Beginners Guide to...Tooth Whitening

Friday 6th October, 2006
Before & After
beforesmall.jpg   aftersmall.jpg

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.

  1. 1) Scott Said: (06/10/2006 12:53:23 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    What category does "Ionic White" come under?

    { Link }

    Does it work?

  2. 2) Dr Jarrad Rose Said: (06/10/2006 20:38:00 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening


    As far as i know Ionic White is not officially available in the UK but i am sure it can be purchased on the net. As i am not aware of the active ingredients i cannot catagorically say whether it is truly effective or not but i would think it falls into the over the counter catagory above. I refer you to the links below. You decide.

    { Link }

    { Link }

  3. 3) Mr. D Said: (28/10/2006 16:53:12 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    Why are people so focused on ruining their teeth by using tooth whitening ?

  4. 4) Dr Jarrad Rose Said: (15/11/2006 19:56:03 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    Mr D,

    Depends upon what you mean by ruining the teeth. There is actually no "damage" whatsoever to the surface of the teeth. As they say beauty is in the eye of the beholder and one persons ideals are not the same as others. I am not a big fan of body piercing, tatoos or certain football teams but i don't let my prejudices get in my way professionally or socially.

  5. 5) Sam Said: (11/01/2007 19:02:41 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    Dear Dr Rose

    i have found your Q&A page very helpful. I wonder if you could tell me if the procedure is at all painful as I am a complete wimp and don't think I could cope with pain and discomfort for over an hour.

    Do you know of any dentists that perform this whitening in the south west of England as I have looked for zoom 2 specialists and the nearest to me in Plymouth is Cardiff, a little too far for a day trip.


  6. 6) Mark Dickson Said: (15/01/2007 13:34:42 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    thanks for an informative balanced view. my suspicions of infomercial products seems to have been well founded from the nbc links relating to the ionic white system.

    the 'after' photo's on the australian version of the ads (presumably same as the US ones) seemed to be using increased Flash on the camera as the teeth were flaring brightly.

    Also some video footage looked like they were using 'black light' UV lamps that would make a dogs teeth look like a hollywood stars! can't prove this of course but the old adage that if it seems too good to be true it probably is!

    Seems like thorough cleaning & flossing and occasional professional cleaning might get you damned good teeth anyhow your money for a decent toothbrush!

  7. 7) Matt Bell Said: (04/04/2007 21:04:16 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    Hi, I would like to find a dentist in Cardiff that can offer Zoom 2 but can't find anywhere to search for outlets? Please can you help?

    Also how does Zoom compare to BrightSmile?



  8. 8) Parry Said: (11/07/2007 14:03:35 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    Hi, would you reccomend going to see your regular dentist to get your teeth cleaned properly 1st, before getting zoom treatment done? From what i gather when having Zoom done they dont clean your teeth. Or would you say it is not necessary to do this?


  9. 9) Someonewonderful Said: (25/09/2007 23:33:02 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    I have just had zoom 2 whitening treatment on my teeth and i am very very impressed with the result. 9 times whiter. I was very sceptical but am pleased to say it has worked fine on my teeth.

  10. 10) hortert Said: (27/10/2009 10:18:44 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    As far as I know, many patients suffer from sensitivity of teeth after the procedure of whitening. And one more question: can people with weak gums have their teeth whitened?

  11. 11) Dr Jarrad Rose Said: (30/06/2010 10:39:44 GMT) Gravatar Image
    Beginners Guide to...Tooth Whitening

    Brief answers to all questions.

    1) You should always be aware that oral hygiene and cleaning is the first stage in keeping teeth white and healthy and this should never be overlooked as it really is the most important thing of all.

    2) Whitening of teeth can make them more sensitive when the procedure is carried out but this is not usually a long term problem unless you continue to whiten intensely on a regular basis. The in surgery systems are more likely to give an initial intense sensitivity, or ache, but his passes usually within 24-48 hours. The tray whitening sensitivity tends to build up the more it is carried out but it is only the minority of people who get this to any great degree with either system.

    3) There really is no such thing as "weak gums" but if you mean people with gum disease of some kind then yes alongside the important professional cleaning of your teeth and gums whitening can be carried out. you may be more prone to sensitivity due to gum recession though. Strangely there is some anecdotal evidence to suggest that people with gum disease who have there teeth whitened actually experience an improvement in the condition. We do not really know however whether this is due to the action of the oxygen which is released in the whitening products on the anaerobic bacteria that cause the gum disease or just that people generally tend to start taking better care of their teeth.

    4) Britesmile originally came out before Zoom then got swamped by Zoom, Zoom2 and then Zoom advanced. Discuss dental then bought out Zoom and now market both. I would have to say that the new Zoom Advanced Power whitening is probably the best I have used.

    Finally, tooth whitening does work very well and is a refreshing way of improving your smile without invasive treatment.

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