TEETH WHITENING (BLEACHING)

Overview

Technically, 'tooth whitening', restores natural tooth colour and 'bleaching ', whitens beyond the natural colour. However these terms are used interchangeably and require the same procedure to be performed.

You've got two options for bleaching your teeth:

  • in-office bleaching (which is done by a professional dentist)
  • at-home bleaching.

Both tooth-whitening options use peroxide-based bleaching agents. At-home systems contain 3-15% peroxide, whereas in-office systems contain up to 30-45% peroxide.
Though bleaching is meant for whitening your teeth, the paradox here is that overuse or over bleaching can cause more stains and can also dull the surface of teeth/crowns /veneers, thus giving you a lacklustre smile.
Generally, the longer you keep a stronger solution on your teeth, the whiter your teeth become. However, the higher the percentage of peroxide in the whitening solution, the shorter the time for which it should be applied to the teeth, else it will dehydrate the teeth , increase sensitivity and cause dullness.
Whether or not you decide to whiten your teeth, keep in mind that good daily oral health habits like brushing, flossing and cleanings go far in keeping your smile bright and healthy.

THE IN-OFFICE TEETH WHITENING PROCEDURE

While details may vary, a fairly standard routine is followed. Typically, the steps involved are not painful or uncomfortable; in fact, many patients doze off during the procedure.

  • A cheek retractor is inserted into the mouth, exposing all the "aesthetic zone".
  • A rubber dam is placed or hardening resin is painted onto the gum tissue to protect against any irritation caused by the bleaching gel.
  • A bleaching gel containing hydrogen peroxide is applied to the teeth (aesthetic zone) and kept on for approximately 15 to 30 minutes.
  • The bleaching gel is suctioned or washed off, and fresh gel is applied for one or more additional periods of 15 to 30 minutes
  • Some whitening treatments incorporate an intense light that is focused on the teeth and is said to activate or enhance the bleaching process. Opinions vary as to whether this light improves the bleaching outcome.
  • Between gel applications, the teeth are checked to see how well they have whitened, and whether more bleach needs to be applied.
  • After the final gel application, the cheek retractors are removed, the patient rinses and the immediate post-treatment shade change is measured. The teeth may whiten by as few as two to three shades or as many as eight (out of a total of 16).

Part of the whitening effect is due to dehydration during the bleaching process, which makes the teeth look whiter than their true new color. The new 'true' colour will emerge after a couple of days.

If a satisfactory level of whitening hasn't been achieved, follow-up in-office bleaching at a future date, and/or a regimen of take-home bleaching trays are advised.

AT-HOME

The best time to begin at-home whitening is soon after a dental hygienist's prophylactic cleaning. This procedure removes the surface layer of plaque and grime that can interfere with bleaching . There are many popular natural ways to whiten one's teeth. Some natural teeth whitening methods can be very gentle on the teeth, while others can lead to enamel damage. One efficient type of natural teeth bleaching is through the use of malic acid (present apples, celery, carrots etc.) or baking soda or hydrogen peroxide mouth rinses.
There are also several commercial whitening products intended for home use such as gels, chewing gums, mouthrinses, toothpastes, among others. The most common include:

Tray-based tooth bleaching systems.

Home bleaching kits typically contain plastic trays which have to be filled with a bleaching gel or paste and placed over the teeth for one to several hours a day, repeating every few days for several weeks. Most at home bleaching kits come with standard sized trays, but you can also get custom-fitted trays from your dentist.

Tooth whitening toothpastes.

Technically speaking, all toothpastes are whitening toothpastes, since they are mild abrasives and remove surface stains, plaque and debris. But only a few contain key whitening ingredients: chemical bleaching agents and abrasives in high enough concentrations. When used regularly, these toothpastes may prolong the effects of tooth whitening but they aren't left on the teeth long enough to have a marked whitening benefit.
Although home treatments are less expensive, they may require a longer treatment period, and the risks of gum irritation or damage to enamel surface or previous dental work are increased. It may also not give you any result or noticeable change in colour at all. So, if you want quicker and more reliable results, you should get in-office whitening or laser whitening.

SIDE EFFECTS OF BLEACHING

These include, but are not limited to:

  • Chemical burns -- due to contact of bleaching agent with tissue. Usually seen with home bleaching when instructions are not correctly followed. Also occurs when tissue barriers are not properly applied. These are genrally not painful and the bleached tissue returns to its normal colour in few hours or a couple of days.
  • Increased hot/cold sensitivity -- pain or "sensitive teeth" are caused by open dentinal tubules. This sensitivity is transient and reduces
  • Prolonged exposure to bleaching agents may damage tooth enamel, especially in case of brushing with abrasives such as salt or baking soda, or prolonged application of home bleach.
MAINTAINING YOUR TEETH WHITENING RESULTS

Bleaching is not a permanent solution. Shortly after treatment is completed, the teeth resume accumulating stains.

To extend the longevity of newly whitened teeth, we recommend:

  • At-home follow-up or maintenance whitening – can be implemented immediately or performed as infrequently as once a year depending on your requirements and the product used.
  • Avoid dark-colored foods and beverages for at least a week after whitening. In general, avoid acidic and tannin-rich foods and beverages such as: teas and coffee, white and red wine, sports drink, carbonated beverages (coloured sodas), berries and other strongly-coloured foods or sauces.
  • Whenever possible, sip coloured beverages with a straw.
  • Practice excellent oral hygiene – rinse after every meal. Brush and floss in morning and at bedtime.