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Whiten Up!

Dingy teeth have more options than ever in their quest for dazzling whiteness. This month, Listerine introduced Whitening Pre-Brush Rinse, which promises noticeably whiter teeth in 12 weeks of twice-daily, 60-second swishing sessions. It follows the April introduction of two new Crest products: Whitestrips Premium Plus, aimed at people who want whitening that lasts for 18 months (instead of 12), and Night Effects Premium for Sensitive Teeth, an overnight paint-on bleach.

Tooth whitening is the No. 1 concern on patients’ minds, according to the American Dental Association. But with dentist-supervised whitening regimens running $400 or more, many pearly-gray smiles are turning to over-the-counter remedies, which racked up more than $275 million in sales last year alone.

The proliferation of products may leave confused consumers gnashing their grimy, discolored teeth in frustration. How to evaluate all the hype and pick a product that does the job?

First, it helps to understand the basics of bleaching. Successful whitening, says Stephen Chu, director of the aesthetic dentistry program at New York University, rests mainly on the concentration of the bleaching agent (usually a form of hydrogen peroxide), the length of time it remains on the teeth, and the frequency of application. The delivery mechanism–molded tooth tray, rinse, paste–is important, too, since the more completely and consistently the teeth are covered, the more effective the bleaching will be.

Dentists’ whitening regimens are the gold (tooth) standard. They use the most concentrated bleach–typically 10 to 20 percent hydrogen peroxide or its equivalent–and customized molds called “trays” that hold the bleach against a patient’s teeth for anywhere from an hour to overnight.

Listerine’s pitch is that it’s easy to use. Just swish the 2 percent hydrogen peroxide solution in your mouth for 60 seconds twice a day, and voila , whiter teeth in 12 weeks. Chu is skeptical. “Think about the amount of time the solution is on the teeth,” he says. “How much whitening can you get?” By comparison, Crest Whitestrips Premium Plus contain 10 percent hydrogen peroxide and are applied like little saran wrap covers to the teeth for 30 minutes twice a day. “These are extremely effective, because they move toward a tray-type concept,” he says, “and they’ve increased the concentration of the bleaching material to almost professional levels.” Be careful, however: You can overbleach. Tooth enamel becomes so translucent that teeth look blue.

Whitestrips aren’t for everyone. If you have overlapping, crooked teeth, “the part that sticks out will get the bleach,” says Nicholas Davis, president of the American Academy of Cosmetic Dentistry. The others will remain dingy. Likewise, paint-ons can wear off unevenly as saliva dilutes the whitener, says Irwin Smigel, a cosmetic dentist in New York who has his own whitening products called Supersmile.

Just brush. As for whitening flosses and toothpastes, don’t get your hopes up. While floss can polish away stains between teeth, it isn’t in contact with them long enough to whiten, says Matthew Messina, a Cleveland dentist and a consumer adviser for the American Dental Association. In tests, “a whitening toothpaste was comparable to a placebo.” Brushing with any toothpaste within an hour of ingesting a stain-provoker may be the best way to reduce staining.

Over-the-counter whiteners can help–as long as your expectations are realistic. They’d work for “someone who’s 20 and just wants to brighten up their smile,” Messina says. “But for someone who’s older and may have smoked, even Whitestrips aren’t going to get them where they want to be.” And those blindingly white incisors that actors flash? Even in-office dental bleaching won’t turn your teeth that white. Those Chiclet-like choppers are almost surely veneers. But at $1,000 or more a tooth, it’s no surprise that consumers bite when advertisers promise a toothpaste or floss can do the same for just $4.99.

WHITE-O-METER

Floss. Removes food that could stain but won’t actually whiten.

Mouthwash. A 60-second rinse isn’t long enough to do much good.

Paste. A good brush is more important than choice of toothpaste.

Strips. Best over-the-counter option, but not for really grimy teeth.

Professional bleaching. Works wonders.

Veneers. Like white porcelain gloves for your teeth.

This story appears in the May 23, 2005 print edition of U.S. News & World Report.

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