1. What tooth whitening choices are there if I am interested in whitening my teeth?
There are a number of different ways to whiten teeth. There are two main choices. One is professional bleaching which requires visiting a dentist and the second is over the counter whitening i.e. buying it from a retail store or through the internet.
Different ways to bleach teeth:
- Chair-side bleaching, which involves getting your teeth bleached in usually a single dental visit at a dentist
- There are 2 kinds of At-home-tray whitening systems.
- From moulds of your teeth fabricated by a dental lab, which you use at home with a bleaching agent.
- A WARM N FORM or BOIL AND BITE at home and is made by you in minutes and used with bleaching gel and most affordable
- Tray-less Whitening using MOST Popular Crest Whitestrips or Pola Pen applicator which are fast and easy
Chair-side bleaching can be done in two ways. The dentist uses a very strong bleaching agent alone or in combination with a light/laser. With both, the dentist cleans your teeth with a sandy, pumice-like material to remove plaque and cleans the surface of the tooth. Then a peroxide-based gel is applied after which a light may be applied to assist the whitening process. Most gels are self-activating and others are activated and by the use of a light. The laser does NOT whiten teeth. It merely activates the bleaching gel and initiates the chemical reaction that produces the whitening effect (the laser doesn't actually penetrate the teeth). The procedure takes about an hour and a half and offers immediate results, although it may take more than one session to achieve the desired level of bleaching.
The at-home bleaching tray methods require a fitted mouth tray (bleaching tray) to hold the bleaching gel against the tooth either overnight or hourly depending on the strength of the bleach dispensed. In the past, this bleaching tray was fabricated only by a dentist. Today, these custom trays can also be ordered via the internet. You take the mold of your teeth and mail the molds to a dental lab who fabricates the trays and mails them back to you. The turn-around time is approx. 2-3 weeks. Alternatively, the boil n bite trays bypass having to wait for them to be mailed but are more bulky and don't fit as well. You mold the trays against your teeth yourself after placing the thermoform trays in boiling water for a few minutes to soften it. It is advised you visit your dentist before whitening to make sure that you don't have any cavities or any other limitations that would compromise your tooth whitening results.
There are also tray-less over-the-counter options available for tooth whitening. These are the Crest Tooth Whitening Strips, or whitening pen etc. Crest whitening strips maybe a better option for those who don't want to wear a tray. These strips are more difficult to keep in place especially on the lower teeth while the paint on whitening needs be kept dryish to adhere and prevent wash-out.
No matter which method you choose, how white your teeth will get depends on what color they are to begin with and the source of the discoloration. Brown or yellow teeth (often the result of superficial staining caused by smoking, coffee, and tea) will usually get whiter. Gray teeth (caused not by stains but by pigment deep inside the tooth) will lighten less, sometimes not at all. Results cannot be guaranteed. To determine the initial color of your teeth, compare them to a sheet of bright white computer paper held up to your mouth.
Chairside bleaching is the fastest but also the most expensive, anywhere from $4-$600 per session and usually requires more than one session for maximum results. Take-home bleaching kits average around $300 from the dentist, less costly online and can be used with your own schedule. Over-the-counter options, as you might expect, are the least expensive, but are thought per dentists to be less effective. Recent research has shown white strips to be as effective. The most common side effect of any of these procedures is sensitivity to hot and cold, but that lasts only while you are using the bleach and tends to persist for 1-2 days afterwards.
If there's little chance that you'll remember to pop in a mouth tray every night, or if you are impatient to see results, chair side bleaching may be a better option for you. This method also allows the dentist to treat teeth individually, which is ideal if you have veneers or teeth that vary in shade.
With proper aftercare, whitened teeth can stay bright for a few years. To keep your smile bright as long as possible, try these easy tips:
- Follow the "white teeth diet" Drink white wine instead of red wine, cappuccino instead of espresso, and grapefruit juice instead of cranberry juice.
- DO NOT Use "whitening" toothpaste with a mild abrasive. It is not recommended because they contain sand like rough particles which actually thin or remove a layer of enamel while removing stains. It is almost like using a "sand paper" paste which is harmful and damaging which is why we don't sell these products.
To our knowledge nothing detrimental has been documented and microscopic research shows no changes to the tooth surface with use of 10% bleaching solution. Most research available was initially done with a 10% concentration. There is no literature that we have come across showing any structural changes or irreversible damage to the tooth structure whatsoever.
All bleaching gel causes some degree of tooth sensitivity. This is sensitivity to cold/hot fluids and even air can cause discomfort. This is normal and an expected side effect. Some of the brands of bleaching gel contain desensitizing agents which claim to alleviate post bleaching sensitivity. From customer feedback, this doesn't seem to be noticeably effective. All bleaching causes tooth sensitivity and we recommend to either discontinue use for a few days and the sensitivity will dissipate within 24-48 hrs. Don't be concerned as bleaching does not need to be done consecutively. You will get to the same whitening point, it will just take a little longer. Using a desensitizing toothpaste like Sensodyne or any of the over the counter toothpastes containing potassium nitrate as the active ingredient will help.
Are your teeth sensitive from using bleaching gel? - Try MI paste of desensitizing gel, otherwise just stop whitening for a few days or weeks or try a weaker gel.
Results vary. Some teeth whiten dramatically in just a few days, while others can take a few months. The majority of people whiten within 2-3 weeks. The more yellow versus gray color you have in your teeth, the better the bleaching. Grey enamel similar to that of Tetracycline (antibiotic) staining is more difficult to bleach and can take a few months to achieve a result.
Generally, immediately after bleaching, the color will fade slightly and then remain stable for approx. 6 months to a year, sometimes longer. It is recommended for maintenance to touch up your smile every 4-6 months with 1-2 applications. How often you will need to whiten depends on your age, diet and habits. Example regular coffee drinker or smoker will need more applications more frequently than a non drinker and non smoker.
No research has been done into bleaching teeth while nursing or pregnant, so manufacturers for liability reasons recommend NOT to bleach while pregnant or nursing.
All bleaching agents used to whiten teeth will only work on natural tooth structure. This means that all dental work including but not limited to bonding, veneers, crowns (caps) and bridges will NOT bleach or whiten. All dental work would need to be replaced to match the newly whitened teeth.
There is no objective research at the present time comparing the different tooth whitening systems or the effectiveness of various bleaching gels currently available. They all work, some bleaching gels just gets you there quicker. They will all eventually get you to the same bleaching plateau (maximum whitening). Results vary, some teeth whiten very well as others show minimal changes no matter what product is used. We recommend to stay with a brand or strength that has worked for you and to maybe try another brand or strength if you are unhappy with your current bleaching results. Ultimately the choice of bleach agent is really a personal one. If you have never done teeth whitening start with a weaker gel like 10% carbamide peroxide to calibrate results and sensitivity.