article: Sitting in a restaurant with friends, Teresa James pushed food longingly around her plate, desperate to eat but unable to stand the pain it would cause. Her mouth felt as if it were on fire, her gums were beginning to blister and her teeth had grown so sensitive that she knew that if so much as a sip of water came into contact with them she would wince. But Teresa’s agony was tempered with pride, because when she did manage to summon a smile, it was the most dazzling at her table. Teresa James, 40 (pictured), believes the discomfort involved with teeth whitening is worth it for the end result of a bright smile . She had spent four hours earlier that afternoon bleaching her teeth and, as far as she was concerned, the considerable discomfort was worth it. ‘Whitening has been unbearably painful at times,’ says Teresa, 40. ‘But I am obsessive about having a bright smile.’ Teresa’s regimen may sound somewhat masochistic, but she is one of an increasing number of women for whom whitening their teeth has become an integral part of their beauty routine — as normal as colouring their hair or waxing their legs. In America, sales of tooth whitening products have risen 300 per cent since 1996, and the trend for excessive bleaching has grown so commonplace there that dentists have coined a new word for it — ‘bleachorexia’. Symptoms include burning gums, tooth infection and the conviction that, no matter how much a tooth has been whitened, it could be paler still. Perhaps predictably, it has caught on in Britain. Almost a third of Britons are now preoccupied with whitening their teeth, and research this week revealed the highest-earning cosmetic dentists made a collective turnover of £1 billion last year — a 22 per cent increase from 2010. ‘When it is done properly, tooth whitening is a simple and safe way of improving your appearance,’ says cosmetic dentist Dr Mervyn Druian. ‘But if it is performed in an unregulated fashion, with the wrong product, it can cause enamel erosion, receding gums and infection.’ Tessa (pictured) is part of a growing group of women for whom teeth whitening has become an integral part of their beauty regime . Teresa, a banking finance officer from London, started whitening her teeth five years ago, influenced by the brilliant smiles of celebrities she admired. ‘My own teeth looked grey in comparison after years of caffeinated drinks and they were affecting my confidence,’ she says. The active ingredient in most professional whitening products is hydrogen peroxide, in gel form. In October 2012, an EU council directive made it illegal in Britain to use hydrogen peroxide — which can cause sensitivity and burning when applied too often or at too high a dose — in concentrations above 6 per cent, and decreed any concentration over 0.1 per cent could be administered only by a dental professional. When carrying out the procedure, a dentist makes a mould of the patient’s teeth from which a special tray is constructed. Hydrogen peroxide gel is then squirted on to the tray via a syringe, and the tray fitted over the teeth and left for 45 minutes. Teresa (pictured) started whitening her teeth five years ago having been influenced by the brilliant smiles of celebrities she admired . Usually, the first treatment is carried out at the surgery, then the patient is given syringes and the tray to use at home — 45 minutes a day, for a fortnight, being the norm. The treatment normally costs up to £500, so when Teresa spotted a DIY whitening kit online for £17.99, she was tempted. It looked authentic enough: a silicone tray and five syringes of bleach. Teresa isn’t sure how strong this hydrogen peroxide was, or indeed even if it was hydrogen peroxide. But the tray had to be moulded to her teeth — by softening in boiling water first — then worn overnight. That’s when the warning bells should have sounded, says Dr Druian: ‘Trays should always be properly fitted by a dentist otherwise they will never fit well and can cause leakage, which irritates gums.’ Lisa Arbiter (pictured) has been bulk-buying high-strength bleach from America to whiten her teeth every month for the past 13 years . Sure enough, the minute Teresa put the tray on, her gums started to tingle. ‘I just assumed it meant it was working,’ she says. Keen to go whiter than white, she kept the bleach on for an hour — another mistake, says Dr Druian. ‘After 45 minutes out of the syringe, hydrogen peroxide loses effectiveness. More time won’t make your teeth whiter, it will just lead to irritation and sensitivity. And if you have decay in your teeth, it can enter and lead to infection.’ But Teresa was so delighted with the initial results that she used her whitening kit once a week, leaving it on for longer each time. By the time she had reached her last syringe, she was bleaching for up to four hours at a time. Lisa (pictured) was just 19 when she first tried bleaching her teeth, she now says it's addictive and she'll carry on doing it for ever . ‘My teeth were so weak and sensitive I worried they were going to fall out. I was in agony. I knew I was being irrational, but having white teeth had become a part of my identity. It was only after an evening of not being able to eat and waiting for days for my swollen gums to go down that I realised I’d gone too far.’ So Teresa invested in whitening toothpastes, a whitening powder and a whitening pen instead. Ironically, the changes made to the law in 2012, which were supposed to protect patients’ dental health, have seen a flood of illegal DIY whitening products on to the market, alongside unqualified practitioners who cater for those — like Teresa — who can’t afford a dentist’s whitening service. ‘There has been an upsurge in beauticians whitening teeth with unregulated materials,’ says Dr Druian. ‘Many use chlorine dioxide — a strong antibacterial chemical sometimes found in swimming pools — which is easier to get hold of, given the Government’s restrictions on hydrogen peroxide. Lisa (pictured) buys £50 boxes of syringes of a 25 per cent solution from the U.S and insists she has no pain or side effects from the treatment . ‘At a high concentration, this can burn gums, leading to receding, and make tooth enamel rough and porous, which leaves it prone to further staining — trapping users into a vicious cycle of whitening.’ Natasha Crane, from Norwich, is suffering from suspected enamel erosion after having her teeth whitened, for £30, by a beautician operating illegally. She had seen an advert on Facebook. Unknown to Natasha, aged 17, she is a year under the legal age limit for teeth whitening, but the beautician didn’t check. ‘She painted the whitening gel on with cotton wool,’ remembers Natasha. ‘It didn’t feel professional or hygienic, but this was my first experience of tooth whitening.’ As soon as the beautician removed the gel an hour later, and Natasha rinsed her mouth, her teeth felt agonisingly sensitive. Newlywed Donna Bilson (pictured) is a recent convert to tooth bleaching but is already very taken with it . ‘The beautician said this was normal,’ she recalls. ‘When the pain didn’t go away over the next few days I called her back, but she still said there was nothing to worry about.’ After later discovering that her beautician had been operating illegally, she reported her to the General Dental Council — the regulatory body for British dentists. Since then, Natasha’s teeth have grown more painful. ‘They’re so sensitive that it hurts when they come into contact with fresh air,’ she says. ‘I have to wear a scarf over my mouth outdoors. Eating is agony and I drink through a straw.’ Meanwhile, her teeth are starting to turn yellow because the dentine that is underneath the enamel is becoming exposed. ‘Not only am I in pain, but, ironically, my teeth have never looked worse,’ says Natasha. Beauticians practising illegally are not the only problem, however. Increasing numbers of women are ordering industrial-strength hydrogen-peroxide whitening products online from the U.S., where there are no legal limits on levels. Donna (pictured) and her husband, Andy, both started bleaching their teeth before they got married last October . Lisa Arbiter, 33, has been bulk-buying high-strength bleach from America to whiten her teeth every month for the past 13 years. She was 19 and working as a beauty therapist when she first tried it. She buys £50 boxes of syringes of a 25 per cent solution from the U.S., yet insists she has no side-effects other than sensitive teeth. ‘At work, having white teeth makes me look more professional,’ she says. ‘And having so many pictures of ourselves plastered on social media makes it obvious who has whitened their teeth and who hasn’t. Un-whitened teeth look dirty. ‘Tooth whitening is addictive, and I’ll carry on bleaching mine for ever.’ According to the British Dental Health Foundation the effects of professional whitening can last for up to three years. Although her husband stopped after their wedding, Donna (pictured) has carried on and says its part of her beauty routine now . But newlywed Donna Billson — a recent convert to tooth bleaching — is already hooked on doing it far more frequently than that. Donna and her husband Andy, 34, started whitening their teeth last January in the run-up to their wedding last October. ‘We wanted to look our best in the pictures,’ says Donna, 36, a HR manager from Birmingham. They ordered £55 boxes of 20 whitening strips — fabrics impregnated with 6 per cent hydrogen peroxide gel that users stick to their teeth for 45 minutes — from the States. ‘Andy stopped after our wedding and says I don’t need to whiten my teeth any more either,’ says Donna. ‘But I’ll carry on. It’s as much a part of my beauty routine as having my hair coloured and legs waxed.’
highlights: Teresa James, 40, believes the pain involved is worth it for a bright smile .
  Lisa Arbiter, 33, has bought high-strength bleach from America for 13 years .
  Donna Billson started before her wedding last year and is already a convert .
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