Teeth Whitening

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Teeth Whitening is a cosmetic treatment done for those who desire a brighter smile.  It is done to reduce discoloration and staining from coffee, cigarettes, medications such as antibiotics like tetracycline or other substances that have permanently stained or discolored the teeth.  Sometimes it simply done to give the patient a whiter, brighter smile.  Also, teeth are usually whitened before placing crowns, bridges or veneers so as to be color matched to the newly whitened teeth.


While most teeth whitening products and procedures available on the market today are safe, they may not be effective or recommended for everyone.  One should have a proper dental exam, by a dental professional, prior to any whitening treatment so that the patient can be advised of the most appropriate procedure for them and what the likely results will be.  Whitening may not be recommended for people with gum disease, receding gums or sensitive teeth and certain whitening procedures are not advised for patients with worn enamel.  Also, women that are pregnant or nursing should avoid whitening treatments except for toothpaste whiteners because the high levels of peroxides can potentially be dangerous to the child.

What is Teeth Whitening?

Whitening is done by applying of a bleaching agent or some other material to the surface of the teeth.  Whitening can be done at a dental office, at home with the supervision of a dentist, or at home using one of  the many over-the-counter (OTC) products available.  Each of these methods has a different level of effectiveness and cost.  Since teeth whitening is typically considered a cosmetic procedure, it is not usually covered by dental insurance.

Treatment Options

A dental office treatment (also known as chair-side bleaching, in-office bleaching or power bleaching) is the most effective and safest method of teeth whitening, though not the cheapest.  Prior to applying the whitening gel, the dental professional first protects the patient’s gums and soft tissues using either a protective gel or a rubber shield.  Most dental office whitening solutions contain hydrogen peroxide,  which comes in concentrations ranging from 15% to 35%, as the bleaching agent .  Some of the whitening procedures then use a light or laser to accelerate the whitening agent’s effect.  These procedurees can last anywhere from 30 minutes to an hour.

At-home dentist supervised treatment combines dental office visits with steps done at home.  This method has also been called night-guard bleaching or tray bleaching because a patient uses a special mouthpiece that protects the gums when applying the whitening solution.  For this treatment, a dental professional takes an impression of the patient’s upper and lower teeth in order to make a custom-fit tray, or mouthguard.  Then, the patient applies a special gel, provided by the dentist, into the custom-fit mouthguard.  This special gel usually contains carbamide peroxide as the whitening agent.  Carbamide peroxide gel comes in various concentrations (e.g. 10%, 16%, and 22%) with the 10% concentration being roughly equivalent to a 3% concentration of hydrogen peroxide.  Typically, these treatments last one to two weeks, but can vary.  Appointments with your dentist are used to monitor progress as well as any issues such as gum or tissue inflammation.

Over-the-counter (OTC) products can be purchased at most pharmacies and many supermarkets and come in a variety of forms such as mouthtrays, strips or gels.  Most of these have carbamide peroxide as the bleaching agent, which is not as strong as the hydrogen peroxide that is used in dental office treatments.  Whitening toothpastes work differently and do not typically contain a bleaching agent.  Instead, they contain mild abrasives that remove surface stains but have no real effect on tooth color.

Aftercare Risks:

It is common for patients to have some teeth sensitivity to hot and cold during and after any of these treatments, especially the dental office treatments.  This sensitivity is only a temporary side effect and it usually subsides once the treatment ends.  Additionally, some patients can experience gum irritation or inflammation, especially if the tray is loose or does not fit well.

Normal Results:

Because dentist typically use hydrogen peroxide which is a much stronger bleaching agent than what is found in the commercial products, a dental office whitening treatment gives better results than the other methods.  Additionally, those results are longer lasting too, but only if the teeth are properly cared for afterwards.  These results are not permanent, but can last from six months to a year… and even longer.

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