Do You Have Bleachorexia?

Many of us see sparkling white teeth as a sign of both health and beauty. But how white is too white? And at what point does the desire for a dazzling smile become an obsession?

Bleachorexia is a term coined by dental professionals to describe patients who exhibit addictive behavior toward teeth whitening. Think of it like this: If the pursuit of “whiter than white” teeth means you just can’t resist a spin in the dental chair for yet another whitening procedure – you may have bleachorexia.

Since whitening is a cosmetic procedure, the challenge for dentists is in meeting patient expectations while still protecting dental health. Some suggest matching tooth shade to the whites of your eyes for a more natural result, but others say it comes down to patient preference. “I don’t push my personal color preference on a patient, but I do try to guide as much as possible, as to aesthetics,” says Roger Johansen, DMD, associate professor of restorative dentistry at the University of Medicine and Dentistry of New Jersey.

Why Whiten At All?

Whitening can be a very effective way to improve the appearance of teeth and can be done in place of non-reversible procedures. “Bleaching teeth is relatively inexpensive compared to a crown or veneer, and since there’s no cutting and no enamel removal, the procedure doesn’t really affect teeth,” says Dr. Johansen. And, he explains, bleaching may even offer advantages for patients who later opt for veneers. “Veneers are translucent, so you still see a bit of the tooth underneath. Bleaching before veneers are applied actually gives a better appearance.”

Teeth that have been stained by age, antibiotics or bad habits – think coffee, wine and tobacco – can all benefit from whitening techniques. Some stains respond better to bleaching than others. Johansen finds developmental stains, such as those caused by antibiotic use in childhood, are usually more difficult to erase. It’s also important to note, whitening products only work on natural tooth enamel. They can’t change the color of crowns, veneers, bonding or tooth-colored fillings.

Whitening Product Options

If you prefer to whiten in the privacy of your own home, you’re in luck. From dentist-dispensed kits to do-it-yourself strips, there are a number of ways to whiten and brighten in your off-hours. But before you start, it’s always a good idea to consult your dentist about which whitening system to use.

• Chair-side bleaching. Performed in-office under a dentist’s supervision, a protective gel is applied to protect the gums and mouth while a chemical bleaching agent whitens the teeth. Sometimes an ultraviolet light is applied to speed the process, but Johansen says he prefers using only chemicals. “Here at our dental school, we’re moving away from using the light,” he says. Although tooth dehydration can be a side effect of any bleaching procedure, he finds the risk is greater in UV light-activated whitening procedures.
• At-home products. Professionally dispensed take-home whitening kits contain a peroxide gel that’s applied to teeth via a custom-fit tray. The mouth guard type tray is fitted to protect the gums and mouth. Over-the-counter whitening trays, gels, strips and rinses sold commercially are less expensive and usually considered safe. Results vary depending on the product. “I frequently recommend whitening strips to my patients, because I think they really do a pretty amazing job,” Johansen says. Rinses may be less effective, since they remain on the teeth only a short time.
• Whitening toothpastes. All toothpastes use mild abrasives to remove surface stains and make teeth appear brighter. Now, some toothpastes containing peroxide are turning up on the market. While they may have some whitening benefits, since they remain on the teeth for only a short time, results may be limited.

Risks of Bleachorexia

Bleachorexia can lead to more than just a blinding smile. Obsessive bleaching can actually be harmful to teeth and gums. “If I get any sensitivity with whitening, I stop, even if it’s in the first 10 minutes,” says Johansen. He cautions that continuing to bleach in the presence of tooth sensitivity or pain can lead to permanent damage. In severe cases, the nerve in the tooth can be destroyed and require a root canal.

Bleaching solutions can also spill over to the mouth and gums causing pain and irritation. Sensitivity typically disappears in a few days, if you stop using the bleach.

Overzealous bleaching may eventually defeat the goal of a healthy, beautiful smile that you’re striving for. Continuing to bleach overly-white teeth can wear away the enamel making them appear transparent.

What You Need to Know about Bleachorexia

There’s nothing wrong with using a whitening product to improve your smile. But having movie-star white teeth won’t change your life. Try to keep expectations reasonable.

If you have repeat staining, take a look at what could be causing the problem. Poor brushing techniques or dietary habits can lead to discoloration. “I had a patient who was vegetarian and drank large quantities of carrot juice which were causing staining,” says Johansen. In these cases, he suggests trying to slow the return of stains. “I never tell patients to change their lifestyle, because it just doesn’t work,” he says. But brushing immediately after meals or using whitening strips can keep stains at bay and maintain whiter teeth between professional bleaching sessions.

Finally, realize the minute the whitening process ends, the staining process begins. That’s just the nature of the beast. After all, the real purpose of teeth is to prepare food for digestion – not merely to make a beauty statement.