Public awareness, preferences, and myths regarding tooth whitening: a cross-sectional survey

Abstract

To evaluate public awareness, information sources, treatment preferences, safety perceptions, and common myths regarding tooth whitening and to investigate whether these perceptions differ according to gender and educational level. A cross-sectional survey was conducted among 532 adults recruited via convenience sampling in Türkiye. A 19-item questionnaire, developed through a literature review, expert evaluation, and pilot testing, assessed participants’ demographic characteristics, information sources, treatment preferences, safety perceptions, and beliefs regarding professional and alternative whitening methods. Associations between responses and gender or educational level were analyzed using Pearson chi-square and Rao–Scott chi-square tests (α = 0.05). Associations among the questionnaire items were additionally explored using Pearson chi-square tests with Cramer’s V and Bonferroni adjustment. Dentists were the primary source of tooth-whitening information (58.08%), followed by social media (36.09%). Gender significantly influenced both beliefs and behaviors related to tooth whitening. Female participants were more likely to believe that white teeth improve self-confidence, perceive whitening as harmful, believe that whitening causes enamel thinning and dental caries, and consider alternative whitening methods effective (all p < 0.05). Educational level was associated with both whitening-related perceptions and behavioral practices, although the specific pattern of associations varied across questionnaire items. Participants with lower educational attainment reported greater use of alternative whitening methods, whereas those with higher educational attainment relied more frequently on dentists for information and reported lower use of alternative methods ( p < 0.05). Over-the-counter whitening toothpaste/gel was the most commonly reported whitening approach across all educational groups. In the exploratory item-by-item analysis, 55 of 78 pairwise associations were significant after Bonferroni adjustment, but almost all were of small magnitude; the strongest were between the two harm-related beliefs (V = 0.443) and between the two safety perceptions (V = 0.320). Misconceptions regarding tooth whitening remain common despite dentists being the primary information source. Gender was associated with a broader range of whitening-related beliefs and behaviors, whereas educational level showed associations with selected perceptions and behavioral practices. These findings emphasize the need for evidence-based patient education and improved oral health communication to counter misinformation and promote safe tooth-whitening practices.