DIY Dental Treatments

Before considering do-it-yourself (DIY) dental treatments—such as at-home tooth whitening, bleaching, or remote clear aligner orthodontic therapy—it is important to get the facts and speak to your dentist about potential risks.

If you have experienced injury or adverse results from using mail-order orthodontic devices or undergoing remote dental treatment, you can report the issue to state and federal regulators using the links below.

In Massachusetts, the Office of the Attorney General can help resolve consumer complaints against businesses, and the Department of Public Health Bureau of Health Professions Licensure investigates complaints about dental treatments on behalf of the Board of Registration in Dentistry. In addition to filing a complaint online, consumers can call the Massachusetts Attorney General's Office Health Care Division Health Care Helpline at 888.830.6277.

At the federal level, because plastic teeth aligners and dental impression materials are regulated by the U.S. Food and Drug Administration as “by prescription only” devices, consumers can report any problems using the FDA MedWatch Voluntary Reporting Form.

Dental Fads: Charcoal and Oil Pulling

Charcoal Tooth Whitening

There is no evidence that dental products with charcoal are safe or effective for your teeth, according to the September 2017 issue of the Journal of the American Dental Association. In fact, using materials that are too abrasive on your teeth can make them look more yellow. Your tooth enamel is what you’re looking to whiten, but using a scrub that is too rough can actually wear it away. If that happens, the next layer of your tooth—a softer, yellow tissue called dentin—can become exposed.

Oil Pulling

Despite reports in the mainstream media about the benefits of “oil pulling” (an ancient folk remedy that involves swishing or “pulling” oil through the teeth and mouth), there are no reliable scientific studies to show that it reduces cavities, whitens teeth, or improves oral health. For this reason, the ADA does not recommend oil pulling as a dental hygiene practice.

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Benefits of an Office Visit

Before taking your dental health in your own hands, talk to your dentist. When you see a licensed dentist, he or she will assess your overall oral health.

Through a clinical examination of your teeth, bite, jaw alignment, and the relationship of your teeth to your skeletal structures, your dentist or orthodontist will identify any problems, especially those not seen with the naked eye. An in-person exam and X-rays are often critical for diagnosing if a specific treatment is right for you and helping to ensure any treatment does not lead to more problems than it cures.

Your dentist can discuss the risks and benefits to any dental treatment, as well as options that address budgetary concerns.

The Massachusetts Dental Society (MDS) and the American Dental Association (ADA) discourage the use of direct-to-consumer dental products, including aligners, veneers, mouthguards, snoring appliances, teeth whitening trays, and bleaching products. Self-administered, unsupervised dental treatments have the potential to cause damage and irreversible complications for patients.

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Direct-to-Consumer Orthodontics: Questions to Consider

The standard of care for determining the suitability of a person to receive orthodontic treatment requires the performance of a clinical examination by a licensed dentist and the review of X-rays. Dentists take X-rays to identify cavities that cannot be seen by the naked eye or by simply reviewing pictures, as well as to determine if there is sufficient supporting bone of adequate density.

Without an in-person evaluation by a licensed dentist and review of X-rays that could identify undiagnosed dental disease or underlying issues that would make a patient an unsuitable candidate for clear aligner orthodontic therapy, a patient may be exposed to irreversible harm, including potential bone loss and receding gums, loose teeth, a misaligned bite, and other issues.

While remote treatment through a direct-to-consumer orthodontic company may sound simple, the American Association of Orthodontists suggests a number of questions you may want to consider. Some of these questions include:

As part of your treatment, are comprehensive diagnostic records like X-rays taken before your treatment?
As part of your treatment fee, do you receive any in-person visits to a dentist’s or orthodontist’s office during your treatment?
If a dentist or orthodontist is involved with your treatment, do you know the name of the dentist or orthodontist who will be specifically involved with your case (for example, is it available on the company’s website or elsewhere)?
Is only one treatment type offered (such as invisible aligners or a certain appliance)?
How do you know if your teeth and gums are healthy enough for orthodontic treatment?
What are the possible risks (financial, health, etc.) associated with your orthodontic treatment?
Who can you speak with at the online orthodontic company about your orthodontic treatment?
Who is responsible for detecting any issues that may occur during your orthodontic treatment?
If an issue arises during your treatment, how will it be handled and who will be responsible for handling it?
If a doctor is involved with your orthodontic treatment, how can you contact him or her over the course of your treatment or if an emergency arises?
If an emergency arises, does the company have a dentist or orthodontist in your area that you can see in-person? If not, who would cover the costs associated with seeing a dentist or orthodontist in your area?
Are you asked to sign any forms that seek to release the company from liability?
If you are injured or have another dispute involving your orthodontic treatment, how is it handled (litigation, arbitration, etc.)? State dental boards have their own complaint processes for patients who have had issues with orthodontic treatment. Contact the Massachusetts Board of Registration in Dentistry for more information or file a complaint with the Bureau of Health Professions Licensure.

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Tooth Whitening: What You Should Know

Before deciding to whiten your teeth, it’s important to talk to your dentist. Whiteners may not correct all types of discoloration, and not everyone is a good candidate for teeth bleaching.

Can All Teeth Be Whitened?

Teeth that are yellow respond best to bleaching. Brown teeth may not respond as well, and teeth with gray tones may not bleach at all. Whitening will not work on caps, veneers, crowns, or fillings. Bleach will not change the color of these materials, so you may want to investigate other options with your dentist. Whitening also won’t be effective if your tooth discoloration is caused by medications or a tooth injury.

Who Is Not a Good Candidate for Tooth Whitening?

People with periodontal disease or especially sensitive teeth may want to avoid chemical whitening techniques that can irritate tender gums.

Tooth sensitivity is one side effect that some people who use tooth whiteners may experience. This occurs when peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. Because the sensitivity is temporary in most cases, you may be able to delay treatment and try again.

It’s important to keep in mind that overuse of whiteners can damage the tooth enamel or gums, so be sure to follow the directions and talk to your dentist.

Whitening Options

Many DIY tooth whiteners are advertised on television, online, and in print magazines. The MDS and the ADA recommend that if you choose to have your teeth whitened or use a bleaching product, you should do so only after consulting with a licensed dentist. If chemicals used to whiten teeth are not applied properly, they could damage soft and hard tissues in your mouth.

Consumers also should be wary of tooth-whitening kiosks in places like malls or salons. Staff running the kiosk may have no health care training or licensing to provide health care services, yet they are dispensing chemicals that could permanently impact your teeth and gums. And, unlike dental office staff members, the kiosk staff may not have any training in infection control techniques that follow the U.S. Centers for Disease Control and Prevention’s guidelines.

If your dentist indicates that tooth whitening will work for you, there are several options to consider:

Stain Removal Toothpastes – Look for whitening toothpastes that have earned the ADA Seal of Acceptance for stain removal. These toothpastes have polishing agents that are safe for your teeth and provide effective stain removal. Unlike bleaches, these types of ADA-Accepted products do not change the color of teeth because they only remove stains on the surface.
In-Office Bleaching – Known as chairside bleaching, this procedure usually requires just one office visit. Your dentist will apply a gel or a rubber shield to protect your gums, then bleach is applied to your teeth.
At-Home Bleaching from Your Dentist – Your dentist can provide a custom-made tray for at-home whitening, along with specific guidance on how to apply the bleaching solution and for what length of time. This process can take a few days to a few weeks.
Over-the-Counter Bleaching Products – Discuss these options with your dentist and look for products with the ADA Seal of Acceptance to determine if they have been tested to be safe and effective for tooth whitening.

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