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There are essentially two types of kits: Those that bleach your teeth to take stains off and ones that physically scrape off the stains.
Whitening trays and strips have been the standard for decades and generally rely on carbamide or hydrogen peroxide. Activated charcoal powders had a spike in popularity recently, but the dentists we interviewed would tell you to nix the powders.
Ira Handschuh, DDS, cosmetic dentist at The Dental Design Center in White Plains, NY, and Ania Mohelicki, DDS, a cosmetic dentist in Boulder, CO, both told Insider they don't recommend these because they can be abrasive and only remove surface stains.
A third type of teeth whitening product simply blasts your teeth with LED light, which typically aims to speed up the process and achieve more intense results. However, most of the dentists we interviewed agreed that any gains from this treatment are short-lived or nonexistent.
"Most studies show some difference detected by computers, but no visual difference detected by the human eye. Most studies conducted in actual patients (in vivo) found no added benefit for light-activated systems," Charles Sutera DDS, FAGD, a professional dentist at Aesthetic Smile Reconstruction in Waltham, MA, told Insider.
Only the SmileDirectClub system in our guide uses this technology. Still, it is used with a whitening gel and a mouthguard that may offer better control over your placement and avoid increased gum sensitivity compared to strips.
"There is only one active ingredient in all teeth whitening products: hydrogen peroxide. It's the same agent, whether prescription or over-the-counter," said Dr. Sutera. "Any other ingredients in the product are inactive fillers needed to create the right product consistency."
If you see carbamide peroxide on your ingredient list, it's just a derivative of hydrogen peroxide.
Pregnant or nursing women may want to stop using peroxide-based whitening products. It also isn't suitable for children under 14 years old. You should not use peroxide for longer than two weeks of daily use without the supervision of a dentist.
The FDA does not recommend using whitening gels with a peroxide concentration higher than 18%. Two of the kits we recommend have peroxide (Crest Whitestrips and SmileDirectClub) but they should be safe for most people.
Again, you should always consult with your dentist before starting a course of treatment. For instance, if your darkened teeth are due to the natural thinning of tooth enamel that comes with aging, whitening kits will not help you. Also, they cannot whiten fillings, dentures, veneers, crowns, or caps.
Most importantly, Dr. Mohelicki says the biggest concern is wearing whitening kits for the right amount of time. "Over-the-counter options are inexpensive when compared to in-office whitening, but they offer no gum protection. With no gum protection, users can experience increased sensitivity and even burns in severe cases."
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Before using a teeth whitening kit, brush your teeth so your whitening agent can make contact with the surface of your teeth to improve efficacy and so it doesn't accidentally create an uneven white. After you've whitened, try to avoid food and drinks that stain your teeth.
"Any buildup of plaque or food debris will not allow for the whitening agent to contact the tooth and therefore not allow the whitening agent to do its job," Dr. Campbell explained. "You could end up with a speckled, uneven-whitened appearance."
As Dr. Sutera explained, whitening your teeth and then having a glass of red wine is like "two people in a canoe paddling in different directions. The whitening products open the pores and clean them out. If you have coffee, tea, or red wine within 72 hours of whitening your teeth, your teeth are more likely to absorb dark stains and adversely impact your whitening results."
"Most studies show that whitening does not damage enamel," Dr. Sutera said.
However, research shows teeth whitening can affect proteins deeper in the tooth but researchers aren't currently sure if the damage is temporary or permanent, according to Dr. Sutera.
For whitening toothpaste, Dr. Sutera recommends that patients with sensitive teeth use toothpaste with potassium nitrate and fluoride and a fluoride mouth rinse. According to Dr. Sutera, potassium nitrate is the primary ingredient that helps with sensitive teeth, and fluoride is a secondary option that's also been shown to help.
If you have sensitive teeth and want to use a teeth whitening agent, you may just want to avoid higher concentrations of hydrogen peroxide.
"The suggestion I would make is to use a lower concentration of whitening agent to get their desired whitening outcome while minimizing the risk of tooth sensitivity." Dr. Campbell said. "Although anecdotal, I've found that brushing with Sensodyne toothpaste before and after whitening has helped me avoid sensitivity."
The bleaching temporarily weakens your enamel so the bleach can pass through it and further lift those stains, explained Dr. Mohelicki.
"When [our enamel] is weakened during the bleaching treatment, many patients find that it can be hard to consume hot beverages, ice-cold beverages, or even eat certain foods. This typically wears off within 72 hours of ending treatment."
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