Everybody loves a bright white smile, and there are a variety of products and procedures available to help you improve the look of yours. Many people are satisfied with the sparkle they get from brushing twice daily with a fluoride-containing toothpaste, cleaning between their teeth once a day and the regular cleanings at your dentist’s office. If you decide you would like to go beyond this to make your smile look brighter, you should investigate all of your options. You can take several approaches to whiten your smile:
- In-office bleaching
- At-home bleaching
- Whitening toothpastes
Dentist Supervised Whitening
Dentist-supervised tooth whitening involves the controlled use of carbamide or hydrogen peroxide, tailored to a particular patient. Dentists may administer in-office treatments or at-home treatments.
Before the tooth whitening treatment, most dentists clean the teeth, fill any cavities, and make sure the patient's gums are healthy.
Most in-office systems use 15 to 35 percent hydrogen peroxide gels, sometimes coupled with a high intensity light to expedite the bleaching chemical reaction. (Some recent research has questioned the need and effectiveness of the light source used during in-office tooth whitening.)
The in-office procedure involves the dentist gently cleaning your teeth with pumice and then putting a protective barrier on the gums. The dentist then places hydrogen peroxide paste on the teeth for several minutes, rinses it off, and usually reapplies it several times. The procedure can achieve about four to six shades of whitening after only one 40-minute treatment.
At-home systems will often use 10 to 20 percent carbamide peroxide gels that also contain glycerin, carbomer, sodium hydroxide, water, and flavoring agents. Some gels that contain more than 10 percent carbamide peroxide will also include sodium fluoride to reduce sensitivity and strengthen teeth.
To begin the at-home procedure, the dentist takes impressions (molds) of your mouth, and then has soft, custom mouth trays made. To administer the treatment, the you put a thin ribbon of the gel into the tray and wears it for two hours during the day, or while sleeping. Most whitening occurs in one to two weeks. In difficult cases, trays may need to be worn for up to six weeks.
A combination of in-office and at-home systems can achieve up to 12 to 15 shades of whitening in most patients. At-home systems used alone can obtain similar results, but may take longer. These procedures are considered safe and effective when monitored by a dentist.
Dentist supervised systems have advantages when compared to over-the-counter tooth whitening products. The main advantage of the dentist supervised system is that the dentist can help determine if tooth whitening should be performed and if it will be effective for the patient. Patients with decayed teeth, infected gums, white spots on their teeth, and multiple tooth colored fillings or crowns (caps) on the front teeth may not be good candidates for tooth whitening.
The dentist can also help decide what type of tooth whitening is required (in-office, at-home or both) and the concentration of the whitening gels. The dentist can monitor and treat patients who experience sensitivity to the whitening agents and modify the procedure for those who are having difficulty getting optimal results. Finally, the dentist can help the patient explore other cosmetic dental options such as porcelain or resin veneers, tooth colored fillings, gum lifts and tooth shaping used with or without tooth whitening. With the help of the dentist, the patient's cosmetic dental goals may be more easily attained.
Over-the-Counter Whitening also involves the use of carbamide or hydrogen peroxide. It isn't always mentioned in the product instructions, but it's a good idea to get your teeth professionally cleaned, have all your cavities filled, and make sure your gums are healthy before using these products.
The most popular products use either carbamide or hydrogen peroxide gels or hydrogen peroxide containing polyethylene strips. Most of these products are relatively easy to use, and independent research has shown that they are effective.
The main benefit of over-the-counter tooth whitening is the cost. Few cost more than $35, and some are less than $10. Another benefit of the over-the-counter tooth whitening systems is that they are available to use immediately. All you need to do is go to your local drugstore and you can start whitening your teeth right away.
The primary drawback of the over-the-counter tooth whitening systems is that customers who use them may not be good candidates for tooth whitening, and there is no professional making sure everything works correctly. Many of the products do not list the concentration of the whitening agents or contain alternatives of varying strengths, so the consumer can not modulate the dosage to improve results or reduce sensitivity should it develop. In some cases, systems that use trays or strips may not adequately cover all the teeth, and less than desired results or irritation to the gums could occur.
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