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Tooth Whitening

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 night.

  -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 about bleaching.

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: