladies. They also can determine the appropriateness of the treatment for the patient and what products would be the most effective and continuous monitoring of the process and outcomes.
Whitening toothpastes (dentifrices) in the ADA Seal of Acceptance program contain polishing or chemical agents, rather than bleaches, to improve tooth appearance by removing surface stains. They do this through gentle polishing, chemical chelation, or some other non-bleaching action. Several whitening toothpastes that are available over-the-counter have received the ADA Seal of Acceptance
Teeth whiteners are used to improve the appearance of teeth by removing stains and natural discolorations. According to the American Dental Association, only certain types of teeth whiteners are effective at permanently whitening teeth, and some products may cause side effects. Teeth whiteners only work on natural teeth.