Teeth Whitening/Bleaching
Teeth whitening has become more and more popular in the past two decades. These days, there are so many different types of dental bleaching available on the market that it can be confusing to decide which one is right for you.
Here are the four basic types:
Whitening toothpaste — These use special abrasives or chemicals that polish off surface stains such as those caused by drinking coffee or smoking. It is generally safe to use everyday but will not change the natural color of teeth nor remove internal discolorations. Examples of whitening toothpastes are Crest 3D Vivid Toothpaste and Colgate Total Advanced Whitening and prices range from $4 go $8 depending on the brand. Whitening toothpastes will make teeth shiny and feel clean but you’re probably not going to see any visible difference in color.
Whitening Strips — Drugstores often carry these. The active ingredient is either hydrogen or carbamide peroxide. Each box contains little sticky strips that are placed on the teeth (upper and lower arch) for 10 to 20 minutes each time. The strips are definitely effective but because they only carry about 5% to 10% of the active ingredient, the results are very limited. In addition, the gel on the strips are in direct contact with gum tissue which can cause sensitivity. Costs run between $40 to $60. Good examples of these are FORM-FIT Whitening Strips by Rembrandt and Crest Whitening Strips. The best candidates for these products are people who have already had professional bleaching who want to freshen up their results but lost their bleaching trays.
Professional Bleaching with bleaching trays — These are best done in a dental office. An impression is made of the two dental arches and two well-fitting and soft plastic trays are custom made for the patient. Peroxide bleaching gel is then placed in the trays and inserted into the mouth. Bleaching gels can be applied in office or taken home. Because they contain a much higher percentage of the active ingredient peroxide, the results can be very dramatic. The trays are made to avoid contact between the gel and the gums to decrease sensitivity. However, because of the higher percentage of peroxide, the enamel becomes more porous temporarily and some sensitivity is still to be expected. The sensitivity can be minimized by picking a gel with lower percentage of peroxide (20% instead of 40%) and/or cutting down the amount of time trays are worn (1 to 2 hours instead of overnight). Examples of these are Opalescence and PolaWhite. Fees for bleaching trays and gel usually cost $250 – $300. The good thing is that the bleaching trays are yours to keep forever. If touch-ups are needed later on, the patient can simply purchase more gel ($20-$50) and use the same trays.
Lighted Activated In-Office Whitening — This is always done in a dental office. A silicone shield is used to pull back the tongue, cheeks, and lips. The bleaching gel is applied to the teeth then activated by a special light to help the solution penetrate further. The entire treatment only take 40 minutes to an hour to complete and is very comfortable. Although the concentration of peroxide is lower than most take-home bleaching gels, light-activated systems are highly effective. Sensitivity after bleaching is expected just like the other types of whitening systems. Unfortunately, there are two major disadvantages. First, it’s usually more expensive, around $400. Second, there is no bleaching tray for you to take home so if you want to do it again you have to pay the full fee. The two most popular light activated systems are Zoom and BriteSmile.
I hope this clears up some confusions about teeth whitening. The American Academy of Pediatric Dentistry encourages patients to consult their dentist prior to whitening their teeth. I typically don’t recommend my patients to whiten their teeth until they are at least 14 or 15 years old. Young permanent teeth tend to have larger nerves and are therefore more sensitive.
If you have any questions about bleaching please contact me at my Las Vegas pediatric dental office.