Bleaching

Dental bleaching, also known as tooth whitening, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry.

There are many methods to whiten teeth: bleaching strips, bleaching pen, bleaching gel, laser bleaching, and natural bleaching.

Traditionally, at-home whitening involves applying bleaching gel to the teeth using thin guard trays. At-home whitening can also be done by applying small strips that go over the front teeth.

Oxidizing agents such as hydrogen peroxide or carbamide peroxide are used to lighten the shade of the tooth.

Power bleaching uses light energy to accelerate the process of bleaching in a dental office.

The effects of bleaching can last for several months, but may vary depending on the lifestyle of the patient.

Factors that decrease whitening include smoking and the ingestion of dark colored liquids like coffee, tea and red wine.

Why Teeth Whitening?

During routine chewing, dentin remains intact while millions of micro-cracks occur in the enamel. It is these cracks, as well as the spaces between the crystalline enamel rods, that gradually fill up with stains and debris. As a result, the teeth eventually develop a dull, lackluster appearance

During routine chewing, dentin remains intact while millions of micro-cracks occur in the enamel. It is these cracks, as well as the spaces between the crystalline enamel rods, that gradually fill up with stains and debris. As a result, the teeth eventually develop a dull, lackluster appearance.

Teeth whitening removes the stains and debris, leaving the enamel cracks open and exposed. Some of the cracks are quickly re-mineralized by saliva, while others are filled up again with organic debris.

Tooth Discoloration: The Two Types of Tooth Stains

There are two categories of staining as it relates to the teeth: extrinsic staining and intrinsic staining.

Extrinsic stains are those that appear on the surface of the teeth as a result of exposure to dark-colored beverages, foods and tobacco, and routine wear and tear.

Superficial extrinsic stains are minor and can be removed with brushing and prophylactic dental cleaning. Stubborn extrinsic stains can be removed with more involved efforts, like teeth bleaching.

Intrinsic stains are those that form on the interior of teeth. Intrinsic stains result from trauma, aging, exposure to minerals (like tetracycline) during tooth formation and/or excessive ingestion of fluoride.

In the past, it was thought that intrinsic stains were too resistant to be corrected by bleaching. Today, cosmetic dentistry experts believe that even deep-set intrinsic stains can be removed with supervised take-home teeth whitening that is maintained over a matter of months or even a year.

What Causes Tooth Staining?

Age

Starting color

Translucency and thinness

Eating habits: Smoking habits

Drugs / chemicals

Grinding

Trauma

Teeth Whitening Options

Three major teeth whitening options are available today.

In-Office Whitening

Significant color change in a short period of time is the major benefit of in-office whitening. This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel, applied to the teeth by the dentist or trained technician.

Professionally Dispensed Take-Home Whitening Kits

Many dentists are of the opinion that professionally dispensed take-home whitening kits can produce the best results over the long haul. Take-home kits incorporate an easy-to-use lower-concentration peroxide gel that remains on the teeth for an hour or longer (sometimes overnight). The gel is applied to the teeth using custom-made bleaching trays that resemble mouth guards.

Over-the-Counter Whitening

The cheapest and most convenient of the teeth whitening options, over-the-counter bleaching involves the use of a store-bought whitening kit, featuring a bleaching gel with a concentration lower than that of the professionally dispensed take-home whiteners. The gel is applied to the teeth via one-size-fits-all trays, whitening strips or paint-on applicators.

Are You a Candidate for Tooth Whitening?

Not everyone can use tooth whitening solution. Circumstances that may prevent the use of tooth whitening product are:

  • Teeth that have restorations, such as veneers or having been bonded with white fillings, cannot be whitened with hydrogen or carbamide peroxide.
  • Teeth that have internal staining, discoloration from developmental conditions or have been root canalled may not be affected by the typical whitening process. Internal tooth whitening or permanent restorations may be an option to consider.
  • Natural tooth colors that are brown or gray in hue may not produce desired results. Typically, teeth with a yellow hue will produce the best results.
  • Pregnant or nursing mothers should avoid whitening their teeth as there is not enough research to determine the safety of tooth whitening products during pregnancy or lactation.
  • People with hypersensitive teeth should avoid tooth whitening, because this process may enhance the level of sensitivity they experience.

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