The Fight for White

Possible Link to Oral Cancer

Tooth whiteners have proven increasingly popular in recent years, tripling in use since 2001. Now a study of 19 oral cancer patients at Georgetown University Hospital in Washington, DC, has raised questions about their safety, pointing to a possible link between tooth whiteners and oral cancer. Cause for alarm? Or alarmist?

Given the very small size of the study and the uncertainty of the connection, Van B. Haywood, DMD, a professor at the School of Dentistry at the Medical College of Georgia in Atlanta, believes that it is alarmist.

ABOUT THE STUDY

A team of Georgetown head and neck surgeons conducted a retrospective study of 19 people of all ages with oral cancers. These abnormal growths typically occur in individuals over age 45 after years of smoking or drinking -- but researchers discovered that six out of the 19 patients developed oral cancer before age 40. Two of these used tooth-whitening products, did not smoke or drink more heavily than the others and had more advanced cancer.

The theorized culprit is the hydrogen peroxide used in the tooth-whitening kits, both the over-the-counter kits and those offered by dentists. Hydrogen peroxide has caused cancer in rodent studies. Ideally, the whitening gel which contains the peroxide comes into contact only with tooth enamel, not the soft tissue in the mouth. Researchers theorize that hydrogen peroxide may leak from the trays that hold the whitening material in place, triggering an inflammatory response in soft tissue and the release of free radical compounds that are implicated in cancer. Trays that are custom-fitted by a dentist most likely fit better and are thus less likely to leak.

NO DISCERNIBLE LINK

The limitations of the study: It was very small, it did not compare cancer patients with controls and, because it was presented at a conference, it did not undergo the rigorous peer review demanded of a journal article. The researchers themselves acknowledge that further study is necessary to establish any conclusive link.

In the meantime, the American Dental Association (ADA) has investigated the question of hydrogen peroxide and oral cancer risk and found no cause for concern. Although some peroxides are potential carcinogens, they do not include those used at relatively low concentrations in tooth-whitening kits, according to Dr. Haywood. Moreover, toothpastes that contain peroxide (such as Mentadent) are considered safe for lifetime use by the US Food and Drug Administration (FDA).

Of course, there are proper safety precautions to take with any dental intervention. Before using a tooth-whitening product, always consult your dentist. While the custom-fitted trays that hold the whitening material in place generally fit well, stop using the product and speak to your dentist if you are having any problems with leakage, tooth sensitivity or gum irritation.

For more information on tooth whitening options see

Oral Hygiene and Teeth Whitening.

 

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