It's no secret that white teeth are highly coveted around the world. After all, psychological studies show that not only are people with white teeth perceived as more attractive and intelligent than those with an average smile, but those with white teeth are more likely to receive a job offer and larger salary.

However, not all enamel is naturally bright, and years of drinking coffee and wine, as well as smoking can easily dim a smile.

To compensate for lackluster teeth, patients turn in droves to their dentists or to teeth whitening kits purchased online. Teeth whitening is the most requested cosmetic dental procedure in the United States.

Combining professional teeth whitening systems along with over-the-counter products, the teeth whitening industry continues to top over $11 billion annually. In fact, the American Academy of Cosmetic Dentistry claims 90 percent of adults believe white teeth make you more appealing to the opposite sex.

The not-so-bright side of the teeth whitening industry is that patients continue to turn to online resources to whiten their teeth, simply due to cost. This can be dangerous to their overall oral health, as inexperienced persons will expose their teeth longer than recommended to the whitening solutions or improperly fit the whitening tray to their teeth.

An investigation in The Telegraph details the stories of patients who damaged their mouths so heavily from at-home teeth whitening kits they needed reparative skin grafts. In fact, the article states experienced dentists claim, "some home teeth whitening kits available on the internet can contain a solution of hydrogen peroxide to 250 times stronger than the legal limit." It goes on to add that "only dentists can use the chemicals authorized for teeth whitening. What some companies are [using is] bleaches of the kind used to clean swimming pools."

Yikes.

This is probably the best fact to tell patients leaning toward online teeth-whitening kits. If patients are overly concerned with the price of in-office treatments or dentist-prescribed teeth kits, let them know how much skin grafts can cost them and what the procedure involves.

On average, a single gum skin graft can cost around $600-$1,200, and that's assuming the damage only needs one skin graft to completely repair. That's significantly costlier than the $200-$400 they can expect to spend on a dentist issued, take-home whitening treatment.

But how likely are chemical burns?

Studies have shown that one-tenth of all people who buy online teeth whitening treatment show signs of gum damage and chemical burns. This is most likely due to the higher-than-legally-allowed levels of peroxide, combined with patient inexperience in molding their teeth whitening trays.

Unfortunately, despite efforts by dental associations all over the world, sites like Amazon and eBay continue to allow individual, unlicensed retailers to sell their products.

Dentists need to be vigilant in explaining these negative (and not unlikely) side effects of online whitening to their patients. This keeps them safe and allows them to make a properly informed decision about their own oral care.