Disgusted by those yellow-ish stains on your teeth? Here’s the lowdown on bleaching procedures for the pearlies.

As Americans diet and exercise their way to a more youthful appearance, they are realizing more and more that one of the hallmarks of appearing youthful is having a bright, beautiful smile. Psychological studies repeatedly confirm that oral and dental beauty is very important to the perception of an individual’s confidence and well-being.

Smile whitening is no longer a luxury reserved only for the rich and famous. These days, whiter teeth is the most popular esthetic request from dental patients, and tooth whitening is a well-tolerated, non-invasive approach to achieving this goal.

Over-the-counter whitening products such as toothpastes floss and chewing gums are relatively ineffective at best. Some of these whitening pastes are very abrasive and can actually cause damage to your enamel. And while brushing with toothpaste removes the extrinsic stains by mechanical means; little to no change in color actually takes place. As for the do-it-yourself bleaching kits, they often cause one to have ill-fitting trays, unnecessary sensitivity and results that do not meet one’s expectations.

One over-the-counter product worth mentioning however is Crest whitening strips – a new whitening technology that has recently enters the market. It uses a 5.3 percent hydrogen peroxide-impregnated polyethylene strip that is to be placed twice daily for thirty minutes.

While these strips are in my estimation to be a step above the do-it-yourself whitening systems, they do not replace the custom-fabricated tray-whitening systems that your dentist can provide for you. They are simply an alternative for patients unable to tolerate trays or who cannot afford the expense or time commitment of tray whitening.

Dental Procedure

It is imperative that one’s dentist performs a proper examination and diagnosis in order to identify abscessed teeth, existing cavities, internal or external resorption, and other pathological problems before bleaching.

Your dentist can help you prevent corn-on-the-cob effect (yellow tooth, white tooth, yellow tooth, etc.) by pointing out which of your teeth have restorations that will not whiten. A prophylaxis may be indicated to remove extrinsic stains, and a full series of X-rays and a detailed dental history should help to determine if someone is more prone to having sensitive teeth.

Home Bleaching

These are two basic options for home bleaching: daytime and nighttime intervals. Home bleaching is achieved by wearing a simple appliance known as night guard, which functions as a reservoir for the whitening gel.

Patient’s compliance is usually better at night, although some people may not be able to tolerate going to sleep with the night guard in their mouth.

Night use affords the individuals maximum benefit from each application because of the longer exposure time and diminished salivary flow. However, occasionally people may need to reduce the duration of their treatment as a result of sensitivity or personal preference. For these individuals, daytime wear is recommended for 1-2 hour intervals of treatment. It is imperative that your dentist professionally supervises this procedure, and your mouth guard be custom made to ensure a perfect fit.

The importance of a custom-fitted tray cannot over-emphasized – allowing for maximum patient comfort, reduces side effects and maximized efficacy. It should also be noted that composite (tooth color) fillings, veneers and dental crowns might need to be replaced after bleaching, as these restorative materials will not change color.

Whitening treatment is considered complete when the patient has reached his desired shade. With good oral care, results may last over two years. Recent studies show that most patients notice only a one-shade regression after 6 months.

Of course, those patients who smoke, drink dark teas and coffee, indulge in red wine and other readily staining food and beverages, are more likely to relapse sooner and require additional whitening sessions. Night guard whitening usually tends to revert less than in-office techniques, but it takes longer to achieve desired results.

In-Office Whitening

This procedure (i.e. power whitening or laser whitening) is a faster alternative for achieving that bright smile. People are interested in a tooth whitening system that is quick, safe and easy to do. In-office procedures can offer a high degree of predictability and an assurance of great results.

This method has been very popular – not only among actors and models but with anyone who’s free time is limited and wants instant results. In-office whitening procedures allow the dentist to whiten their patient’s teeth up to 15 shades in about an hour (the average change being about 8 shades). The primary ingredient is peroxide is various concentrations (those of higher concentration may cause a greater degree of temporary sensitivity).

Although some patients may experience tooth sensitivity and gum irritation, these symptoms are usually mild and disappear by the end of treatment. For some individuals, this method is popular because they don’t have to wear a tray that could trigger a gag reflex. In others, a tray is contraindicated because of grinding or clenching habits.

Summary

According to an article in the June 2000 issue of Compendium, laser whitening was not shown to be any more effective than conventional in-office whitening. Lasers don’t actually bleach the teeth, but rather are used to activate the bleaching chemicals – just like any other light source. It doesn’t matter which light source you use, the energy (wavelength) of the light source (whether it be from argon lasers, curing lights, ion plasma, lamps, etc.) must match the energy required to activate the peroxide into a higher energy state. If this is not achieved, the light will simply be converted to heat. And with laser treatments, you will be paying a lot more money for similar results.