Beginners Guide to...Tooth Whitening

Friday 6th October, 2006
Before & After
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In the first of a series of articles surrounding the mystery of going to the dentist; Dental Surgeon Dr. Jarrad Rose, BDS (L’pool) DPDS (Bristol), looks at the modern trend of Tooth Whitening used by celebrities and politicians.

What exactly is Tooth Whitening? How much does it cost? How long should it last? These are among the answers, along with dismissing a few of the myths surrounding the topic.

Any questions you may have on the topic should be answered below but, if you do have any queries on this or indeed any other topic, then please feel free to post them in our comments section and Dr. Rose will address them here or in a future article.

On with the show...

What is tooth whitening?

Tooth whitening can be a highly effective way of lightening the natural colour of your teeth without removing any of the tooth surface. It cannot make a complete colour change; but it will lighten the existing shade.

Why would I need my teeth whitened?

There are a number of reasons why you might get your teeth whitened. Everyone is different; and just as our hair and skin colour vary, so do our teeth. Very few people have brilliant-white teeth, and our teeth can also become more discoloured as we get older.

Your teeth can also be stained on the surface through food and drinks such as tea, coffee, red wine and blackcurrant. Smoking can also stain teeth.

Calculus or tartar can also affect the colour of teeth. Some people may have staining under the surface, which can be caused by certain antibiotics or tiny cracks in the teeth which take up stains.

What does tooth whitening involve?

Professional bleaching is the most common form of tooth whitening. Your dentist will be able to tell you if you are suitable for the treatment, and will supervise it if you are. There are 2 main types; tray/home bleaching or power/laser bleaching.

Tray/Home Bleaching

Once your dentist has made sure you are dentally fit for the procedure they will take impressions of your teeth to send to a dental laboratory. The dental laboratory will then construct special custom made bleaching trays specific to your mouth. These are like thin gumshields and the bleaching gel is placed inside them. The shields help keep the bleach in place over the teeth and away from the gums.

The ‘active ingredient’ in the product is usually hydrogen peroxide or carbamide peroxide. As the active ingredient is broken down, oxygen gets into the dentine on the teeth and the tooth colour is made lighter.

How long does this take?

Usually most patients feel that the procedure is successful in 1 to 2 weeks if the trays are worn consistently for the recommended amount of time. This may take longer if the teeth are very dark, have root fillings or some other complicating factor like tetracycline staining.

Power/Office/Laser bleaching (Zoom)

There is now laser whitening or ‘power whitening’. During this procedure a protective layer is put over your teeth to protect the gums, and a bleaching product is placed onto your teeth. Then a light or laser is shone on the teeth to activate the chemical. The light speeds up the chemical reaction of the whitening product and the colour change can be achieved more quickly using this procedure. Laser whitening can make teeth up to nine shades lighter and is usually supplemented with bleaching trays and gel to keep the teeth white or to increase the whitening effect.

How long does this take?

Your dentist will need to assess your teeth to make sure that you are suitable for the treatment. Once it has been agreed, this procedure usually takes about one to one and a half hours.

How much does tooth whitening cost?

You cannot get whitening treatments on the NHS. Private charges will vary from practice to practice and region to region. Laser or power whitening will be more expensive than professional bleaching. We recommend you get a written estimate of the cost before you start any treatment.

Prices average around £350 for tray bleaching and £600 for power bleaching eg. ZOOM whitening

How long will my teeth stay whiter?

If the whitening procedure is performed only once the effects can last up to three years. However, this will vary from person to person and is usually irrelevant as the newly whitened teeth are “topped up” from time to time by re-using the bleaching trays and gel. This keeps the smile as white as the first time the whitening was performed.

What are the side effects?

Some people may find that their teeth become sensitive to cold during or after the treatment. Very few others report discomfort in the gums or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days of the treatment finishing.

What about home kits?

Home kits are cheaper and generally ineffective, especially in the UK where the concentration of the active ingredient is so much lower than places like the USA. Because tooth whitening is a complicated procedure you should only have it done by a dentist, after a thorough examination and assessment of your teeth.

Over-the-counter kits sold in the UK are not recommended as they usually contain only a small concentration of hydrogen peroxide (the whitening product). The legal limit in the UK is 0.1% of hydrogen peroxide and effective bleaching products need to have about 3.6% so home kits may not be able to lighten your teeth noticeably. Also, some contain mild acids and others are abrasive. This could cause ulcers and damage to the gums if the product is not used properly

What about whitening toothpastes?

There are several whitening toothpastes on the market. Although they do not affect the natural colour of your teeth, they may be effective at removing staining and therefore may improve the overall appearance of your teeth. Whitening toothpaste may also help the effect last, once your teeth have been professionally whitened.

Can a single tooth which has been root filled be whitened?

Yes. Many dead teeth go discoloured after a root filling. If the tooth has been root treated, the canal (which previously contained the nerve) may be reopened. The whitening product is applied working from the inside to whiten the tooth.

When might tooth whitening not work?

Tooth whitening can only lighten your existing tooth colour. Also it only works on natural teeth. It will not work on any types of ‘false’ teeth such as dentures, crowns and veneers.

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