Home teeth whitening products have become very popular. (Photo: Olivia Babb)

DIY teeth whitening: to peroxide or not?

Social media, particularly Instagram, generally shows us unrealistic images of teeth, with beaming smiles filtered and Photoshopped.

It’s rare to see a celebrity with anything less than perfect white, straight teeth. According to the American Academy of Cosmetic Dentistry, 99.7% of us believe a perfect smile is the most important social asset.

And as we search for that perfect smile, one of the fastest-growing markets today is DIY teeth whitening kits. Global sales of these products topped USD $6.1 million in 2020 alone.

And why not? With products on the market stating ‘no peroxide’ and ‘no sensitivity,’ consumers are choosing to go it alone rather than seeing a registered, much more expensive, dentist.

Hismile’s ‘Peroxide-free’ slogan. (Photo: Facebook)

For example, leading teeth whitening company Hismile just launched a new product, ‘PAP+’, claiming their treatment won’t leave teeth feeling sensitive, will leave them three shades whiter within 10 minutes and do it all without using peroxide. Their slogan ‘peroxide free, as it should be’ leads the campaign.

Hydrogen peroxide in whitening form does slightly demineralise the enamel of the tooth and this can cause sensitivity, but this demineralisation of the tooth structure is temporary. With a normal saliva flow in your mouth, the teeth begin to remineralise again.

Instead of using peroxide, Hismile uses an ingredient called peroxyhexanoic acid (PAP). It’s a synthetic organic peroxy acid most often used for the bleaching of pulp and the detoxification of cyanide in the mining industry.

“This claim has no independent objective high quality evidence to support it. All effective oxidants will cause soft tissue reactions.”

Sensitivity is a common complaint after teeth whitening. While some brands claim they offer ‘no sensitivity’ products, Australian Dental Association (ADA) spokesperson and former chair of the ADA Infection Control Committee Professor Laurence Walsh says this is wrong.

“This claim has no independent, objective, high quality evidence to support it,” he said. “All effective oxidants will cause soft tissue reactions.”

Hismile’s research states they applied different levels of hydrogen peroxide for 6 x 10-minute applications and PAP for 6 x 10-minute applications. Their results claim there was no sensitivity resulting from PAP use but sensitivity was felt in those using hydrogen peroxide.

Dentistry guidelines recommend only using hydrogen peroxide for a maximum of 30 minutes daily.

“The trial (done by an unnamed third-party dentist) concluded that 0% of participants experienced sensitivity,” Hismile researcher Fabio Alfieri said, “and 0% presented any signs of gum irritation or morphological changes to their oral mucosa.”

“It is not possible to make the assumption that continued use (past the recommended time) would end up causing damage.”

The Australian Dental Association is clear on where they stand on PAP.

“This ingredient is NOT safer than using peroxides of various types,” said Prof Walsh. “They are all oxidants, so they all come with a risk. PAP softens and etches enamel of teeth – more so than peroxides – as well as posing a risk of soft tissue injury.”

“Only carbamide peroxide and hydrogen peroxide bleaching gels used in dentist-supervised home bleaching with custom-fitted trays, have over 30 years documented history of safe and effective use, and are supported by high-level evidence (systematic reviews and meta-analyses).” said Prof Walsh. “This is not the case for PAP.”

Whitening at a dental clinic costs between $200 to $750, a significant difference to the online options which cost between $70 and $200, making the appeal obvious. Many reviews on the online products state they saw no difference at all from the various products and they were all met with the same generic response.

(Screenshot: Trustpilot)

By securing celebrity endorsements from the likes of Kylie Jenner and Conor McGregor, teeth whitening companies are saturating social media.

In 2019 Khloe Kardashian was called out for claiming Hismile was responsible for her white teeth. Fans quickly flooded her Instagram posts, pointing out that she has had cosmetic procedure veneers, making whitening impossible. Kylie Jenner also has veneers, making the product useless for her.

Influencer Kylie Jenner with Veneers and Hismile (Photo: Hismile Facebook)

Professor Walsh says people should be wary of celebrity endorsements.

“Several reality TV people who are not dentists have been sent to jail for illegal tooth whitening treatments,” he said. “This should serve as a warning as to how serious the consequences can be.”

(Floyd Mayweather Jr works on his smile. (Photo: Instagram)

Boxing star Floyd Mayweather Jr has been one of two celebrities named as defendants in a $5 million class-action lawsuit against a teeth whitening company that he endorsed.

“While defendants unequivocally claim that their teeth whitening light delivers amazing results,” the lawsuit states, “independent lab testing proves that their light does nothing to enhance their product’s purported ability to whiten teeth.”

NYU dental school graduate Jennifer Jablow told instyle.com that the bulk of light-accelerated systems on the Internet do nothing.

“In order for stains to be lifted from the surface of teeth there are key additives that must be included in gels,” she said. “It is scientifically proven that the added light does nothing without the photocatalytic ingredient.”

The statement was backed up by Professor Walsh.

“There is no evidence for any effect of light of the type used in that product (in terms of its wavelength, operating mode and power) having any benefit,” he said. “A product that uses a light needs a set of special light sensitive chemicals included in the gel.”

Under Australian law and Dental Board of Australia regulations, only dentists can use teeth whitening products containing more than 6% hydrogen peroxide or 18% carbamide peroxide.

In 2019, the ADA published a media statement regarding online DIY teeth whitening kits, asking the Australian Consumer and Competition Commission to immediately enforce the law and maintain more effective ongoing regulatory oversight of this burgeoning consumer market to protect consumer health and safety better.

There is not necessarily a ‘one size fits all approach to teeth whitening. Going to the dentist is often associated with fear and financial strain for a lot of people. However, the safety and risks of DIY kits are questionable in non controlled environments.

The ADA strongly urges consumers to visit dental professionals when seeking teeth whitening services.