The desire for a whiter and brighter smile has been increasing steadily over the past two decades and is now the number one requested cosmetic dental procedure in The United States, according to data published by the American Academy of Cosmetic Dentistry. Discolored or stained teeth can cause apprehension and insecurity, and millions of Americans buy whitening products, either over-the-counter or through a dentist, for brighter, dazzling smiles.
As we age, teeth discolor and become stained by foods, beverages, smoking, and certain medications. Over time, the surface of enamel begins to crack and erode, which causes further stains and discoloration. The most common solution to this problem is teeth whitening treatments, which use peroxide to bleach discoloration and stains. During the bleaching process, discolored teeth will generally lighten four to five shades, depending on the severity of the stains. This cosmetic procedure is recommended and ideal for people who have both healthy teeth and gums.
Consumers have access to a variety of over-the-counter whitening gels, toothpastes, and mouthwashes. Though over-the-counter whiteningproducts are generally the easiest and least expensive solution, the results can be disappointing.
The biggest difference between professionally dispensed and over-the-counter whitening products is the level of concentration of peroxide. Most over-the-counter whitening products have weaker bleaching solutions, which requires more time to whiten the teeth and leads to only temporary results (up to 4 months).
There are also other problems with home whitening kits. The inability of whitening strips to fully stick to teeth can lead to tooth and gum sensitivity. Whitening pastes, despite their ease of use, will not bleach teeth. They contain mild abrasives with some polishing factors that only remove stains, and with excessive use, the abrasive pastes can even wear away the tooth enamel. Brush-on whitening gels usually don’t work well as the gel is painted directly on the tooth surface and washes away quickly with the mouth’s natural saliva flow. Tray-based tooth whitening systems use a tray to deliver the bleaching solution over a period of time. Often, these kits use “one size fits all” bleaching trays, which can be messy, as the trays may not fit each individual correctly and the bleach can spill over to the gums, causing irritation. Whitening rinses contain hydrogen peroxide, which does whiten teeth, though not effectively because of the short contact time. There are also issues related to the starting age of bleaching. Permanent teeth need to reach complete formation
and growth before whitening teeth, or the newly developed component will have a different color than the bleached tooth resulting into a two-toned look.While these can all be serious problems, the greatest danger of all is the lack of dentist supervision. When whitening teeth at home, there can be unknown issues related to nerve damage or cavities, which combined with whitening products can lead to additional problems. There is also a greater likelihood of sensitivity or discomfort. People with periodontal disease may face more problems with bleaching. When a patient visits a dentist for treatment, the dentist verifies that the patient is an acceptable candidate for the procedure, monitors the progress of bleaching and addresses problems that arise.
Dentist teeth whitening can be preformed in-office or can take the form of custom-made, take home bleaching trays. In-office bleaching uses a light or laser to accelerate the bleaching process during a one or two hour visit. It is the most expensive, as it takes the longest time, but causes less gum irritation and provides longer
lasting results. With take home trays, the trays are custom fit to one’s teeth and mouth. This customization allows for maximum contact between the gel and the teeth and minimizes the gel’s contact with gums. There are usually several follow-up appointments after the treatment to evaluate the progress and address any complications.
The American Dental Association (ADA) evaluates these dentist used products and verifies their adherence to the guidelines with the ADA’s Seal of Approval. ADA has only granted the Seal of Approval to dentist dispensed whitening products and in-office applied bleach. Over-the-counter bleaching products are not endorsed by the ADA and bleaching solutions are not drugs, and therefore, they are not regulated by the ADA.
When considering whitening treatment options, it’s important to think beyond convenience. While it may seem easier and cheaper to use a self whitening treatment system, it likely won’t have long lasting results and can even lead to severe discomfort. A visit to the dentist for whitening treatments may be more expensive, but it will provide safer and long lasting results.
Dr. Nushin Shir
Expert Dentist, Dr. Nushin Shir, a UCLA School of Dentistry graduate, is highly trained in complex and cosmetic dental procedures and was recently included in the 2010 edition of Guide to America’s Top Dentists. The Artistic Center for Dentistry offers all aspects dental care. For more information please contact www.theartisticdentistry.com.
