Teeth Whitening

1 What Is Teeth Whitening?

Teeth whitening is procedure ideal for patients who have healthy teeth with no fillings and healthy gums who would like a brighter smile.

This procedure is not recommended in children under the age of 16 in pregnant or lactating women, in people with sensitive teeth and allergies to products, in people with gum disease, worn enamel, cavities, and exposed roots, fillings, crowns and other restorations, in people with unrealistic expectations and in people with darkly stained teeth because yellowish teeth respond well to bleaching, brownish-colored teeth respond less well, and grayish-hue or purple-stained teeth may not respond well to bleaching at all.

The degree of whiteness vary from individual to individual and it depends on the condition of the teeth, nature of the stain, the concentration of the bleach and the duration of time and bleaching system used.

Caring for your teeth

The procedure can be done by:

  • Whitening toothpaste (dentifrices) contain gentle polishing or chemical agents that provide additional stain removal effectiveness. They do not contain bleach so they can lighten the tooth’s color only by about one shade.
  • At-home bleaching:
  1. Over-the-counter whitening strips are very thin strips coated with a peroxide-based whitening gel. They must be applied twice a day for 30 minutes for 14 days. The initial result is visible after few day and final result sustained for about 4 months. The cost is about $10-$55 for a 14-day treatment.
  2. Over-the-counter whitening gels are clear, peroxide-based gels. The gel must be applied like toothpaste twice a day for 14 days. The initial result is visible after few days and final result sustained for about 4 months. The cost is about $15 for a 14-day treatment.
  3. Over-the-counter tray-based bleaching systems purchased at a local drug store, over the Internet or by mail contains a mouth guard-like tray which is filled with a gel-like whitening solution that contains a peroxide bleaching agent. The tray must be placed over the teeth during few hours a day or during the night for up to 4 weeks and even longer.
  4. Dentist supervised tray-based whitening system is purchased through dentist's office and it is similar to the over-the-counter system but the main difference is in the strength of bleaching agent which is stronger when it is used by a dentist and that a mouthpiece tray used by a dentist is custom made for every patient. The cost is approximate $150 to $300 per upper or lower set of teeth, or $300 to $600 for the whole mouth.
  • In-office bleaching, also called chair-side bleaching or power bleaching is done at the dentist’s office. The dentist will first protect the gums with protective gel or guard positioned over the gums and then apply bleaching agent directly to the teeth and heat it with the use of heat, a special light or laser light. The results are visible after the first treatment. The cost is from $200 to $500 per arch or $500 to $1,000 for the whole mouth.

The side effects which can occur most often are a temporary increase in tooth sensitivity and mild irritation of the soft tissues of the mouth, particularly the gums but they usually disappear within 1 to 3 days of stopping or completing treatment.

If this happens, a person should reduce or stop whitening for two to three days, ask the dentist or pharmacist for a high fluoride-containing product, which can help remineralize your teeth and brush teeth with toothpaste made for sensitive teeth which contain potassium nitrate, which helps soothe teeth's nerve endings.

Some bleaching only dentist-dispensed home-use and office-applied products have received the ADA Seal of Acceptance, which indicates that the product has met ADA guidelines for safety and effectiveness but no over-the-counter products have the Seal of Acceptance. Also, several whitening kinds of toothpaste that are available over-the-counter have received the ADA Seal of Acceptance.

It is important to mention that not all manufacturers seek the ADA's Seal of Acceptance, so just because a product does not have the ADA Seal of Acceptance does not necessarily mean that the product is not safe and effective, but products with seal meet the ADA's standards for safety and effectiveness when used as directed. Also, teeth whiteners are not drugs and therefore are not regulated by the FDA.

Whitening is not permanent so 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 and those who avoid this kind of food and beverage can wait one year or longer before another whitening treatment or touch-up is needed.

Good oral hygiene is important, so a person must brush regular toothpaste or rinse immediately after consuming stain-causing beverages or foods and at least twice daily and also floss. Also, it is recommended to use whitening toothpaste but only once or twice a week.

Dental insurance usually does not cost the cost of the tooth whitening procedure.

Studies show that whitening products which contain 10% carbamide peroxide cause little or no effect on the hardness or mineral content of a tooth's enamel surface, that effect on the health of a tooth’s nerve or the existing filling but also it is important to notice that existing restorations like as tooth-colored fillings, crowns, bonding, veneers, and bridges do not lighten so any preexisting dental work may need to be replaced to match the new tooth shade.

2 Related Clinical Trials