Tooth Whitening

How does the process work?

The bleaching gel is usually hydrogen or carbamide peroxide that breaks down into oxygen molecules. These molecules go into the tiny pores of the enamel and dentin, and break up the stains that block out the light. As the stains are broken into smaller and smaller pieces, more light passes through the teeth and makes them look lighter. Stains that are accumulated over time that are yellow to slightly brown produce the best results. Teeth that are dark brown to blue-gray are the most difficult to bleach because the stain is deeply embedded into the tooths structure. These types of stains are usually caused by medications taken during the development of the teeth such as tetracycline, and can take a minimum of three weeks to see results, and as much as six months for complete results.

Depending on the bleaching gel used and the length of time it is worn, results can be seen within an hour, overnight or within three to four days. Complete results can be achieved in as little as a week or as much as several months depending on the source of the stain and the ability of the teeth or tooth to be bleached. The whitening procedure may last for up to three years -- even longer in some cases, depending on personal habits. To brighten the color back up, a simple process of bleaching for one or two nights with a single syringe is usually sufficient.

What will happen at the initial consultation?

At the first visit with your dentist, youll be able to talk with him/her about the changes youd like to make in your appearance. Your dentist will explain the different options available to you, the procedure itself, and its risks and limitations.

How are the treatments performed?

There are three types of bleaching procedures to choose from. Two of them are performed in the dentists office, and the third is a take-home, self-administered treatment.

In-office whitening procedures:

For laser and power bleaching, a dentist begins by applying a protective material to your gums and lips in order to isolate the teeth. A special bleaching solution  usually containing hydrogen peroxide - is applied to the teeth. A high intensity light or laser is directed at the teeth and activates the bleaching agent, causing the gel to release the oxygen molecules. Treatments for both power and laser bleaching can take as little as 45 minutes, but usually last somewhere between one and two hours.

These techniques work great for a single discolored tooth as well. If the tooth has become dark due to trauma but has not had a root canal, the bleaching solution is placed on the outside of the tooth. If the tooth has had a root canal, the solution can be placed on the outside as well as the inside of the tooth. Leaving a bleaching solution inside the tooth and sealing the opening is referred to as walking bleach. The solution inside the tooth for a walking bleach is changed about once a week. Results can take several weeks but nothing has to be worn in the mouth.

Take-home whitening:

Home bleaching is performed at home, under the indirect supervision of a dentist. At the first appointment, the dentist takes impressions of the patients teeth and then creates a perfectly fitted mouthpiece. This mouthpiece will allow the patient to apply a bleaching solution to the teeth while protecting the rest of the mouth from contact with the bleaching chemicals.

The concentration of hydrogen peroxide or carbamide peroxide in the gel is not as strong as that used in power or laser bleaching procedures. No strong light source or laser is needed to activate the bleaching agent. Instead, it is contact with something organic, in this case the teeth, that causes the gel to release oxygen. In most cases, home bleaching can take from one to three weeks to achieve maximum results. During this time, the dentist may want to check the progress of the treatment.

How much pain is there?

The amount of discomfort experienced varies from person to person, and depends on the method used. Most adults usually experience little if any discomfort, however, the discomfort should subside within 24 hours. If needed, an over-the-counter anti-inflammatory may help. If the discomfort lasts for more than 2  3 days, consult your dentist for more options.

Decreasing the sensitivity may be as easy as placing a gel fluoride, under your dentists instruction, in your bleaching tray for an hour or so. Other materials may be used to address the sensitivity you may experience. Check with your dentist for the best options for your paticular needs.

What can I expect afterward?

The results of bleaching your teeth are somewhat variable, but most people are happy with the results. After any bleaching treatment, patients should avoid foods that stain, such as tobacco and red wine for about a week. Keeping teeth clean with flossing and brushing can maintain whiteness. Tooth bleaching lasts, on average, about 1-3 years. If you are not a regular tobacco user, and do not eat many foods that are known to stain teeth, bleaching may last even longer.

Decalcified spots are white spots that bacteria, not removed from the teeth frequently by brushing, affects the calcium in the enamel. These spots appear chalky white and are difficult to treat with just bleaching. Your dentist may recommend a procedure called microabrasion. This procedure can be done by itself or in conjunction with bleaching. The microabrasion material is much like the paste used to clean and polish teeth. The paste consists of an abrasive combined with a hydrochloric acid used to polish out the white or brown spots. The procedure can be performed usually in one office visit and can be done without anesthesia.

Ideal candidate:

In general, the best candidates for tooth bleaching are:

Alternatives:

Risks and Limiations:

Bleaching can produce side effects ranging from increased tooth sensitivity to pain and tenderness in the gums, tongue and other soft tissues. There is also a possibility of over-bleaching. The result will be a translucency that may appear gray from the shadows of the mouth. There is a very low percentage of this occuring, and only if the bleaching process is over-extended. Having a dentist suppervise the process can eliminate this risk.

With home bleaching, there is a small risk of ingesting the gel administered by the dentist. The chances of this occurring are relatively small since your bleaching tray should fit almost perfectly around your teeth. However, if the gel is ingested, it may result in nausea, vomiting or burning. Under these circumstances, you should contact a doctor immediately.

Cost:

Cost of the treatment will range from dentist to dentist and patient to patient depending on the difficulty and severity of the case. No two people are alike and the procedure may work faster for one person than another. Take-home type treatments can range from $100 to $500. In-office treatments can range from $500 to $2000.

Questions to ask your dentist:

Are the desired results I described realistic?

Is there an alternative treatment that I should consider as well?

How long will the procedure take?

How much does it cost?

What is your experience in performing this procedure? (How many he/she has performed in the past year?)

What percentage of patients have had significant complications? (The dentist should provide this information to you.)

Will you repeat or correct the procedure if it does not meet agreed upon goals? And if the procedure must be repeated / corrected, will I be charged again? (The dentist should provide you with his/her policy on this issue.)

May I see "before and after" photos of recent patients? (The dentist may have a book that will provide many photos of recent patients.)

Could I observe the exact procedure I am considering before I decide to have it done? (Either on videotape or live.)

What should I expect after the procedure and what things should I avoid?

Do you offer patient financing?