Tooth Whitening
Most methods of tooth whitening involve a bleaching agent containing hydrogen peroxide in some form. All whitening methods work by a combination of the concentration of the bleach and the duration that the bleach stays on the teeth. However, as the concentration of bleach goes up, the potential for tooth sensitivity may also increase. To address this issue, we only use professional brands of bleach that minimize sensitivity by incorporating anti-sensitivity agents in the formulation. We offer both at home as well as the in office modes of whitening the teeth.
At Home Whitening
At home tray tooth whitening involves the use of carbamide peroxide placed in clear fitted trays that snap tightly over the teeth. The trays are custom made for the patient from impressions taken at the initial visit.
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.
Whitening requires two main appointments, one for making the impression and one for delivery of the trays and explanation of the process. Patients frequently combine the first visit with their cleaning appointment.
After tray delivery, we do schedule quick evaluation appointments to monitor the effectiveness of the whitening agents and to check soft tissue. Occasionally a patient needs to change the strength or type of whitening agent to achieve a better effect for their teeth.
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, whitening may be achieved through bonding or porcelain veneer application.
Some teeth may whiten unevenly, and there is no way to predict this occurrence. However, 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). The whitening process can be repeated periodically to maintain the lighter tooth shade. However, the whitening trays may wear out over time, and additional ones may need to be fabricated.
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.
Very 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.
In Office Whitening
We offer in office tooth whitening for three reasons.
- It is much faster.
- Some people don’t like the trays
- Some people just like the convenience of the office treatment.
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. In office whitening offers a quicker result.
Possible Complications
Sensitivity to hot and/or cold has been more noticeable in patients with in office bleaching. If this occurs, trays with fluoride and or other sedative medicines may be indicated. Rarely analgesic medications are necessary to relieve the acute sensitivity after treatment.
Since the bleach is stronger there is a greater likelihood that soft tissue may react to the whitening agent, causing a burning sensation or a blister. If this does occur, vitamin E oil and other topical medications may be indicated to relieve the symptoms until the tissue heals naturally.
