A Primer on Whitening Teeth
~ by Robert S. Leland, DMD
Take a look at the smiles around you – on TV, in magazines, even on your co-workers, friends and family. Clearly, the fashion trend of the day is to flash ultra white teeth, even though nature originally designed them to come in subtler milk and cream tints.
You may not be pining for the blinding white teeth of toothpaste commercials. But even attractive natural teeth can darken over time. And since whitening is easier and more accessible than ever, you may be considering whether your own smile could use a makeover. If so, you’ve probably wondered how permanent will it be? How can I be sure that the results will match my expectations? What will it cost? Most importantly, is whitening safe for my teeth?
Frankly, it depends. One approach is through the multitude of inexpensive over-the-counter kits available. Over time, they can bring about a brighter smile, or more mixed results, and can trigger side effects if over-used. At the other end of the scale, your dentist’s customized whitening procedure can provide stunning results safely and predictably – sometimes immediately – but requires a financial investment. Here are some things to consider when making your decision.
Healthy young teeth are most often naturally white without artificial brighteners. Permanent teeth will always be slightly darker than baby teeth, but at an early stage permanent teeth generally need nothing more complicated than regular brushing and flossing to maintain brightness.
And that would be fine if we all lived on baby food and spring water throughout our lives. But any-aged teeth can be stained by some of the foods and beverages that we favor and certainly by smoking.
At first this discoloration is superficial and can be polished away. Over-the-counter whitening toothpastes will usually do the trick. They have special chemicals or polishing agents that remove stains effectively, but will not permanently change the color of your teeth. If you choose this method, use American Dental Association-approved peroxide-free products, go lightly with your toothbrush and consider alternating with non-abrasive fluoride toothpaste.
A slightly stronger option is over-the-counter whitening strips, which contain low concentrations of peroxide. They work relatively quickly to lighten your teeth up to two shades. But most whiten only the six top front teeth and may produce uneven whitening on less than perfectly aligned teeth.
Keep in mind that peroxide whiteners of all types can cause temporary side effects – most commonly gum irritation and/or sensitive teeth. Under supervised conditions or used according to directions, both usually subside soon after the treatments stop.
Genetics is an important factor in how bright and impervious to staining your teeth will be. Generally though, teeth are porous. With age, tooth structure itself can become stained and darkened. Physical trauma to teeth and certain medications can cause discoloration as well. In these cases, stronger whitening methods may be called for.
I advise patients who are considering this level of whitening first to come in for an exploratory (and free) exam that will match the current shade(s) of your teeth against a dental shade guide, and determine the level and causes of staining. We look for recurring problems, such as irritated gums, that must be resolved before whitening. If all is well, we’ll offer advice on whitening options tailored to each patient’s unique needs and expectations.
If the shade of your teeth is not as white as you would like, but still on the bright side of the guide, a home whitening system might be an option. I don’t generally recommend over-the-counter/online tray whitening kits for my patients however. They are unregulated, so can vary widely in strength and safety; some concentrations on the market are just too strong and acidic for the surface of your teeth. One-size-fits-all trays can’t always whiten uniformly, and they may push whitener up into the gum area, causing major irritation and sensitivity.
If a patient does decide on tray whitening, we provide them with a custom home-whitening system, a 10% – 16% carbamide peroxide gel kit that is ADA approved. More importantly, we custom-fit a gel tray tailored to insure that gel is evenly distributed, teeth uniformly whitened and gums protected. Depending on the current shade of your teeth and how diligent you are about following directions, you can expect whiter, evenly shaded teeth from a custom home system at a reasonable cost.
Tray whitening works best on healthy cream-colored teeth – and on patients who are conscientious about follow-through. Professional whitening is a better option for patients who are less than meticulous about following directions or are looking for immediate results. Professional whitening is also a better option for darker gray, brown or black shades that are more difficult to whiten and may require multiple sessions to reach optimal color.
In fact, your smile may not be enhanced by whitening of any kind if you have had crowns, veneers, dental bonding or tooth-colored fillings placed in your front teeth. Whitener will not lighten these materials, and they will stand out in your newly brightened smile. In these cases, we will recommend other options.
If you are a candidate for professional whitening, we customize a plan that factors in unique concerns such as color goal, current alignment, structure and condition. We perform the procedure it in our office, and a visit takes about 90 minutes. To protect lips, mouth and gums and reduce sensitivity, we apply either a protective gel or a rubber shield. Then we apply a whitening agent to teeth. As the agent breaks down, oxygen enters the enamel and dentin, whitening colored substances. The structure of the tooth is left unchanged.
In-office whitening is a custom procedure and at Leland Dental we take the time to ensure not only that it’s done safely, but that results will surpass your expectations. Professional whitening unquestionably produces the highest return on your investment.
Whatever your whitening goals may be, if you are interested in exploring options for a brighter smile, please call us to make an appointment for a free exam and consultation.
Robert S. Leland DMD PC
51 Mill Street, Suite 10