Tooth Whitening

In Office Whitening

We offer in-office tooth whitening as a quicker and more convenient option than at-home tray whitening. With this procedure, we can use a stronger bleaching agent to obtain optimal results. The gums are protected by a protective gel and the teeth to be whitened are isolated before placing the agent on the teeth. A light is shined into the mouth to augment the whitening process. The patient is monitored and new whitening agent is added every fifteen minutes for a total whitening time of 45 minutes. Including preparation time and a post-whitening fluoride treatment, the total chair time for this procedures is generally less than one hour.

Is In-Office Whitening Better?

All whitening is a matter of concentration of bleach and the time applied. Great results can be achieved with at-home bleach, but it takes longer and requires more patience. The major advantage of in-office whitening is its convenience, with no at-home trays to use and with quick and impressive results. A disadvantage of in-office whitening is that with the higher concentration of bleaching agent, the potential increases for temporary post-whitening sensitivity. We have found that this occurs rarely, however, as we use only professional brands of whitener that incorporate anti-sensitivity agents in the formulation, and we follow-up with a desensitizing post-whitening fluoride treatment. Many people also like the combination of the in-office option followed by touch-ups at regular intervals with use of at-home products to maintain the new whiter smile.

At Home Whitening

At-home tray tooth whitening involves the use of carbamide peroxide placed in clear fitted applicators that adapt tightly over the teeth. Modern at-home bleaching has improved to use professional grade bleach in pre-filled moldable application trays. The new materials and methods eliminate the need for fabricating custom trays and are more comfortable and less messy than previous methods used at-home.

The whitening process generally takes from three to six weeks for maximum effect. The peroxide filled trays are worn from one to two hours each day.

After delivery of the whitening kit, we schedule quick evaluation appointments to monitor the effectiveness of the whitening agents and to check soft tissue if the patient has any concerns. Occasionally a patient needs to change the strength or type of whitening agent to achieve a better effect for his or her teeth. With the newer whitening materials, the incidence of tooth sensitivity has greatly decreased.

Tooth whitening is safe. The chemicals used for the process have been used for a long time as antimicrobial rinses in periodontal treatment, and we monitor all patients carefully to make sure the strength of the whitening agent is appropriate.

What to Expect from the Tooth Whitening Process

Tooth whitening varies in effectiveness among different patients. Some teeth are resistant to whitening, and some stains are difficult to remove through this process. In these cases, use of bonding or porcelain veneers may be indicated.

Occasionally, teeth may whiten unevenly. While this may be difficult to predict, one should expect that if the teeth have uneven coloration before whitening, the shade differences will remain after the whitening process.

Tooth whitening is not effective on filling materials, and old tooth-colored fillings will not whiten along with the teeth. After the whitening process is completed, front teeth restorations may need to be replaced to match the whitened teeth.

Care must be taken during the whitening process to avoid foods that stain teeth, since the teeth are more susceptible to staining during this period. We advise using a straw when consuming beverages that could stain.

It is difficult to say how long the whitened color will last on teeth since it varies widely. In general, the lightened color will last longer if habits that caused them to stain in the first place are minimized (such as smoking and dark colored food and beverage). The whitening process can be repeated periodically to maintain the lighter tooth shade.

Possible Complications

The only likely complication may be sensitivity to hot and/or cold. If this occurs, whitening should be discontinued until evaluation is made at the dental office. Sometimes the type and strength of bleach may be changed to a more tolerated choice.

Rarely, soft tissue may react to the whitening agent, causing a burning sensation or a blister. If this does occur, whitening should be discontinued and an evaluation scheduled at the dental office.

Sensitivity to hot and/or cold may be more likely with in-office bleaching. However, we use care to use products that minimize sensitivity, include post-whitening fluoride treatment. Most sensitivity is mild and lasts only a day or two, but occasionally an analgesic medication is needed for temporary sensitivity.

Since the bleach used for in-office whitening is stronger than at-home there is a greater likelihood that some soft tissue may react to the whitening agent, causing a temporary burning sensation or white spot. This happens rarely, but if this does occur, vitamin E oil and other topical medications may be indicated to relieve the symptoms until the tissue heals naturally.