Teeth Whitening

In-surgery whitening

In-surgery bleaching provides the quickest way to whiten teeth. With in-surgery bleaching:

  • The whitening product is applied directly to the teeth.
  • These products can be used in combination with heat, a special light, or a laser.
  • Results are seen in only one, 30- to 60-minute treatment.
  • To achieve dramatic results, several appointments are usually needed.

How long do teeth whitening effects last?

Teeth whitening is not permanent. If you expose your teeth to foods and beverages that cause staining, you may see the whiteness start to fade, without staining, you may be able to wait one year or longer before another whitening treatment or touch-up is needed.

The degree of whiteness will vary from individual to individual depending on:

  • The condition of the teeth.
  • The level of staining.
  • Type of bleaching system used.

At-home teeth whitening vs. dentist-supervised teeth whitening

There are some key differences between whitening teeth at home and having them bleached in a dentist’s surgery, including:

Strength of bleaching agent.

Over-the-counter products and dentist-supervised at-home products usually contain a lower strength bleaching agent. In-surgery, professionally applied tooth whitening products contain hydrogen peroxide in concentrations ranging from 15% to 43% and achieve a better result.

Mouthpiece trays.

With dentist-supervised at-home bleaching products, your dentist will take an impression of your teeth and make a mouthpiece tray that is customised to exactly fit your teeth. This customisation allows for maximum contact between the whitening gel, which is applied to the mouthpiece tray, and the teeth. A custom-made tray also minimises the gel’s contact with gum tissue.

Over-the-counter whitening products also contain a mouthpiece tray, but the “one-size-fits-all” approach means that the fit will not be exact. Ill-fitting trays can irritate the gum and soft tissue by allowing more bleaching gel to seep onto these tissues. With in-surgery procedures, the bleaching agent is applied directly to the teeth.

Additional protective measures.

In the surgery setting, your dentist will apply either a gel to the gum tissue or use a rubber shield prior to treatment to protect your gums and oral cavities from the effects of the bleaching. Over-the-counter products don’t provide these extra protective measures.

Over-the-counter

Bleaching systems are the least expensive option, with in-surgery whitening being the costliest.

Supervised vs. unsupervised process.

Dentist-supervised at-home bleaching and in-surgery treatments offer additional benefits compared with over-the-counter procedures.

  1. Your dentist can perform an oral exam and consider your complete medical history, which can be helpful in determining if bleaching is an appropriate course of treatment based on the type and extent of stains, and the number and location of restorations.
  2. Your dentist can better match the type of stain with the best treatment, if appropriate, to lighten those stains.
  3. Your dentist will likely want to see you a couple of times to ensure you are progressing appropriately, to make sure the customised tray is fitting properly, to inspect the gums for signs of irritation, and to generally check on how the teeth whitening process is proceeding.
  4. With over-the-counter bleaching products, you are on your own.

Who should not undergo teeth whitening?

Whitening is not recommended or will be less successful in the following circumstances:

Children

Bleaching is not recommended in children under the age of 16. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age. Teeth whitening under this condition could irritate the pulp or cause it to become sensitive.

Pregnancy

Teeth whitening is also not recommended in pregnant or lactating women.

Sensitive teeth and allergies

Individuals with sensitive teeth and gums, receding gums, and/or defective restorations should consult with their dentist prior to using a tooth-whitening system. Anyone allergic to peroxide (the whitening agent) should not use a bleaching product.

Gum disease, worn enamel, cavities, and exposed roots

Individuals with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth-whitening procedure. Cavities need to be treated before undergoing any whitening procedure. This is because the whitening solutions penetrate into any existing decay and the inner areas of the tooth, which can cause sensitivity. Also, whitening procedures will not work on exposed tooth roots, because roots do not have an enamel layer.

Fillings, crowns, and other restorations

Tooth-coloured fillings and resin composite materials used in dental restorations (crowns,veneers, bonding, bridges) do not whiten. Therefore, using a whitening agent on teeth that contain restorations will result in uneven whitening — in this case, making the teeth without restorations appear lighter than those with restorations. Any whitening procedure should be done prior to the placement of restorations. Individuals with numerous restorations that would result in uneven whitening may be better off considering bonding,veneers, or crowns rather than a tooth whitening system. Ask your dentist what strategy is best for you.

Smokers

Smokers need to be aware that their results will be limited unless they refrain from continued smoking, particularly during the bleaching process.

Unrealistic expectations

Individuals who expect their teeth to be a new “blinding white” may be disappointed with their results, a healthy guide to is to achieve a shade slightly whiter than the whites of your eyes.

Darkly stained teeth

Yellowish teeth respond well to bleaching, brownish-coloured teeth respond less well and grayish-hue or purple-stained teeth may not respond to bleaching at all. Blue-gray staining caused by the antibiotic tetracycline is more difficult to lighten and may require up to six months of home treatments or several in-office appointments to successfully lighten. Teeth that have dark stains may be better candidates for another lightening option, such as veneers, bonding, or crowns. Your dentist can discuss the options best suited for you.

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