Cosmetic Dentistry Blog Cosmetic and General Dentistry Questions Answered

May 17, 2010

Crest Whitestrips risks – Does Susan now need a root canal?

Filed under: Tooth whitening — Tags: — mesasmiles @ 2:52 pm

Dear Dr. Hall,
My front left incisor was pushed back in my mouth 30 years ago in an accident and then put back into place by an oral surgeon. Since then it has been slightly discolored and the gum has been recessed from it very slightly. Just recently I asked my dentist about teeth whitening products and he suggested that I try CrestWhite Strips. After using them for 7 days with no problems my front incisor started to ache. I did not use the strips any more, yet the pain did not go away. I have not used the strips for 1 week now, yet my incisor still hurts when anything cold gets near it. It is sensitive to hot & aches much more when I exercise (even walking). It is not sensitive to pressure or being tapped on and feels ok as long as I am sitting and non-active. My questions for you are 1) Do you think I need a root canal? My dentist seems to think so. 2)Do you think the Crest White Strips caused the tooth to become infected? 3)If this was caused by the whitening product, than should my dentist not have warned me that this was possible? I’d greatly appreciate your input ASAP as my dentist wants to begin the root canal on Thurs., May 13. Your website has been extremely helpful! Thank you!

– Susan from Missouri

Susan,
I’m not sure why this incisor is hurting now. It is irritated. I don’t think it could be said for certain that it is infected. The sensitivity to cold indicates it is irritated. The sensitivity to heat is more a concern and tends to indicate that it won’t recover on its own.

And the idea of bleaching this tooth with Crest Whitestrips wasn’t a good one. This dentist doesn’t seem to know much about bleaching. The Whitestrips are very mild and will whiten your teeth a little but not a lot, and they will whiten your front six teeth evenly, which would still leave this tooth darker than all the others.

I would get a second opinion from an expert cosmetic dentist. I’m jumping to conclusions a little bit here, but this error of judgment on the bleaching to me reveals a serious lack of knowledge about cosmetic dentistry.

As far as the bleaching irritating your tooth, that is possible. That’s why it is always a good idea to bleach under the supervision of a dentist. There are some rare instances where a tooth that is otherwise irritated or has exposed dentin has been “pushed over the edge” by bleaching it, but that is very rare, and I have never heard of that happening with Crest Whitestrips. As I said, they are very mild.

Dr. Hall
Filed  under: Crest Whitestrips risks.

Follow up:
Susan wrote back a few days later and reported that she had sought a second opinion about the root canal treatment. The other dentist did cold tests on her teeth. On the affected tooth, the pain to cold lasted 2-3 minutes. This is a classic sign of a tooth needing a root canal treatment. Susan subsequently had the root canal on this tooth.

This is a very unusual case, and may be the only reported case of this type of risk – a tooth being damaged by Crest Whitestrips. My recommendation is that Crest restrict their stronger whitening products so that they are only available for use under the supervision of a dentist, and that they issue warnings that these stronger products should only be used after a dental examination reveals that there is no exposed dentin on the teeth to be bleached.
– Dr. Hall

Another follow-up question from Dr. Hall about the tooth damage from Crest Whitestrips, where Susan explains the exact Whitestrips product she used and gives more information about the damage they caused.

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About David A. Hall

Dr. David Hall was one of the first 40 accredited cosmetic dentists in the world. He practiced cosmetic dentistry in Iowa, and in 1990 earned his accreditation with the American Academy of Cosmetic Dentistry. He is now president of Infinity Dental Web, a company in Mesa, Arizona that does complete Internet marketing for dentists.

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