It’s been a while since I’ve had a checkup, so I went in and had a cleaning. I was a little surprised to find out that I had a couple of cavities on my front teeth. The office said that if I’ve ever wanted to do teeth whitening, now’s the time to do it because the color of the fillings can’t be changed later. I left the office with a treatment plan that included teeth whitening and planned to do that first. I got to looking online and I read that you’re not supposed to have teeth whitening done when you have cavities. Which is it?

-Andrew

Dear Andrew,

This is one of the double-edged swords in dentistry. Your dental office was correct in that the color of your fillings cannot be changed later. The only way to lighten them after the fact will be to remove them and replace them with a lighter color, after you’ve finished teeth whitening.

The active agents in prescription-strength teeth whitening solutions are very potent, and they’re known to cause sensitivity, especially in people who already have sensitive teeth. Because you have cavities, the agent can get that much closer to the nerve, and is even more likely to cause discomfort. There are some sources that will say that the agents can weaken your teeth and make cavities worse, but there’s no evidence to prove this. The biggest concern is sensitivity.

Ultimately, what you should do is have those teeth filled and then have teeth whitening done afterward. You could try to guess what shade it will be or you can have the fillings redone to match later. For most people, neither of these are realistic options. You probably don’t want “hope” for a match later and you probably don’t want the time and expense of redoing the fillings later, so going forward with bleaching them now is the most sensible solution.

Your doctor wouldn’t have mentioned tooth whitening to you if you weren’t a good candidate, and it sounds like your cavities are small, and are unlikely to cause you an issue. If you’d like to try to reduce sensitivity ahead of time, you can start using a fluoride rinse at home. There are a few over the counter brands. You may also want to talk to your dentist about using a special fluoride gel at home. It’s different than toothpaste and is non-prescription, though the pharmacist will usually keep it behind the counter. The office may also be able to do some in-office treatments, like a fluoride varnish, and can take special care to protect the cavity during treatment.

Mention your concerns to them and find out which course of action is best for your situation. Most people don’t have any issue with bleaching, even if they have cavities, but it’s certainly not a good situation if you have severe decay.

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