Dover Tooth Whitening

Dr. Dawn M. Grandison is a dentist and has answered some of the common questions Bizymoms visitors have about Tooth Whitening.


Q. What is tooth whitening?

A. As dental education, access and techniques improve, more individuals have more of their natural teeth and cosmetic dentistry, including teeth whitening, is in great demand by young and old alike.

Professional teeth whitening (or bleaching) is a simple, beginning step to enhance the beauty of your smile.  Over-the-counter products work to varying degrees but are certainly not as effective (because they are not as concentrated) or as guaranteed (because there is no professional regulation) as professional treatments that are approved by the American Dental Association (ADA).

Q. Who may benefit from teeth whitening?

A. The effectiveness of a whitening treatment depends on whether the discoloration of the teeth is due to factors that over time darken the teeth.

The outer enamel layer is usually whiter than the underlying yellow dentin layer of the tooth.  As we age, the whiter enamel wears away revealing the yellow dentin.  This change cannot be brightened with tooth whitening.  Instead, such patients should consider porcelain veneers, which are like laminates that the dentist will use to cover the teeth.
Habits like smoking, drinking coffee, tea, wine or anything with color can superficially discolor one’s teeth.  This type of staining can most effectively be treated with whitening, because stains can be ‘bleached’.

Sometimes, the developing teeth of a baby in a mother’s womb or of a young child can become discolored when that pregnant mother or that child takes certain medications, such as the antibiotic tetracycline or excessive fluoride.  When these chemicals get incorporated into the developing material of the child’s teeth, they cause staining that is not as effectively lightened, especially with over the counter whitening products.

Another factor that can affect the color of a tooth is the color of the filling material that was used to restore a tooth.  Silver amalgam is silver in color and over time darkens and looks black.  In addition, this dark filling material can seep into the tiny tubules within the tooth causing the tooth to darken.  Sometimes this discoloration can be treated by replacing old fillings with white ‘composite’ filling material; and/or using porcelain veneers and crowns to cover the tooth.

Finally, a tooth will change color or darken if it becomes traumatized and ‘dies’.  When the tooth dies, the blood within the inner pulp and nerve chamber seeps into tiny tubules within the tooth and turns bluish black (like the color change with a bruise).  This darkening can most effectively be treated by first doing root canal treatment on the affected tooth, then bleaching it internally with powerful agents in the dental office, before finally covering it with an aesthetic porcelain crown.

Because of the factors listed above and varied individual factors, it is imperative that anyone who is considering teeth whitening be first evaluated by a dentist to determine if he/she will have appreciable results and is therefore a good candidate.

Q. Who are not recommended to undergo teeth whitening?

A. Gum irritation is a side effect of teeth whitening that can be severe when the whitening procedure is not supervised by a dental professional.  It is advisable that patients with gum inflammation or ‘gingivitis’ and gum disease or ‘periodontitis’, get these treated by the dental professional before their whitening appointment.  It must be noted here that the pregnant mother can develop a condition called pregnancy gingivitis, which occur as a result of hormonal changes that increase the susceptibility of their gums to infection making them red and painful!  This can be managed by routine cleanings at the dental office during and after pregnancy.

Q. What does tooth whitening involve?

A. When patients present at the dentist office for teeth whitening, they will first receive a comprehensive oral evaluation that will include a series of x-rays.  X-rays are necessary because it is in the patient’s best interest to have any tooth decay or cavities treated, prior to the dentist applying powerful bleaching agents to his/her teeth.  Reasonably so, because teeth sensitivity is a side effect of tooth whitening; especially repeated teeth whitening, which individuals using over the counter whitening agents tend to do.  To help limit this, the dentist may recommend that the patient brush with anti-sensitivity toothpaste for at least two week prior to the whitening appointment.

Next, the dentist will also take impressions or molds of the patient’s upper and lower teeth so that custom trays, with reservoirs for the whitening agent, can be made to fit snugly over the patient’s teeth.  This custom fit ensures that bleaching chemicals do not seep out and irritate the patient’s gum tissue while the trays are being worn as directed by the dentist.

Teeth whitening will be more effective when a patient has a dental cleaning to remove plaque and calculus build up, followed by a ‘touch up’ cleaning, if the first is done too long in advance of the actual whitening visit.  The dentist will then record the shade of the patient’s teeth prior to bleaching so as to later assess the effectiveness of the bleaching process.

Once the bleaching process is finished, the dentist will match the shade of the newly whitened teeth and compare it with the shade prior to bleaching to determine the success of the whitening process.  This new tooth shade can also be used to select the shade of white composite filling materials that will be used to restore a patient’s teeth.

It is important to note that white composite fillings can get stained over time and become obvious against the whiter teeth, necessitating a redo of defective fillings.  Conversely, teeth whitening is not permanent, and over time the whiter fillings that once matched the once whitened teeth become visible against darkening teeth.  When this is the case ‘touch up’ whitening will be necessary every several years so a patient can keep their bright, youthful and confident smiles.

Q. How long does this take?

A. In-home teeth whitening using the bleaching agents and custom trays provided by the dentist is more affordable.  The whitening gel is placed in the reservoirs of the trays which are then worn either twice a day for about 30 minutes or as required by the bleaching system used.  It can take several weeks to achieve the desired whitening results depending on the degree of staining and the cause of staining.

In-office teeth whitening is more immediate because the whitening effect of the bleaching agent is accelerated by the use of a special light that is focused on the patient’s teeth.  It may require more than one visit, with each visit lasting 30 to 60 minutes.  Because the bleaching technique is so powerful, the dentist must ‘block out’ the patient’s gums to protect them from irritation before the bleaching agent is applied to the teeth.  At the end of the appointment, the patient may then be given custom trays and an in-home bleaching kit to continue the bleaching treatment for an additional two weeks.

Q. How much does tooth whitening cost?

A. The cost of teeth whitening at the dental office varies with the whitening option chosen by a patient. 

Q. What are the side effects?

A. The post operative sensitivity that some patients experience after having their teeth whitened is usually temporarily and subsides within a few days to one week.  Young children in particular should not whiten their teeth because their developing teeth have wide open tubules into which the whitening agent can infiltrate aggravating sensitivity.  Likewise, patients with receded gums, such that more of the roots of their teeth are visible when you look, are at a high risk for post op sensitivity because the tooth material covering the roots of our teeth is not as hard and resistant.

Q. How to contact Dr. Grandison if we have further questions?

A. Dawn M. Grandison, D.D.S.
President
Smile-To-Smile Family Dental & Sedation Center, P.A.
429 South Governors Avenue,
Dover, DE 19904
Office: 302-678-3384
Fax: 800-245-2501
Email: smiletosmilefdsc@gmail.com
Web: www.smiletosmiledentistry.com