Teeth whitening strips are thin, flexible plastic strips coated with a peroxide-based bleaching gel designed to lighten tooth enamel. Orthodontic braces, or fixed appliances, consist of brackets bonded directly to the tooth surface, connected by wires and elastic bands. Many people desire a brighter smile while undergoing alignment, but dental professionals generally agree that combining whitening strips with braces is not recommended due to significant aesthetic and health risks.
Uneven Whitening Due to Bracket Obstruction
The primary issue with using whitening strips while wearing fixed braces is the physical obstruction created by the brackets and wires. Whitening agents, typically peroxide, require direct contact with the enamel surface to penetrate and break down stains. Brackets act as a barrier, preventing the gel from reaching the enamel underneath.
This lack of uniform contact means only the exposed areas of the tooth will lighten, leaving the enamel beneath the brackets untouched. Once the braces are removed, this results in a noticeable two-toned appearance. The newly exposed areas will be the original, darker shade, contrasting sharply with the surrounding whitened enamel. This aesthetic problem, often called “reverse staining,” requires subsequent treatment to correct.
The surface area covered by a bracket can be significant, sometimes obscuring up to 20-30% of the visible tooth face. Since whitening strips are designed to lie flat against a smooth surface, attempting to use them with hardware inevitably leads to patchy results. This outcome defeats the purpose of whitening and requires subsequent treatment to even out the color.
Potential Risks to Teeth and Gums
Using peroxide-based whitening strips introduces specific health concerns beyond uneven coloring. The bleaching agent increases tooth sensitivity, which may already be heightened by the pressure and movement of orthodontic treatment. This combination can lead to pronounced and uncomfortable sensitivity.
Whitening strips are also a common cause of gum irritation if the peroxide gel contacts the gingival tissue for extended periods. Braces make correct positioning difficult, potentially forcing the gel closer to the gum line or trapping it around the hardware. This can exacerbate inflammation and discomfort in gums already sensitive from the orthodontic appliances.
A less common, but theoretical, risk involves the possibility of the peroxide weakening the adhesive bond holding the brackets to the teeth. Exposure to the whitening gel could compromise the strength of the bond. A weakened adhesive may lead to the premature detachment of a bracket, requiring an unscheduled visit for repair and potentially extending the overall treatment time.
Whitening Alternatives During Orthodontic Treatment
While fixed appliances make traditional whitening unsuitable, focusing on meticulous oral hygiene is the most effective strategy to maintain a bright smile. This includes brushing immediately after every meal using a soft-bristled or electric toothbrush to thoroughly clean around the brackets, wires, and gum line.
Specialized interproximal brushes or water flossers are highly recommended to clean tight spaces where plaque accumulates. Removing this buildup is crucial, as plaque accumulation can lead to visible discoloration and white spot lesions once the braces are removed.
For a slight brightening effect, patients can use specialized whitening toothpastes or mouthwashes containing mild abrasives to remove surface stains. These products do not contain the high concentration of peroxide found in strips, meaning they will not change the intrinsic color of the enamel but can help maintain the existing shade.
Limiting the consumption of highly staining foods and drinks, such as coffee, tea, red wine, and dark sodas, will also reduce the risk of discoloration. The safest time for any professional, peroxide-based whitening treatment is after the successful removal of all orthodontic hardware.