Teeth Whitening Whitening Safety & Sensitivity 2 — Questions and Answers
Question 1: Overuse of whitening products can lead to a condition where teeth appear translucent or blue-gray. What is this called?
- Over-bleaching or bleachorexia (Correct answer)
- Amelogenesis imperfecta
- Enamel hypomineralization
- Dentin dysplasia
Correct answer: Over-bleaching or bleachorexia
Bleachorexia refers to excessive, compulsive whitening that erodes enamel, causing the underlying dentin's blue-gray hue to show through.
Question 2: What does the FDA currently classify most over-the-counter whitening products as in the United States?
- Cosmetics, not drugs (Correct answer)
- Class II medical devices
- Prescription-only drugs
- Dietary supplements
Correct answer: Cosmetics, not drugs
OTC whitening toothpastes and strips are generally classified as cosmetics by the FDA, whereas higher-concentration professional products may be regulated as drugs.
Question 3: Swallowing a small amount of dilute whitening gel accidentally is likely to cause what immediate effect?
- Mild nausea or stomach irritation at worst (Correct answer)
- Serious chemical burns to the esophagus
- Permanent bleaching of oral mucosa
- No effect whatsoever
Correct answer: Mild nausea or stomach irritation at worst
Small amounts of low-to-moderate concentration peroxide ingested accidentally cause mild GI irritation at most; however, large amounts of high-concentration gel require medical attention.
Question 4: Which of the following tooth conditions is LEAST responsive to conventional peroxide whitening?
- Severe tetracycline staining (gray/brown banding) (Correct answer)
- Yellow aging-related discoloration
- Extrinsic coffee and tea stains
- Mild tobacco staining
Correct answer: Severe tetracycline staining (gray/brown banding)
Tetracycline staining is deeply incorporated into dentin and can require prolonged, repeated treatment or alternative cosmetic options like veneers.
Question 5: What does it mean when gum tissue turns white or 'blanches' during whitening?
- The peroxide has temporarily irritated or chemically burned the gingival tissue (Correct answer)
- The gum is being whitened along with the teeth
- Blood supply to the area has permanently stopped
- The gum is reacting to the tray material
Correct answer: The peroxide has temporarily irritated or chemically burned the gingival tissue
Blanching is a chemical burn reaction where peroxide oxidizes hemoglobin and tissue proteins in the gingiva; it is painful but usually reverses within 30–60 minutes.
Question 6: A patient with a known allergy to peroxide should use which type of whitening alternative?
- PAP-based (phthalimidoperoxycaproic acid) whitening systems (Correct answer)
- Extra-strength abrasive whitening toothpaste
- High-concentration sodium fluoride treatments
- Activated charcoal powder applications
Correct answer: PAP-based (phthalimidoperoxycaproic acid) whitening systems
PAP is a non-peroxide oxidizing whitening agent used in some modern products designed for patients who cannot tolerate hydrogen or carbamide peroxide.
Teeth Whitening Whitening Safety & Sensitivity 2
Overuse of whitening products can lead to a condition where teeth appear translucent or blue-gray.
What is this called?