Your feed on social media is full of ads. One minute you’re looking up pulpal necrosis on Google and the next, a plush, personalized, toothpaste subscription box is asking for your email on Instagram. As a dental student, you can’t help but be skeptical of these products and the broad claims they make. As future dentists, we should know which products have claims that are supported by research and the ones that have potential for harm. In this article, I break down the categories that several trendy dental products fall into and what you should know about each.
UV whitening kits
The sponsored post of an Instagram influencer clutching an LED light and showing off fluorescently white teeth is a norm today. Whitening, or “bleaching,” uses hydrogen peroxide in some form. The whitened effect is achieved via removal of electrons from staining molecules in dentin. Once these pigments break down, less light is absorbed.
So where does the LED light come in? I asked Dr. Rafael Pacheco, professor of dental materials at University of Detroit Mercy School of Dentistry. According to Dr. Pacheco, LED lights, used in both home and office whitening, are purely for marketing purposes. In some instances, it can have a damaging effect. Heat from the light may cause faster generation of free radicals, allowing them to penetrate closer to the pulp, reports an April 2010 study. The U.S. Food and Drug Administration even reported cases of burns from too much heat conduction onto soft tissue from LED whitening.
The ingredients are another component to consider. While no method of “bleaching” is 100% safe, carbamide peroxide is a compound that has been found in multiple studies to reach the dentin easier and at a lower concentration of hydrogen peroxide, according to the Journal of Evidence-Based Dental Practice. This spares some of the negative effects to hard and soft tissue that normally accompanies hydrogen peroxide alone. The literature supports carbamide peroxide at 10% as being the most effective. As for the other compounds found in trendy whitening products? There’s just not enough research to support their effectiveness.
Activated charcoal has made its way into supplements, foods, makeup products and now dental hygiene. I wondered how this black powder could be used so universally. Charcoal particles are porous and have a negative charge allowing them to trap toxins and gases. It is also unable to be absorbed by the body, granting it approval for emergency treatment of overdoses and poisonings. Any other uses outside of this have no definitive research to support them.
So what is it doing in toothpaste, floss and toothbrush bristles? Most likely, nothing. According to the Journal of the American Dental Association, no research has supported the claim that activated charcoal can whiten or prevent decay. In fact, using charcoal toothpastes may cause damage. If they are not ADA-approved, the particle sizes could be big enough to cause dental erosion. It could induce the same kind of trauma as brushing with too much force. Additionally, many charcoal toothpastes do not contain fluoride. With the potential to make your teeth more sensitive by eroding enamel and losing the benefits of fluoride, the unproven benefit does not outweigh the possibility of harm.
Many people who are trying to eliminate their exposure to compounds such as hydrogen peroxide will turn to a more “natural” solution. Coconut whitening products are based on the claimed oral benefits of oil pulling. Oil pulling involves swishing oil and water in the mouth for up to 20 minutes. Dietary lipids act as a protective layer preventing adherence of carbohydrates, which may explain why some say oil pulling is antimicrobial. Coconut whitening strips, while mostly harmless, are likely not whitening. There’s inconclusive research on the effects of oil pulling and even less on the effects of coconut whitening strips. We don’t know yet if coconut oil deserves a spot next to our trusty toothbrush, floss and paste. So until then, we should stick to what has been proven to work.
With social media seeming more like a catalog, it is imperative that we are able to keep up with what our patients (and ourselves) may be adding to their oral care routine. These categories are not comprehensive but hopefully inspire you to maintain a healthy level of skepticism, no matter what the product and its claims may be.
~ Faith Volpe, Detroit Mercy ‘22