Dr. Susan Hollinsworth is a dentist and has answered some of the common questions Bizymoms visitors have about Tooth Whitening.
Q. What is tooth whitening?
A. According to the FDA, the term "whitening" refers to restoring a tooth’s surface to its natural color by removing stain and debris. So any product that cleans (like toothpaste) is considered a whitener. The term "bleaching" is used only when teeth are whitened beyond their natural color. This strictly applies to products that contain bleach--typically hydrogen peroxide or carbamide peroxide. The term "whitening",of course, sounds better than "bleaching" so it is often used to describe the process involving peroxide. Most of us start out with fairly white teeth, thanks to their porcelain-like enamel surface. Composed of microscopic crystalline rods, tooth enamel is designed to protect the teeth from the effects of chewing, grinding, trauma, and acid attacks caused by sugar. But over the years enamel is worn down, becoming more transparent and letting the darker color of dentin--the tooth’s core material--show through. During chewing, the dentin is protected while millions of microcracks occur in the enamel. It is these cracks, as well as the spaces between the crystalline rods, that gradually fill up with stains and debris. The controlled use of hydrogen or carbamide peroxide removes this.
Q. Who may benefit from teeth whitening?
A. Generally, bleaching is successful to some degree in over 90 percent of patients. Consider bleaching if your teeth are darkened from age, coffee, tea, or smoking. Teeth that are dark in the yellow, brown, orange shade range respond better to bleaching than those that are more blue or gray.
Q. Who are not recommended to undergo teeth whitening?
A. AGE--Teeth whitening is NOT recommended for anyone under the age of 16 or so. At this age, the teeth are still maturing and the pulp(nerve) is enlarged. Whitening could cause sensitivity and possibly severely damage the pulp.
PREGNANT--Any woman who is or may become pregnant or who is lactating should NOT whiten their teeth. Swallowing even a small amount of peroxide bleach could be harmful to the fetus.
ALLERGIES--Obviously, anyone allergic to peroxide should NOT use a whitening product of any kind.
TRANSLUCENCY--If you have very thin, translucent teeth, they will not respond to whitening.
FILLINGS,CROWNS,VENEERS--Teeth whitening will NOT work on crowns, veneers, or composite fillings; they will stay the same color. If your teeth have darkened since the crowns or veneers were done, this may even out the color more.
However, in most cases you will end up with multi-colored teeth so you need to go into whitening knowing that you are going to be replacing dental work after you reach the whiteness you desire. You should wait a minimum of 2 weeks after whitening before doing this.
Q. What does tooth whitening involve?
A. First, the dentist will determine if you are a candidate for bleaching and what type of bleaching system would work the best for you.
IN-OFFICE WHITENING: If you need immediate results, you can have either an in-office bleaching process or laser bleaching while you sit in the dental chair. This system involves the carefully controlled use of a relatively high concentration peroxide gel, applied to the teeth by the dentist or trained technician after the gums have been protected by a paint-on rubber dam.. Generally, the peroxide remains on the teeth for several 15-20 minute intervals that add up to an hour maximum. Those with stubborn staining may be advised to return for 1 or more additional bleaching sessions. Almost all patients continue with a home-use whitening system to get the desired final result as the immediate results may be somewhat variable and short lasting.
TAKE-HOME CUSTOM TRAY WHITENING KITS: Many dentists feel that the custom take-home kits produce the best results long term. The dentist or assistant will make impressions of your teeth to fabricate a lightweight mouthguard-type appliance. The trays are so thin that you can wear them comfortably day or night and even talk or work with them in. The peroxide gel used is an easy-to-use lower concentration that remains on the teeth for an hour or so daily. Good results can usually be obtained in 2-4 weeks depending on your teeth, desired whiteness, and consistency in use. The trays can last for a few years if taken care of and can be reused to touch up when needed(usually once a year).
TAKE-HOME PREFORMED TRAY WHITENING KITS: If you desire only a highlighting or small color change, you may choose a system consisting of a set number of preformed trays(usually 10-14). Since they are professionally dispensed, the peroxide concentration can be higher than over-the-counter kits so they work faster .
OVER-THE-COUNTER WHITENING: Over-the counter systems are the least-expensive option and are generally safe and somewhat effective, although it is recommended to check with your dentist first. These systems consist of one-size-fits-all trays, strips, or paint-on applicators to apply the peroxide gel which is a lower strength bleaching agent than can be used or dispensed by a dentist. For this reason, they must be used longer to achieve the same desired effect and in many cases, they may only whiten the front few teeth unlike the custom trays that can whiten the entire smile.
Q. How long does this take?
A. No one can really predict how long it will take. Every person is different in their desired result, in their compliance with the process, and in their color and tooth characteristics. With in-office or laser whitening, you can get significant, although maybe temporary, results quickly. In younger people and possibly those with a small amount of desired whitening, 2 weeks can be sufficient to achieve good results with any of the systems. In older people and those wishing a greater change in degree of whiteness, results may take 4 weeks or possibly longer.
Q. How much does tooth whitening cost?
A. In-office Whitening costs $650 per visit (on average) nationwide Custom Take Home Trays typically cost $250-450 Professionally Dispensed Preformed Trays run $50-150 per kit Over-the-Counter Whitening costs $20 -100 per kit
Q. What are the side effects?
A. Teeth whitening treatments are considered to be safe when procedures are followed as directed. However, there are certain side effects associated with bleaching :
SENSITIVITY--Whitening can cause a temporary increase in sensitivity to temperature and pressure. This is most likely to occur with in-office whitening, where higher concentrations of bleaching gel are used. Some individuals have even reported experiencing spontaneous shooting pains("zingers") in their front teeth. Individuals at greatest risk for sensitivity are those with gum recession, significant cracks in their teeth, decay, or leakage of faulty restorations(fillings, crowns). Sensitivity usually only lasts a day to a few days if whitening is stopped, but may persist up to a month. Your dentist may recommend a desensitizing toothpaste or a fluoride product for sensitive teeth.
GUM IRRITATION-- This usually occurs from ill-fitting trays impinging on the gums or from a higher concentration bleaching gel. Such irritation may last for several days, slowly going away after the bleaching has stopped or the concentration lowered.
Q. How to contact Dr. Hollinsworth if we have further questions?
A. drsueh@qwestoffice.net is my email and my phone is (253)631-8286
