Novi Tooth Whitening

Dr. Tressa Glavin Priehs is a dentist and has answered some common questions bizymoms visitors have about Teeth Whitening.


Q. What is Dental Bleaching?

A. Dental bleaching, also known as tooth whitening, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry. A child’s deciduous teeth are generally whiter than the adult teeth that follow. As a person ages the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous. Teeth can also become stained by bacterial pigments, foodstuffs and tobacco. Certain antibiotic medications (like tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel.

Q. What are the different methods of teeth whitening?

A. There are many methods to whiten teeth: bleaching strips, bleaching pen, bleaching gel, laser bleaching, and natural bleaching. Traditionally, at-home whitening involves applying bleaching gel to the teeth using thin guard trays. At-home whitening can also be done by applying small strips that go over the front teeth. Oxidizing agents such as hydrogen peroxide or carbamide peroxide are used to lighten the shade of the tooth. The oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and oxidizes interprismatic stain deposits; over a period of time, the dentin layer, lying underneath the enamel, is also bleached. Power bleaching uses light energy to accelerate the process of bleaching in a dental office. The effects of bleaching can last for several months, but may vary depending on the lifestyle of the patient. Factors that decrease whitening include smoking and the ingestion of dark colored liquids like coffee, tea and red wine.

Internal staining of dentine can discolor the teeth from inside out. Internal bleaching can remedy this. If heavy staining or tetracycline damage is present on a patient’s teeth, and whitening is ineffective, there are other methods of whitening teeth. Bonding, when a thin coating of composite material is applied to the front of a person’s teeth and then cured with a blue light can be performed to mask the staining. A veneer can also mask tooth discoloration.

Q. Can I do the whitening treatments on my own?

A. According to the American Dentist Association there are different options to whiten one’s teeth that include: in-office bleaching, which is applied by a professional dentist; at-home bleaching, which is to be used at home by the patient; over-the-counter, which is applied by patients; and options called non-dental, which are offered at mall kiosks, spas, salons, or other similar places). Whitening products intended for home use include gels, chewing gums, rinses, toothpastes, among others. The ADA has published a list of accepted over-the-counter whitening products to help people choose appropriate whitening products.

The ADA recommends to have one’s teeth checked by a dentist before undergoing any whitening method. The dentist should examine the patient thoroughly: take a health and dental history (including allergies and sensitivities), observe hard and soft tissues, placement and conditions of restorations, and sometimes x-rays to determine the nature and depth of possible irregularities.

Q. How does Gel Bleaching work?

A. There are two main methods of gel bleaching—one performed with high-concentration gel, and another with low-concentration agents. High-concentration bleaching can be accomplished either in the dental office, or at home. Whitening is performed by applying a high concentration of oxidizing agent to the teeth with thin plastic trays for a short period of time, which produces quick results. The application trays ideally should be well-fitted to retain the bleaching gel, ensuring even and full tooth exposure to the gel. Trays will typically stay on the teeth for about 15–20 minutes. Trays are then removed and the procedure is repeated up to two more times. Most in-office bleaching procedures use a light-cured protective layer that is carefully painted on the gums and papilla (the tips of the gums between the teeth) to reduce the risk of chemical burns to the soft tissues. The bleaching agent is either carbamide peroxide, which breaks down in the mouth to form hydrogen peroxide, or hydrogen peroxide itself. The bleaching gel typically contains between 10% and 44% carbamide peroxide (15% is recommended), which is roughly equivalent to a 3-10% hydrogen peroxide concentration.

Q. How does the level of concentration affect the results?

A. Low-concentration whitening is far less effective, and is generally only performed at home. Low-concentration whitening involves purchasing a thin mouthguard or strip that holds a relatively low concentration of oxidizing agent next to the teeth for as long as several hours a day for a period of 5 to 14 days. Results can vary, depending on which application is chosen, with some people achieving whiter teeth in a few days, and others seeing very little results or no results at all. Whitening is better at a dentist because the strip or mouth-guard does not completely conform to the shape of the teeth, sometimes leaving the tips of the teeth (near the gumline) unbleached. The bleaching agent is typically less than 10% hydrogen peroxide equivalent, so irritation to the soft tissue around teeth is minimized. Dentists as well as some dental laboratories can fabricate custom fitted whitening trays that will greatly improve the results achieved with an over-the-counter whitening method.

Q. What kind of results can I expect?

A. A typical course of bleaching can produce dramatic improvements in the cosmetic appearance of most stained teeth; however, some stains do not respond to bleaching. Tetracycline staining may require prolonged bleaching, as it takes longer for the bleach to reach the dentine layer. Case studies have been performed on people with tetracycline stained teeth. They used custom bleaching trays every night for 6 months and saw dramatic results and improvement. White-spot decalcifications may also be highlighted and become more noticeable directly following a whiting process, but usually calm back down with the other parts of the teeth becoming more white. The white spots become less noticeably with the other parts of the teeth becoming more white0. Bleaching is not recommended if teeth have decay or infected gums. It is also least effective when the original tooth color is grayish and may require custom bleaching trays. Bleaching is most effective with yellow discolored teeth. However, whitener does not work where bonding has been used and neither is it effective on tooth-color filling. Other options to deal with such cases are the porcelain veneers or dental bonding.

The whitening shade guides are used to measure tooth color with Vitapan Classic Shade Guide being the most widely used with 16 shades. These shades determine the effectiveness of the whitening procedure, which may vary from two to seven shades.

Q. How is Laser Bleaching different to other types of bleaching?

A. Power or light-accelerated bleaching, sometimes colloquially referred to as laser bleaching, uses light energy to accelerate the process of bleaching in a dental office. Different types of energy can be used in this procedure, with the most common being halogen, LED, or plasma arc. Clinical trials have demonstrated that among these three options, halogen light is the best source for producing optimal treatment results. The ideal source of energy should be high energy to excite the peroxide molecules without overheating the pulp of the tooth. Lights are typically within the blue light spectrum as this has been found to contain the most effective wavelengths for initiating the hydrogen peroxide reaction. A power bleaching treatment typically involves isolation of soft tissue with a resin-based, light-curable barrier, application of a professional dental-grade hydrogen peroxide whitening gel (25-38% hydrogen peroxide), and exposure to the light source for 6–15 minutes. Recent technical advances have minimized heat and ultraviolet emissions, allowing a less time-intensive patient preparation procedure. Most power teeth whitening treatments can be done in approximately 30 minutes to one hour, in a single visit to a dental physician. Treatment times and recommendations are dependent on the condition of a person’s teeth at time of treatment.

We offer in office Zoom Whitening for $300. This treatment offers instant results, up to 8 shades whiter! The fee also includes custom made whitening trays to take home to touch up as needed.

Q. Are there any side effects to tooth whitening?

A. Some patients may experience tooth sensitivity while whitening. This can be decreased by the use of a toothpaste such as Sensodyne.

Q. How can we contact Dr. Priehs if we have further questions?

A. If you have any further question please feel free to contact our office at 248-348-3100 or visit our website at novidental.com