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Alan L. Stott, DDS

Teeth Whitening


Dental Whitening – Teeth Bleaching teeth whitening before and after

What is teeth whitening?

Teeth whitening is also referred to as bleaching the teeth. Since we don’t actually use bleach on the teeth, the term “teeth whitening” is more accurate. Teeth whitening is the use of gels or pastes to whiten teeth. These solutions can penetrate the enamel of the teeth, and over time, lighten the color of the teeth.

How does teeth whitening work?

Teeth have two types of stain: extrinsic (outside) and intrinsic (inside). The extrinsic stains can be removed by brushing at home and by the dental hygienist using her dental instruments. Intrinsic stains need to have some type of chemical treatment in order for them to be removed. Whitening systems contain either hydrogen peroxide or carbamide peroxide. These solutions break down into oxygen molecules which penetrate the enamel (outer layer of the teeth) to get to the discolored molecules inside. With enough contact time, the oxygen molecules can dissolve the discolored molecules, causing the teeth to look whiter.

What are the types of teeth whitening systems? What are the pros and cons of each whitening system? Which teeth whitening systems are the most effective? What are the costs of the teeth whitening systems? 

Here are some of the different teeth whitening systems:

1) Whitening Toothpastes The pros of whitening toothpastes are: they can help whiten the teeth while you do your normal brushing and they are not very expensive. The cons are: they are not very effective. The whitening ingredients they contain are not very strong and they are not in contact with the teeth for very long. Approximate cost: $8-10.

2) Over-the-Counter or Store-Bought Whitening Systems In order for a whitening system to be very effective, the solution they contain must be in contact with the teeth for an extended period of time. Some of the over-the-counter whitening systems have trays or strips that will keep the solution in contact with the teeth for 30-60 minutes. The pros are: they are more effective than the whitening toothpastes (but not as effective as the take-home or in office whitening systems), are not very expensive, and are easy to purchase at the local store. The cons are: due to their weak solutions, they have limited effectiveness, and their tray or strip application systems are limited in how well they hold the solution against the tooth surface. Most people will get some whitening with these systems. Approximate cost: $25-45.

3) Take-Home Whitening Systems This refers to the whitening systems sold in the dental office. The pros of these systems are: they are more effective than the toothpastes or whitening systems you can buy at the store since they use a stronger solution, they hold the whitening solution against the tooth surface with a custom-made set of trays, and they will lighten the teeth a few shades for most people. The cons are: they usually cost a few hundred dollars, you need to have impressions taken to make the custom-made trays, and the teeth and gums may be more sensitive than store-bought systems since their solutions are stronger. Approximate cost: $300-400.

4)  In-Office Whitening Systems These systems use a strong gel that is applied to the teeth in the dental office. Pros are: they can whiten the tooth a few shades, and it is the quickest of all the whitening systems. The cons are: they use a very strong solution which can cause more sensitivity, the systems are expensive, and the whitening effect can fade over a few weeks. Most dentist who use the in-office system include with the treatment a take-home whitening system to improve the results and prevent the whitening from fading. Approximate cost: $500-$800.

Which whitening systems does your dental office recommend and why?

All patients who use whitening systems will have different results. One person can use the take-home system and get real white teeth, while another person will have very little color change. One person can have very sensitive teeth when using the system while another person will feel no discomfort. This is why we cannot guarantee how white your teeth will get using any of the whitening systems. I like the take-home system provided by the dental office. With the take-home system we make lab fabricated custom trays that hold the whitening gel in close contact with the teeth, thus giving us better results. The whitening system we use has strong effective ingredients that work well and minimize tooth and gum sensitivity. The take-home system is not as costly as the in-office system and does not cause as much sensitivity. Most people will see their teeth lighten a few shades with the take-home system from the dental office.

What is laser or Zoom teeth whitening?

Laser whitening refers to using a laser light in the dental office to activate the whitening gel placed on the patient’s teeth. Zoom whitening is often referred to as laser whitening but it uses some filters to remove some of the harmful lights from a laser. Zoom whitening is an in-office whitening system. The patient will be in the chair 30-60 minutes for this treatment. The gum tissues are covered with a special gel to prevent soreness from the strong whitening solution. The whitening solution is applied and a special light heats up the solution to activate it. We do not have a Zoom in-office whitening system. Even though the Zoom system may be faster than the take-home system, it can cause more sensitivity and costs more. The take-home system can be just as effective if used for several days.

Is it painful to whiten your teeth?

For most people, who whiten their teeth there will be some slight temporary sensitivity. For a few people, there can be mild sensitivity after the whitening solution has been on the teeth for a while. If a patient’s cavities have not been filled, if there is gum infection, or if there is some gum recession exposing the root surfaces, there can be more sensitivity with teeth whitening gels. For those who have more sensitivity, we recommend that they cut back on the amount of time the whitening trays with the gel inside are in the mouth. Instead of wearing the tray all night, use the tray for 1-2 hours in the evening. If that is still too sensitive, use the whitening tray every other day. If the gums are very sensitive to the whitening gel, place a little petroleum jelly on the gums by the teeth. There is less sensitivity when the patients use the whitening system provided by the dentist because that system uses a custom-made tray that keeps the whitening gel on the teeth more and away from the gums. Sensodyne toothpaste with fluoride and potassium nitrate is good for sensitive teeth.

Can teeth whitening damage your teeth? Is it safe?

Teeth whitening is safe and it will not damage the teeth. The biggest downsides are the whitening systems may cause temporary tooth and gum sensitivity and not all people will see their teeth whiten a lot.

How long does it take to whiten the teeth?

This will depend on how easily each person will whiten and how often they use the trays. Some people will see great results after 4-5 days. Typically, with a patient who does not have really dark stains, he/she should see the teeth turn a few shades lighter in 3-4 weeks. There will be some people who have real stubborn stains and they will need to use the system 3-4 months. Some can never get white teeth.

Are some teeth harder to whiten than others?

Not all patients can get real white teeth. Yellow colored teeth can whiten the best. Brown colored teeth can whiten but it may take a lot more time. It is very hard to whiten gray colored teeth. They will whiten some, but it will may take months and they cannot get their teeth nearly as white as those with yellow colored teeth. If you cannot get the whitening results you want using a whitening system, discuss the other cosmetic options with your dentist.

Is there any guarantee if my teeth do not get lighter?

Everyone who uses a take-home or in-office whitening system should see some whitening. Depending on the type of stain (yellow, brown, or gray), the severity of the stain, and how long each person can use the system without sensitivity, the results will vary. If a whitening system does not work well for you due to the type of stain (color) you have or due to bad tooth and gum sensitivity, discuss the other cosmetic options with your dentist.

Is the whitening process a one-time treatment or do I have to repeat it?

The laser or Zoom in-office whitening system is promoted as being a one-time system. However, we have seen that patients need to follow up the use of Zoom with a take-home system to really have some long-lasting results. The take-home system from the dental office can usually provide some good results after 3-4 weeks depending on the type and severity of the stain. If you stop using the whitening system at the end of the

3-4-week period, the teeth will gradually return to their original color. In order to maintain the lighter color, we recommend that all patients do some touchup treatment every 3-4 months. This touchup treatment will be 3-4 days of using the take-home tray system.

 What needs to be done before starting using a teeth whitening system?

 Before starting a whitening program, patients need to have a complete exam with x-rays by the dentist. The teeth and gums need to be healthy before any whitening system is used. Whitening gels can irritate unfilled cavities and infected gums. The dentist needs to evaluate the type of stain or discoloration a patient has to see if he/she is a good candidate for whitening. The pros and cons of each system needs to be discussed. The patient and dentist need to evaluate the existing crowns and fillings. Whitening systems will not lighten the patient’s dental crowns or fillings. Patients need to be aware that if they have some visible crowns and fillings in the front and use a whitening system, they may have to replace some crowns and fillings in order to make everything match.

Am I a good candidate for teeth whitening?

Patients must first have their teeth evaluated by the dentist to see what type of stain they have. They must have any cavities and gum disease taken care of before whitening treatment. If patients have real dark gray stains on their teeth, they may not be good candidates for whitening. If their teeth are a moderate yellow color, they can have great results. Most people will see some whitening of the teeth if they use the whitening system properly. If a patient continues to use tobacco or foods and beverages that stain teeth, their whitening results will not be long lasting.  If a patient has real sensitive teeth and gums and cannot use the whitening trays very much, he/she will not have good results.

Are take-home whitening systems the best way to whiten your teeth?

We recommend the take-home whitening system. It works better than store-bought systems because the solutions used are more effective and it uses a tray system which provides better contact of the solution with the teeth. For patients who want to whiten their teeth, we always recommend starting out with a take-home system. If a patient does not get the results they want, there are some other cosmetic options such as plastic or porcelain veneers.

Does the amount of stain on the teeth and the color of the teeth affect the results of teeth whitening?

There are two types of stain, extrinsic (outside) and intrinsic (inside). Before starting a whitening program, patients need to have their teeth cleaned by the dental hygienist to remove most of the extrinsic stain if possible. If the color of the teeth is yellow, we should see good results with a whitening system. If the color is brown, we should see some moderate results. If the color is gray, the results may not be very good. If a person continues to smoke or consume food and beverages that stain teeth, we will see reduced results.

What foods and beverages cause the most stains on teeth?

Smoking (not really a food or beverage) is one of the worst causes of tooth stain. If you can cut that habit out, your teeth will look better, your gums will be healthier, you will reduce tooth loss (due to bone loss), your overall health will be better, and you will live longer. Some drinks that stain teeth include: coffee, tea, dark colored wines, red or purple juices, sodas (especially colas), and any acidic drink (like orange or lemon juice). Drinking a lot of sweet or acidic drinks without good home care can lead to decay, which will cause tooth stain. Some foods that stain teeth include: dark berries, tomato sauces, curry, beet roots, soy sauce, and acidic foods like grapefruit. Eating a lot of sweet foods (like candy and desserts) without good home care can lead to decay which will cause tooth stain. The staining effect of most of the foods and drinks can be minimized when these food and drinks are used in moderation. Also, staining can be reduced with good brushing and flossing, and regular cleanings by the dental hygienist.

Does teeth whitening have risks?

Teeth whitening systems have risks. The will not damage the enamel, tooth nerve, or gums. However, they can cause some tooth and gum sensitivity. This sensitivity will go away within 2 weeks once the whitening program is discontinued.

Will teeth whitening procedures damage existing dental restorations like crowns and white fillings?

No, teeth whitening will not damage dental crowns or white fillings.

 Can teeth whitening treatment whiten dental restorations like crowns and fillings?

Whitening systems will not lighten the dental crowns or fillings patients have. Patients need to be aware that if they have some visible crowns and fillings in the front and use a whitening system, they may have to replace some crowns and fillings in order for everything match.

Why get a teeth whitening system from the dentist? Why not just use the grocery store systems?

It is best to have a complete exam by a dentist before starting any whitening system. Decay and gum disease need to be taken care of first. The dentist will evaluate if you are a good candidate for teeth whitening. Some patients have teeth that will whiten easily and others have dark colored teeth that will not lighten well. The existence of fillings or crowns needs to be examined. Dental fillings and crowns will not whiten, and if the teeth are whitened several shades, those fillings and crowns may look too dark. The pros and cons of each system need to be discussed with the patients. Store-bought whitening systems are not nearly as effective as professional take-home systems.

Is it OK to just swish with regular hydrogen peroxide to whiten your teeth?

No. This will not be effective. Regular hydrogen peroxide is a weak solution.

 Are Crest Whitening Strips effective?

For some people, Crest Whitening Strips can be effective. Patients can try the over-the-counter whitening systems, and if they work, great. If they do not give you the results you want, then see us for a professional take-home system.

What is internal whitening or internal bleaching?

Sometimes, if a tooth nerve dies due to trauma or deep decay, the tooth will darken. Root canal treatment needs to be done on the tooth to treat the dead nerve. If the color of the tooth remains too dark after the root canal treatment, we can whiten the tooth by placing some special whitening solutions inside the hole in back of the tooth created to treat the nerve. The solution is removed after a few days and a white filling is placed in the access hole. This internal whitening can be done in conjunction with a regular take-home whitening system. Sometimes we cannot get good whitening results with an internal or regular whitening system on a real dark root canal tooth. We can then look at other options such as bonding or dental veneers.

 If I want to whiten my teeth, where do I start?

 You can start with us. Come in for a complete exam with x-rays. We need to treat any existing cavities with filling or crowns, and we need to get the gums healthy. We will evaluate the type of color or stain your teeth have, and how effective the different whitening systems may be for you. We can discuss the pros and cons of each system and their prices. We look forward to seeing you!






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