You may be surprised by what some are doing to have a 100-watt smile

Be cautious with teeth whitening trend, an expert warns

Nicole Nalchajian, a Fresno orthodontist, wants to caution people about the trend for teeth whitening: brushing with charcoal and clay and swishing with coconut oil to whiten teeth.
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Nicole Nalchajian, a Fresno orthodontist, wants to caution people about the trend for teeth whitening: brushing with charcoal and clay and swishing with coconut oil to whiten teeth.

When you describe a perfect smile, do words such as brilliant, gleaming and 100-watt come to mind?

A photogenic smile – the whiter, the better – certainly has become a cosmetic ideal. We’re willing to do just about anything to have pearly-white teeth. Consumers spend billions every year paying dentists to brighten teeth and buying over-the-counter whitening gels and toothpastes.

And now many are trying do-it-yourself “natural alternatives” for whitening teeth that can sound rather unnatural. Consider these popular options: Brushing with activated charcoal or mud-based pastes and swirling coconut oil in the mouth to turn stained teeth a blinding white.

Unconventional teeth whitening has been fueled by social media over the past couple of years and shows little sign of fading. But California orthodontists aren’t smiling over the trend.

The California Association of Orthodontists recently issued a cautionary statement about using activated charcoal and other materials to whiten teeth. “Products touted as natural remedies can actually turn out to be harmful if used without legitimate research,” said association president Andrew Harner.

Some background

People have been whitening teeth for years, and with some interesting substances.

According to Smithsonian.com, ancient Romans used urine – yes, pee – to clean and whiten their teeth. The ammonia in urine was the stain scrubber.

Fast forward a few centuries and teeth whiteners later, and since about the 1990s the agent of choice has been peroxide-based. Yep, that hydrogen peroxide, the same liquid in the brown bottle that’s used as a disinfectant and antiseptic, is in some teeth-whitening products sold over-the-counter.

So why the fuss about people brushing with activated charcoal and bentonite clay, both of which have been around a long time?

Activated charcoal – not the barbecue bricks – is made from coal and wood and other stuff. When it’s activated under high heat, its surface expands so it can absorb toxins. Activated charcoal has been used to treat drug overdoses and in cases of poisoning for years. Bentonite clay typically is a creation of volcanic ash that has come into contact with water.

To whiten teeth with the charcoal, people can break open capsules, mix the powder with water and brush the tar-black paste onto their teeth. Or, they can buy a toothpaste that contains charcoal.

Users of the “natural” pastes, who on social media sites show themselves brushing the substances onto their teeth, say that after brushing and rinsing, their teeth have never felt cleaner or been whiter.

But dental professionals said that even the peroxide-based bleaches in over-the-counter products have to be used properly and with some caution. According to a 2014 study published in the Journal of Evidence-Based Dental Practice, aggressive tooth bleaching can cause increased tooth sensitivity, as well as other dental problems.

You don’t get a do-over with your teeth.

Nicole Nalchajian, Fresno-Clovis orthodontist

But the potentially harmful abrasive qualities in “natural” teeth whiteners is what concerns dentists and orthodontists.

Nicole Nalchajian, a Fresno-Clovis orthodontist and member of the orthodontic association, explained the concern.

There’s a risk of damaging tooth enamel with an abrasive substance, such as activated charcoal and bentonite clay, she said. “You don’t get a do-over with your teeth.”

A way to explain the “no second-chance” rule of tooth enamel: Cut your hair and you’ll need a trim in a month. Get a manicure and the regrown nails will need to be filed and polished in a couple of weeks. But rub the enamel off your teeth – and you’re in trouble. Unlike hair and nails, there’s no growing back the hard, outer protective layer of the tooth.

And for people who already have pitted or thinning enamel, Nalchajian said, brushing with a gritty, tar-black substance could backfire. Dentin, the hard layer under the enamel, can absorb colors and “all of a sudden, you’re going the other direction – you have dark spots,” she said.

The social power

But while dental professionals cringe, a toothpaste, whether it’s tar black or fluorescent white, that could remove stains caused by Starbucks lattes and glasses of merlot is too enticing for many to ignore.

Laura Kamada of Fresno bought a tube of activated-charcoal toothpaste on Amazon after watching beauty bloggers who were using the teeth-whitening product. (Kamada can’t remember how much she paid for the paste, but a quick online search showed $20 for a tub of powder and $10 for a tube of paste is common).

Kamada, 25, said one of the bloggers she follows had whiter-looking teeth after a week of brushing with the charcoal paste, and she hoped for the same. After Kamada brushed once, she said she heard from one of her Snapchat friends who had noticed that her teeth looked whiter.

But she stopped after the single brushing. “It was very messy. When you’re spitting it out, all of this charcoal is everywhere,” she said.

And worse: “The next day, my teeth were really sore,” Kamada said. “My gums were kind of bleeding.”

Kamada’s cousin, Adam Shinkawa, is a Fresno dentist. She called him.

Shinkawa, 27, said patients have different sensitivity levels, and even over-the-counter whitening strips and toothpastes can cause painful teeth for some, but he cautions patients to be careful using charcoal whitening products because they come in different textures. Some are thicker and more abrasive than others.

Shinkawa said Kamada’s teeth were OK, and he gave her a box of whitening materials that she could use instead of the charcoal.

He wasn’t surprised that his cousin had gone DIY to whiten her teeth. One person tries a product and posts it on social media and thousands see it, he said. “It’s been trending for quite awhile now.”

Swirl and swirl and swirl

Dentists and orthodontists are not as alarmed by oil pulling as they are by the charcoal and clay whitening products.

Oil pulling is an age-old East Indian traditional remedy for oral hygiene.

For teeth whitening, the practice involves swishing a tablespoon of oil, often coconut oil, in the mouth for up to 20 minutes and then spitting and rinsing, Nalchajian said.

Oil pulling is fairly popular, says Laine Janzen, a Fresno dentist. There might be some slight benefit to it, she said, but it’s not a replacement for normal brushing and flossing.

And she has had some patients complain of an upset stomach if they swallow some of the oil, she said.

Nalchajian said she found three cases in research literature that cited a link between oil pulling and lipoid pneumonia – oil in the lungs.

It’s not been proven that oil pulling whitens teeth, Nalchajian said. She found one study that subjected extracted teeth to oil and another group of teeth to hydrogen peroxide. Both sets of treated teeth were then measured with a dental shade guide. “That study showed absolutely no effect, no lightening of the tooth with oil,” Nalchajian says. “But it did show lightening with hydrogen peroxide.”

To tell the truth

Is it OK to fess up to a dentist if you’ve tried a DIY teeth-whitening product?

Nalchajian welcomes a discussion.

“A lot of times patients don’t tell you that they do these weird things because they know we’re going to tell them, ‘Hey, knock it off,’ ” she said. “But I’d probably say, ‘Are you really sure you want to do that? Do you have any truth that it actually works, and do you have proof that it doesn’t harm your enamel?’ 

Barbara Anderson: 559-441-6310, @beehealthwriter