TOOTH WHITENING FAQ
How Does The Bleaching Process Work?
Bleaching gels usually contain either hydrogen peroxide or carbamide peroxide. When applied to human teeth, peroxide molecules go into the tiny pores of the enamel and dentin, break down into oxygen molecules and break up the stains that block out the light. More and more light passes through the teeth and they appear lighter.
Yellow to slightly brown extrinsic stains that accumulate over time respond best to bleaching. Intrinsic stains that are dark brown to blue¬gray are the most difficult to bleach because the stain is so deeply embedded into the tooth.
What are the Treatment Options?
Yes. There are two types of bleaching procedures to choose from: One performed in the dentist’s office (Power Bleaching) and gives you immediateresults, and the other is a take¬home, self¬administered treatment (Gradual Bleaching) that produces results slowly over time.
“Power Bleaching” can only be performed in a dentist’s office. A hydrogen peroxide¬based bleaching solution is applied to the teeth and activated by a high intensity light or laser that causes the solution to release oxygen molecules. Treatments for both power and laser bleaching can take as little as 45 minutes, but usually last somewhere between one and two hours.
“Gradual Bleaching "is a take¬home treatment administered under the supervision of a dentist. Impressions of the patient’s teeth are made and a custom¬fitting mouthpiece is created to protect the rest of the mouth from contact with the bleaching chemicals. The active chemicals used are not as strong as those used in Power Bleaching, and provide a more gradual lightening of the teeth. Gradual Bleaching takes 1 hour per day for anywhere from 1¬3 weeks to achieve maximum results, and often requires follow¬up checks by your dentist.
What Causes Tooth Discoloration?
Tooth discoloration can be caused by many factors, including genetics, aging, staining (e.g., tobacco, coffee, tea, soft drinks), and chemicals (e.g., tetracycline). Professional dental cleanings and the regular use of whitening toothpaste can usually remove tooth stains on the outside of the teeth (extrinsic staining). Deeper stains, including the yellow color teeth take on as we age (intrinsic staining) require specialized treatment by your dentist¬ called “tooth bleaching”.
Tooth bleaching was first used on healthy, live teeth in the mid¬1970's. When done professionally it is simple, effective, and has few side effects. Recent long¬term studies have shown bleaching to be a safe and amazing way to get whiter teeth.
How can you brighten your smile?
Your wedding is coming up and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for the movie stars, and it isn't just for one day. Millions of people have had their teeth bleached, and probably millions more are thinking about it. The desire for whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to three years. The most effective and safest method of tooth bleaching is dentist-supervised.
Is bleaching for you?
Generally, bleaching is successful in at least 90 percent of patients. Consider tooth bleaching if your teeth are darkened from age, coffee, tea, or smoking. Teeth darkened with the color of yellow, brown or orange respond better to lightening. Other types of gray stains caused by fluorosis, smoking, or tetracycline are lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal disease, or teeth with worn enamel, your dentist may discourage bleaching.
Step one: First, the dentist will record your medical history to determine whether you are a candidate for tooth bleaching and what type of bleaching system should be used. Next, you'll decide if you want all of your teeth bleached, or just the uppers. If you're in a big hurry for whiter teeth, you may decide to have in-office bleaching where the dentist will whiten your teeth while you sit in the dental chair. However, most patients choose dentist-supervised at-home bleaching, which is more economical.
Step two: At the next appointment, the dentist or hygienist will take impressions of your teeth to fabricate your mouth guard appliance. The mouth guard is custom made for your mouth only and is very lightweight, so that it can be conveniently worn. It is fabricated so that it can be comfortably worn while sleeping or while awake. You should even be able to talk with your mouth guard. Along with the mouth guard, you'll receive the bleaching materials. You'll be instructed to wear the mouth guard for two to four hours a day until your next appointment, generally within one to two weeks. Generally this type of system requires three to six weeks to complete, and works best on patients with sensitive teeth. Other systems recommend bleaching at night while you sleep with their mouth guard. This bleaching treatment usually requires only 10-14 days to complete.
How long does it last?
Lightness should last for about one to five years depending your personal habits such as smoking and drinking coffee and tea. At this point you could use a touch up. The procedure will not be as costly the next time because you can probably still use the same mouth guard. The retreat time also is much shorter than the original treatment time.
How does it work?
The active ingredient in most of the whitening agents is 10 percent carbamide peroxide (CH4N202), also known as urea peroxide; when water contacts this white crystal, the release of hydrogen peroxide lightens the teeth.
Is it safe? Any side effects?
Several studies have proven its safety during the past five years. The American Dental Association has also granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.
What are realistic expectations?
No one can really predict how much lighter your teeth will become. Every case is different. However, typically there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of stain and your compliance. Bleaching can only provide a shift in color from gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as resins, silicates or porcelains.
What About Home Bleaching Systems I Can Buy At The Store?
Store¬bought bleaching systems are not as effective, and can cause painful sensitivity to untreated dental cavities. Why? First, the active chemicals are not as strong as those you can get from your dentist. They may eventually lighten your teeth some (5¬6 shades: much less than a dentist¬provided system), but who wants to wait 6 months to a year for results? Second, without a custom mouthpiece, the likelihood of severe gum irritation is dramatically increased. In addition, a poor fitting mouthpiece can lead to ingesting the active chemicals — and stomach upset, nausea, and vomiting. Third, individuals using store¬bought bleaching systems can over¬bleach their teeth — and cause damage to the enamel.
Dentist¬provided systems are backed by scientific studies that prove their safety and effectiveness when administered by a highly skilled professional like those at Advanced Dental Care Centre.
What Kind Of Results Can I Expect With A Dentist¬Provided System?
Both Power Bleaching and Gradual Bleaching provide whitening results as much as 12 – 15 shades lighter than the original tooth color. Results vary depending on the condition of the individual patient’s teeth. Patients should avoid all tooth¬staining foods and tobacco for 1¬2 days after Power Bleaching. Gradual Bleaching patients should do the same both during treatment and for up to 2 weeks after treatment. Tooth bleaching lasts an average of 2¬3 years depending on diet and tobacco habits.
How Much Does Bleaching Cost?
Bleaching costs vary by procedure type. Dr. Anshu can help you decide which treatment type is best for you. Contact us for your free Cosmetic Consultation today!!
Who are the best candidates for teeth whitening?
Teeth whitening is ideal for patients who have healthy, unrestored teeth (no fillings) and healthy gums who would like a brighter smile. Patients with yellow tones to their teeth respond best.
Who are not good candidates for teeth whitening?
Circumstances under which teeth whitening is not recommended or will be less successful include:
Age and pregnancy issues. Bleaching is not recommended for children under the age of 16. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age. Teeth whitening under this condition could irritate the pulp or cause it to become sensitive. Teeth whitening is also not recommended for pregnant or lactating women.
Sensitive teeth and allergies to products. People with sensitive teeth and gums, receding gums and/or defective restorations should consult with their dentist before using a tooth whitening system. Anyone allergic to peroxide (the whitening agent) should not use a bleaching product.
Gum disease, worn enamel, cavities, and exposed roots. People with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth whitening procedure. Cavities need to be treated before undergoing any whitening procedure. This is because the whitening solutions penetrate into any existing decay and the inner areas of the tooth, which can cause sensitivity. Also, whitening procedures will not work on exposed tooth roots because roots do not have an enamel layer.
Fillings, crowns, and other restorations. Tooth-colored fillings and resin composite materials used in dental restorations (crowns, veneers, bonding, bridges) do not whiten. Therefore, using a whitening agent on teeth that do and do not contain restorations will results in uneven whitening—in this case, making the teeth without restorations appear lighter than those with restorations. Any whitening procedure should be done before the placement of composite fillings, bonding, veneers, crowns, dentures, or porcelain restorations in order to best match the degree of whitening to your new tooth color. A minimum of 2 weeks following a whitening procedure should be allowed before crowns, bondings, or veneers are completed. This will allow enough time for the enamel to remineralize and optimize the bonding strength. Tooth-colored fillings will need to be replaced after the bleaching process is complete. People who have numerous restorations that would result in uneven whitening may be better off considering bonding, veneers, or crowns rather than a tooth whitening system. Ask your dentist what strategy may be best for you.
Unrealistic expectations. Individuals who expect their teeth to be a new "blinding white" may be disappointed with their results. Smokers need to be aware that their results will be limited unless they stop smoking, particularly during the bleaching process. A healthy guide as to a reasonable degree of whiteness to achieve with a whitening process is a slightly whiter color than the whites of your eyes.
What teeth whitening options are available?
There are 2 general approaches:
Whitening toothpastes (dentifrices)
Over-the-counter whitening strips
Over-the-counter whitening gels
Over-the-counter tray-based bleaching systems (purchased at your local drug store, over the Internet, by mail)
Dentist-supervised tray-based whitening system (whitening supplies purchased through your dentist’s office)
In-office bleaching, also called chairside bleaching or power bleaching.
How do whitening toothpastes work? How effective are they at whitening teeth?
All toothpastes help remove surface stains through the action of mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach; over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth. None of the home use whitening toothpastes can come even close to producing the bleaching effect you get from your dentist’s office. Whitening toothpastes can lighten your tooth’s color by about one shade. In contrast, light-activated whitening conducted in your dentist’s office can make your teeth three to eight shades lighter.
How do whitening gels and whitening strips work?
Whitening gels. These clear, peroxide-based whitening gels are applied with a small brush directly to the surface of your teeth. Instructions generally call for application twice a day for 14 days. Initial results are seen in a few days and final results are sustained for about 4 months.
Whitening strips. These are very thin, virtually invisible strips that are coated with a peroxide-based whitening gel. The strips are applied twice daily for 30 minutes for 14 days. Initial results are seen in a few days and final results are sustained for about 4 months.
Both of these products contain peroxide in a concentration that is much lower than the peroxide-based products that are used in your dentist’s office. Although some teeth lightening will be achieved, the degree of whitening is much lower than is achieved with in-office or dentist-supervised whitening systems. Additionally, use of over-the-counter products do not benefit from the close supervision of your dentist -- to determine what whitening process may be best for you, to check on the progress of the teeth whitening process, and to look for signs of gum irritation. On the positive side, the over-the-counter gels and strips are considerably less expensive than the top-of-the-line in-office whitening procedures,
What’s involved in the typical tray-based, tooth whitening procedure?
For the more traditional types of procedures using tray-based whitening systems purchased over-the-counter or through your dentist’s office, the first step involves filling a mouth guard-like tray with a gel-like whitening solution, which contains a peroxide-bleaching agent. This tray is then placed over the teeth and worn for a period of time, generally a couple hours a day or every day during the overnight for up to 4 weeks and even longer (depending on the degree of staining and desired level of whitening). (For more information, see section about mouthpiece trays below.)
What’s involved with an office-based tooth whitening procedure?
Bleaching procedures performed in the dentist’s office involve a few different or additional steps. A protective gel or guard is positioned over the gums before the bleaching agent is applied, the bleaching agent is applied directly to the teeth, and the whitening process is hastened with the use of heat, a special light, or laser light that is directed at the chemically coated teeth.
What are the main differences between in-office bleaching procedures and at-home and over-the-counter tray-based bleaching systems?
Strength of bleaching agent. Over-the-counter home use products and dentist-supervised at-home products usually contain a lower strength-bleaching agent (from 10% carbamide peroxide—equivalent to about 3 percent hydrogen peroxide -- up to 22% carbamide peroxide). In-office, professionally applied tooth whitening products contain hydrogen peroxide in concentrations ranging from 15% to 43%.
Mouthpiece trays. With dentist-supervised at-home bleaching products, your dentist will take an impression of your teeth and make a mouthpiece tray that is customized to fit your teeth exactly. This customization allows for maximum contact between the whitening gel, which is applied to the mouthpiece tray, and the teeth. A custom-made tray also minimizing the gel’s contact with gum tissue. Over-the-counter whitening products do contain a mouthpiece tray, but the "one-size-fits-all" approach means that the fit will not be exact. Ill-fitting trays can irritate the gum and soft tissue by allowing more bleaching gel to seep onto these tissues. With in-office procedures, the bleaching agent is applied directly to the teeth.
Additional protective measures. In the office setting, your dentist will either apply a gel to the gum tissue or use a rubber shield (which slides over the teeth) before treatment to protect your gums and oral cavity from the effects of the bleaching. Over-the-counter products don’t provide these extra protective measures.
Speed of the bleaching process. Dentist-supervised at-home bleaching and over-the-counter bleaching products typically need to be applied every day for 1 or 2 hours or every overnight for up to 4 weeks. In-office bleaching provides the quickest and most effective way to whiten teeth. With in-office bleaching, the whitening product is applied directly to the teeth. These products can be used in combination with heat, a special light, and/or a laser. The light and/or heat accelerate the whitening process. Results are seen in only one 30- to 60-minute treatment. To achieve dramatic results, however, several appointments are usually needed. With laser-enhanced bleaching, however, dramatic results can be seen after the first treatment.
Supervised versus unsupervised process. Dentist-supervised at-home bleaching and in-office treatment offer additional benefits compared with over-the-counter procedures. First, your dentist can perform an oral examination and consider your complete medical history, which can be helpful in determining how your teeth became discolored and if bleaching is an appropriate course of treatment based on your type of stains and number, type, and location of restorations. Your dentist can then better match the type of stain with the best treatment, if appropriate, to lighten those stains. With dentist-supervised bleaching procedures, your dentist will likely want to see you a couple of times to ensure you are following directions, to make sure the customized tray is fitting properly, to inspect your gums for signs of irritation, and to generally check on how the teeth whitening process is proceeding. With over-the-counter bleaching products, you are on your own.
What follow-up is needed?
After in-office whitening, your dentist may want to see you in a few days to check on your gums. If whitening your teeth at home under a dentist-supervised process, your dentist may want to check your gums and your teeth whitening progress after about a week of applications and again a couple weeks later.
How often does the teeth whitening need to be touched up?
Whitening is not permanent. People who expose their teeth to a lot of foods and beverages that cause staining may see the whiteness start to fade in as little as 1 month. Those who avoid foods and beverages that stain may be able to wait 1 year or longer before another whitening treatment or touch-up is needed.
What can I do to maintain my brighter smile?
Tips for maintaining your newly whitened teeth include the following:
Avoid the consumption of or exposure to products that stain your teeth (see above on what causes teeth to become stained). If you do choose to consume beverages that stain, consider using a straw so that the liquid bypasses your front teeth.
Brush or rinse immediately after consuming stain-causing beverages or foods.
Follow good oral hygiene practices. Brush your teeth at least twice daily and floss at least once daily to remove plaque. Use a whitening toothpaste (once or twice a week only) to remove surface stains and prevent yellowing. Use a regular toothpaste the rest of the time.
Consider touch-up treatments. Depending on the whitening method used, you may need a touch-up every 6 months or after a year or two. If you smoke or drink lots of stain-causing beverages, you may need a touch-up more often.
Are there any risks associated with teeth whitening?
The two side effects that occur most often are a temporary increase in tooth sensitivity and mild irritation of the soft tissues of the mouth, particularly the gums. Tooth sensitivity often occurs during early stages of the bleaching treatment. Tissue irritation most commonly results from an ill-fitting mouthpiece tray rather than the tooth-bleaching agent. Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment.
If you do experience sensitivity, you can reduce or eliminate it in the following ways:
Wear the tray for a shorter period of time (for example, two 30-minute sessions versus two 60-minute sessions).
Stop whitening your teeth for two to three days to allow your teeth to adjust to the whitening process.
Ask your dentist or pharmacist for a high fluoride-containing product, which can help remineralize your teeth. Apply the fluoride product to the tray and wear for 4 minutes before and after the whitening agent.
Brush your teeth with a toothpaste made for sensitive teeth. These toothpastes contain potassium nitrate, which helps soothe your teeth’s nerve endings.
Are these products safe and effective?
Some bleaching products dispensed through dentists’ offices as well as professionally applied (in-office) bleaching products have received the American Dental Association (ADA) Seal of Acceptance, which indicates that the product has meet ADA guidelines for safety and effectiveness. Currently, only dentist-dispensed home-use products containing 10% carbamide peroxide and office-applied products containing 35% hydrogen peroxide have received the ADA Seal of Acceptance. No over-the-counter products have received the Seal of Acceptance. Over-the-counter bleaching products are not endorsed by the ADA because the organization believes that professional consultation is important to ensuring safe and effective use. No whitening products using lasers currently are on the ADA’s list of accepted products. Several whitening toothpastes that are available over-the-counter have received the ADA Seal of Acceptance. For a list of specific toothpastes that have gained the ADA’s Seal of Acceptance, visit: www.ada.org/ada/seal/sealsrch.asp.
It should be noted that not all manufacturers seek the ADA’s Seal of Acceptance. This is a voluntary program that requires considerable expense and time on the part of a manufacturer. Just because a product does not have the ADA Seal of Acceptance does not necessarily mean that the product is not safe and effective. You can be assured, however, that products that do carry the seal have meet the ADA’s standards for safety and effectiveness when used as directed.
Teeth whiteners are not drugs and therefore are not regulated by the FDA.
Other frequently asked questions about teeth whitening procedures:
Do teeth whiteners damage tooth enamel?
Studies of whitening products using 10% carbamide peroxide showed little to no effect on the hardness or mineral content of a tooth’s enamel surface.
Do teeth whiteners damage existing dental restorations?
More than 10 years of clinical use of whitening products containing 10% carbamide peroxide have not shown any damage to existing fillings. The issue is not "damage" to existing restorations; rather, keep in mind that existing restorations such as tooth-colored fillings, crowns, bonding, veneers, and bridges do not lighten. This means that any preexisting dental work may need to be replaced to match the new tooth shade achieved in the natural teeth, should a bleaching process proceed.
Do teeth whiteners damage a tooth’s nerve?
There’s no evidence to date that the tooth whitening process has a harmful effect on the health of a tooth’s nerve. One study reported that at both a 4.5 and 7-year follow up, no individual who used a tooth whitening system needed a root canal procedure on any teeth that had been whitened.