The procedure tooth whitening
Tooth whitening has become popular as more people are seeking a more youthful appearance and a smile free from the effects of staining caused by tea, wine, coffee, and cigarettes.
The dentist will use peroxide-based bleaching to blench the teeth to leave the teeth whiter. Bleaching solutions generally contain carbamide peroxide and hydrogen peroxide as the active bleaching ingredients. Carbamide peroxide breaks down into hydrogen peroxide and urea upon exposure to water or saliva. Other ingredients include stabilizers, preservatives, and pH balancers. The strength of the bleach can range from 8 – 30 % concentration.
Bleaching works, since tooth enamel is porous. This allows the bleach to penetrate the enamel. This allow the stains to be removed.
Tooth whitening can reduce or eliminate the need for more invasive and expensive restorative dentistry, such as porcelain veneers and crowns. If veneers or crowns are needed for structural reasons, bleaching the teeth before they are done can make the outcome of the treatment more aesthetic.
There are no health-related consequences if you choose not to bleach your teeth. However, tooth whitening can be an effective and cost-effective way to improve the smile and boost the self-image.
The process of tooth whitening
There are two options available to bleach your teeth, that of home bleaching and bleaching by a dentist.
- Home bleaching
Even here are different options available. You can buy a home bleaching kit that have similar ingredients as dentist-dispensed systems. The problem with home kits are that they aren’t bespoke for your own needs. They can be messy, and you can waste a lot of the bleaching gel. More so it can leave your teeth sensitive.
- Bespoke bleaching at the dentist
If a dentist is doing the bleaching the formula can be made bespoke for your needs and there can be less of a waste of bleaching gel. An impression of your teeth will be made, then a mold that covers the teeth. This mold will be used where the bleaching gel is placed before being placed over the teeth.
Concentrated bleach solution (30% or more) is applied to the teeth and left for 20-30 minutes, while the teeth are exposed to a bleaching accelerant (laser, UV, etc.). Advantages to in-office bleaching include the rapidity with which whitening is achieved; and the protection from the oral soft tissues (gums, lips, cheeks) from the bleach. Disadvantages include the cost (which may be twice that of home bleaching); the noticeable relapse toward the darker shades when the teeth rehydrate; and, there have been reports of patients being sunburned from UV lamps which may be used to accelerate the bleach.
When the enamel is bleached, it can only bleach the actual teeth and not the dental material that was applied before, such as fillings, veneers or crowns. If needed, such restorations may need to be replaced following tooth whitening procedures, generally at additional cost.
There can also be a risk that the teeth are over bleached. If that happens, there is a risk that the teeth will become transparent, and showing an unhealthy appearance.
More so, the damage of over bleaching can lead to stress for the teeth. This can impact the nerve and blood vessels in the teeth. Worse, a tooth may die, and then you will need root canal treatment.
Also teeth whitening can cause tooth sensitivity or irritation to the gums, both of which are generally temporary. Irritated gums may be due to a poorly fitting bleach tray, which can be repaired or remade. Plus, it is common to experience pain during and after tooth whitening, but it will go away after couple days. And children under the age of 18 should not bleach their teeth due to the risk of prolonged sensitivity. Furthermore, bleaching exposed tooth roots will not make them noticeably whiter, and may make the teeth more sensitive.
There can be a risk of oral cancer risk. The link has not been conclusively demonstrated. But, peroxides used to whiten teeth are known “free radical initiators,” which encourage the growth of cancerous tumors. In animal models, peroxide has been shown to promote the growth of cancerous tumors in the cheeks of rodents, and to cause gastrointestinal cancers if ingested. No studies have been done on humans.
Other treatment options
Whitening toothpastes can produce noticeably whiter teeth without exposing the soft tissues to peroxides. The ingredients in whitening toothpastes include mild abrasives for removing superficial enamel stains, and chelating agents, which bind to, and remove some types of molecules that have stain pigments. You should be careful not to overuse bleaching toothpastes, as sensitivity can result. For deep intrinsic stains, veneers may be an option. For isolated, superficial stains which are not responsive to tooth whitening agents, enamel micro-abrasion with or without bonding of tooth-colored composite resin fillings can sometimes be done.