Is tooth whitening forbidden in patients with dentin hypersensitivity?

Sensitivity is a common side effect of tooth whitening. For those already experiencing dentin hypersensitivity, then, you may think that tooth whitening is not an option. However, with recent advances in preventing and managing dentin hypersensitivity, we discuss why this condition is no longer a contraindication for whitening procedures.

Tooth whitening and dentin sensitivity

Tooth whitening treatments typically use hydrogen peroxide, carbamide peroxide (which breaks down to release hydrogen peroxide and urea), or a combination of the two. Whitening is achieved when the hydrogen peroxide has diffused into the tooth, and breaks down to release oxidizers. These then bind with stain molecules (chromophores), and break their double bonds, causing the molecules to become a lighter color (and thereby removing the stained appearance). However, the tooth whitening agent can reach all the way to the pulp itself, causing inflammation and reversible pulpitis. The greater the concentration of peroxide bleaching agents, the higher the risk of sensitivity.

For a patient already dealing with dentin hypersensitivity, you might reasonably fear that tooth whitening will only make the problem worse. However, there are a number of steps you can take to make whitening a more comfortable experience for your patients.

How to help your sensitive patients

1. Recommend a desensitizing toothpaste

There are several options for desensitizing toothpaste, depending on your location. One option is Colgate PreviDent 5000 Sensitive, which is available in the US. It contains prescription-level 1.1% sodium fluoride and 5% potassium nitrate, a clinically proven desensitizing agent. This paste offers extra protection for patients at increased risk for caries in addition to treating sensitivity.

For patients in the UK and Europe, consider recommending a toothpaste with Pro-Argin technology, like Colgate Sensitive Pro-Relief or elmex Sensitive Professional. The patented combination of arginine and calcium carbonate seals the dentin tubules with a highly resistant plug, preventing fluid movement and protecting against external stimuli.

Pro-Argin toothpastes have been shown in three studies to provide relief in as little as one minute. They can also be used to provide ongoing protection and relief.

Both Pro-Argin technology and potassium nitrate have been shown to have no impact on the results of whitening treatments.

2. Offer on-the-spot sensitivity relief

Pro-Argin technology can also be found in Colgate Professional Sensitivity Relief Serum. You can use it as a topical to prevent sensitivity before treatment, and then give the tube to your patient to take away. Patients can then get rapid relief at home by gently massaging the serum into the affected teeth for one minute.

3. Choose a gentle whitening system

Research shows that whitening treatments with a lower concentration of hydrogen peroxide can reduce tooth sensitivity without compromising whitening results. The Colgate Optic White Professional Take-Home Kit uses a 6% hydrogen peroxide serum that is precisely applied with a pen-like applicator, rapidly dries to a more concentrated thin film. A short wavelength LED device is worn for 10 minutes and the film then keeps working to whiten teeth before being removed during brushing in the morning. It's designed for no sensitivity.

Thanks to the technology available to us today, dentin hypersensitivity doesn’t have to mean saying no to whitening. With careful management and the right products, you can help patients comfortably achieve their esthetic goals — and help to build great relationships in the process.