Tooth whitening (or bleaching) is a simple, non-invasive dental treatment used to change the color of natural tooth enamel and is an ideal way to enhance the beauty of your smile.
Because having whiter teeth has now become the number one aesthetic concern of most patients, there are a number of ways to whiten teeth. The most popular method is using a home tooth whitening system that will whiten teeth dramatically. Since tooth whitening only works on natural tooth enamel, it is important to evaluate replacement of any old fillings, crowns, etc. Replacement of any restorations will be done after bleaching so they will match the newly bleached teeth.
Tooth whitening is not permanent. A touch-up may be needed every several years, and more often if you smoke, drink coffee, tea, or wine.
Reasons for tooth whitening:
Fluorosis (excessive fluoridation during tooth development).
Normal wear of outer tooth layer.
Stained teeth due to medications (tetracycline, etc.).
Yellow, brown stained teeth.
What does tooth whitening involve?
Having a beautiful smile
that you are proud of may be even easier than you think. By now, most
people know basically what bleaching is. To simplify, we will discuss
the three main types of bleaching.
1. Over-The-Counter Bleaching Products
Crest White-Strips are probably the most common
over-the-counter bleaching product. All bleaching products, including
over-the-counter, work by using a chemical that releases hydrogen
peroxide. The chemical in the bleaching gel may not be pure hydrogen
peroxide, but it releases hydrogen peroxide. The main difference in the
three categories of bleaching techniques is the concentration of
hydroxide peroxide being released. In the case of over-the-counter
products, the concentration of hydrogen peroxide being released is a
lower concentration than the other two categories of bleach, which are
both initiated in the dental office.
Over-the-counter products do bleach teeth, but they
would have to be used over a longer period of time and the end result
would probably not be as “white” as with the other categories. However,
if the patient only wants a slight shade change and is willing to be
patient, over-the-counter products may do the job just fine.
2. Tray Bleaching
Tray bleaching is the bleaching we usually recommend. Tray bleaching is not as messy as
over-the-counter products because the bleaching solution itself is kept
in contact with the teeth with a clear plastic “tray”. Impressions are
made of your teeth and models are made from the impressions. We have
our own laboratory for basic dental procedures so of course
we can make the bleaching trays very quickly in our office, many times
within a few hours.
We dispense the bleaching solution to you when you pick
up the trays. We will show you how to use the trays and answer any
questions you have.
Depending on the concentration of the gel we dispense
to you, we may recommend that you bleach in the trays before you go to
bed and just leave the trays in all night. Some patients would rather
put the trays in their mouth an hour or so before they go to bed, then
remove the trays before going to bed. Some gel concentrations should be
left in the mouth for shorter periods of time. We will discuss this
with you when we dispense the gel.
The reason that the bleaching gel dentists dispense is
not sold over the counter is that some “supervision” is required. The
bleaching solution is perfectly safe, but it can make teeth sensitive
and some patients report that the bleaching gel irritates their gums.
If this happens, we recommend that patients either leave the trays in
for less time or use the trays every other night rather than every
-How long will it take to bleach my teeth?
That is a question we always get and is a difficult
question to answer. We usually tell patients that after 2 or 3 weeks of
bleaching they will usually see a significant lightening of their
teeth. However, the actual result a patient gets from bleaching varies
tremendously from patient to patient. Some people’s teeth simply bleach
better than others. Yellow shaded or brown shaded teeth generally
bleach better than gray shaded teeth. We usually tell patients that
they are the judge as to how their teeth look. Patients should be
careful not to “over bleach” their teeth.
Bleaching does not add white color to teeth, bleaching
takes away color. Some teeth start to get more clear (dentist call this
translucent) with long term http://www.yourdentistryguide.com/teeth-whitening/bleaching. The problem with teeth becoming
more translucent is that the teeth “pick up” the color of the back of
the mouth which is dark, and the teeth actually start to look bluish or
blue-gray. For that reason, we tell patients to decide every day how
their teeth look. When they are light enough, stop bleaching.
When the bleaching trays are removed by the patient the
teeth will appear almost “frosty”. This is because the teeth become
dehydrated because the hydrogen peroxide takes water out of the teeth.
In a few hours the teeth will absorb water from the saliva and
“re-hydrate”. The teeth will not have the “frosty” appearance an hour
or two after tray removal, but they are actually getting lighter
gradually. Some patients become confused by this and think the “frosty”
appearance is their “bleaching target”. These patients keep coming
back and buying more bleaching gel from us because they are trying to
maintain that “frosty” appearance. Long term bleaching to maintain this
“frosty” appearance is not recommended.
The bleaching kit we dispense with the trays is enough
to last 3-4 weeks of bleaching depending on how much gel the patient
places in the tray each night. Some teeth genuinely need more bleaching
than this to get a result the patient is pleased with.
-Will my teeth stay white?
Amazingly, the answer is basically yes. We tell
patients to keep any left over bleaching gel in the back of their
refrigerator so it will stay fresh. In a year or two the teeth may
darken just slightly, but usually 2-5 nights of bleaching will get the
teeth back to the bleached shade.
Call our office and ask our fee for the bleaching trays
and bleaching gel kit. Our fee has been less than $300.00 for several
years for the trays, the gel, and the instructions. By the time you
call, the fee may be slightly higher, depending on how much we pay for
the gel and how often we update the text in this web site, but the fee
will be very reasonable. We keep our fee reasonable so that many of our
patients can afford this worthwhile procedure. We will probably not
suggest that you bleach your teeth when you come in for regular cleaning
because we feel that this is your decision, but do not hesitate to ask
3. Power Bleaching
Power bleaching is bleaching with a higher
concentration of bleach, and this type bleaching is done in the dental
office in the dental chair. At our office, we
invested several thousand dollars in a power bleaching system, which is
mainly a special light. To power bleach teeth, the teeth must first be
isolated. This means that lip retractors are placed in the patient’s
mouth; then a silicone-like material is placed over the patient’s gums
to protect the gums. A high concentration of bleaching gel is then
applied to the teeth; then the special light can be placed very close to the
teeth and the light stays on periodically for usually about an hour. An assistant
is either at chairside or close by to monitor the process. The
bleaching gel is re-applied every 15 minutes or so because the high
intensity light dries the bleach out.
We purchased the system because we believed the
manufacturer’s claim that a one hour session would bleach a patient’s
teeth to a shade they were happy with. We did several “power bleaching”
cases and we started to find that many times we were not seeing results
as good as what we saw with the tray bleaching we had been using. We
had to charge an appropriate fee for the power bleaching, and we were
having to bring the patient back for repeated sessions. We started
having the patients tray bleach their teeth after power bleaching
because we actually were seeing better results with tray bleaching. We
talked to other practices that we respected around the country about
this and these practices reported similar experiences.
An excellent resource site on tooth whitening in general can be found below: