There has been a great deal of

attention placed in recent years on

tooth color. We are all aware of how

marketers have dazzled us with whiter

than normal smiles. Tooth bleaching

(whitening) ads appear regularly on

television and in magazines.

There seems to be a global trend to

have lighter teeth as opposed to a

more natural smile. Even in Europe and

Asia, there is an increased demand for

whiter crowns and veneers although

ceramic experts have developed

exquisite techniques for matching the

natural colors of teeth.

The public’s current perception of

beauty includes a lighter shade than

normal for smiles. You may have seen

this well-documented in a Discovery

Channel’s program titled, “Survival of

The Prettiest.”

As we age, tooth color naturally

darkens. A lighter shade evokes the

image of youthfulness. Who among us

doesn’t aspire to have youthful health,

vigor, and beauty? Even those of us

dentists, who idealize a natural-looking,

beautiful smile, are helping our patients

achieve a lighter shade on the

front central teeth and a gradual shading

back to a more natural color on the

remaining teeth.

When patients ask me about

bleaching, I like to size up their desires

for change. I want to make sure their

expectations are not unrealistic. I also

want to help the patient select the

whitening process most appropriate

for them.

The Various Methods

Many products and techniques are

available for bleaching teeth. There are

three different approaches or categories.

are three types of over- the- counter

whitening products – toothpastes,

strips, and trays. Whitening toothpastes

remove surface stains but do

not change the color of the tooth structure.

The surface stains are slowly

worn away with mild abrasives or special

chemical or polishing agents. It

can take more than a year to whiten

your teeth one shade lighter even if you

use the whitening toothpaste every

day. This is because the toothpaste is

diluted by saliva and in your mouth for

a few minutes at most.

with a bleaching agent and can be

pressed on the surface of your teeth

like a bandaid. From these, some

patients get excellent results at a very

low cost.

are generic, not custom fitted. The purpose

of the trays is to hold a whitening

gel against your teeth. Because generic

trays are mostly loose-fitting, they

lack the ability to hold the bleaching

agent against all teeth and thus lose

effectiveness.

next category of bleaching products

can be used at home and are available

from your dentist. After making impressions

of your upper and lower teeth,

your dentist will have two custom trays

fabricated to hold the bleaching agent

(whitening gel) firmly against your upper

and lower teeth. This is the most effective

and cost containing approach.

Depending on your circumstance,

your dentist will provide you with an

appropriate bleaching gel to use with

your custom trays and instruct you how

long and often to wear the trays.

Excellent results can be achieved with

these products.

of treatment is called “power

bleaching.” This technique is performed

in the dental office. The bleaching

agent is painted on the teeth after

the gums surrounding the teeth are

protected with another material painted

on them. The bleaching gel is left on

is agitated or slightly moved with a

brush. A high intensity light is shone on

the gel to facilitate the bleaching process.

Usually one session and sometimes

two sessions are required to get

optimal results. Many dentists utilize

the power bleaching technique to start

their patients and then provide custom

trays and gel to be

used at home to

enhance the results.

Please Note:

stains caused by coffee, tea,

tobacco (after smoking is stopped),

and aging.

patches and composite fillings

will not lighten in color with

bleaching. If restorations are planned,

especially in front part of your

mouth, your dentist will recommend

bleaching your teeth first so

the new restorations can be

matched to the color of the whitened

teeth.

teeth may give them a greenish

gray appearance that cannot be

changed by bleaching.

composite patches and fillings will

not lighten with bleaching, you may

need to have some of these

replaced in order to achieve desirable

esthetic results. This is espe

cially true if you have restorations

in the front of your mouth.

varies from person to person.

You will not know the level of

whitening that can be achieved in

your case until you try. In general,

we see excellent results from custom

tray and power bleaching, and

patients can achieve good results

from using whitening strips.

of bleaching by using custom trays

or strips once or twice a year. If

you do not smoke or drink coffee,

tea or red wine, the level of whitening

you have achieved may last up

to as long as five years.

is an increase in sensitivity immediately

following the process. It is

not uncommon for gums to feel irritated

and for teeth to be temperature

or pressure sensitive. One in

two patients report some sensitivity

that discontinues within two

days.

likely to experience sensitivity. If

you have a pre-existing sensitivity,

you are apt to experience some

increased sensitivity for a few

days.

while home bleaching, you can

reduce the amount of bleaching gel

you apply and/or decrease the

amount of time you wear the

bleaching strip or tray.

bleach for the number of pre

scribed days and do not exceed

the recommended duration of each

bleaching session.

you experience pain. Contact your

dentist if you think you are experiencing

an abnormal amount of sensitivity

– after power bleaching or

during or after bleaching at home.

gray-blue ones caused by the

antibiotic tetracycline, are difficult

to remove and sometimes impossible

to remove. Your dentist can

help you bleach stubborn stains to

the extent possible. Do not over

use whitening products at home in

hopes of removing these stains.

Summary

Tooth whitening is an easily

achievable cosmetic enhancement

that can rejuvenate your smile. You

should speak with your dentist to determine

which products and methods are

most appropriate for you and to ascertain

if you have any special conditions

warranting caution, professional monitoring,

or treatment prior to bleaching.

Your dentist will discuss with you any

additional dental treatments that may

be needed in order to achieve the

esthetic results you desire. If you think

you are experiencing an abnormal sensitivity

during or after bleaching, you

should tell your dentist. R