Cosmetic Dentistry in Victoria, BC

Teeth Whitening: What you should know

Have you looked in the mirror and wondered if having a whiter and brighter smile would make you more attractive or give you the confidence to smile more often? You are not alone. Many of us at one point or another ask this question. Advertising and the media ask us this question over and over again when we are in the supermarket picking up a tube of toothpaste, buying a pack of gum or headed to the local salon for a manicure. There seem to be so many options out there, but do they work and are they safe? Here's a better question: will they work and are they safe for YOU?

A visit to your dentist can help you determine a safe, effective and simple way to whiten your teeth and improve your smile. Your smile is uniquely your own, and your dentist can help you decide whether or not whitening is a means to improve your particular smile, or whether an alternative treatment might be more suitable in your case. Whitening can help to take years off of the appearance of your teeth and can be started in less than an hour. Find out which options are best for you by talking to your dentist.

Whitening - A safe first step

Teeth whitening is generally a safe way to improve the appearance of stained or discoloured teeth, if done correctly. In fact, the Canadian Dental Association, American Dental Association and British Dental Association all see whitening as a recognized form of dental treatment and recommend that a qualified dentist be consulted if you are interested in teeth whitening. Teeth whitening may be all that you will ever need to have a brilliant smile. On the other hand, you might benefit from a thorough plan that works with your long-term needs that only a sympathetic dentist can provide by consulting with you to generate a plan.

Can anyone have their teeth whitened?

It is important that a thorough dental exam has been completed and the patient has a healthy oral cavity prior to teeth whitening. Problems such dental decay (cavities), gum disease, worn/cracked teeth need to be addressed, otherwise these can be exacerbated by the dental whitening products. If restorative dentistry is required to improve your oral health, your dentist will likely recommend you have this work done before undergoing teeth whitening to prevent further damage or sensitivity from developing. This is one reason that a visit to your dentist and a discussion of your dental needs is integral to your dentist providing the correct and effective whitening treatment.

Did you know? Teeth whitening has been used for over 100 years.

Whitening - is that bleaching?

It can be quite confusing that the terms teeth whiting and tooth bleaching in their various forms are generally used interchangeably. We prefer to use the term tooth whitening, as tooth bleaching refers more specifically to using a bleaching agent, most commonly peroxide based. The different techniques used to make the tooth brighter will be discussed in a moment, but first we need to talk about the reasons, types of stains and location on the tooth that cause the smile to darken. 

Why our teeth look darker with age

Dirty teeth look darker. It is obvious isn't it? On some conscious or subconscious level a beautiful, harmonious, and bright smile is an overt manifestation of a healthy mouth. Of course, the gums need to look healthy and the breath needs to be fresh. Only your dentist and dental team can help you eliminate the bacteria, its plaque and tartar (also called calculus) that are at the root of most accumulated dental problems. It is not just having a great looking smile, but having truly healthy teeth that really counts.

Besides becoming darker over time, our teeth are also exposed countless times to food and drink that have intense pigments and staining potential. Remember how difficult it was to remove that berry stain from your carpet or spaghetti sauce from that white shirt? Some examples of foods and drinks that have the potential to stain teeth are coffees, teas, red wines, curries, soya sauces, among others, and tobacco products. The pigments in these and other substances penetrate the enamel and absorb the light, causing the teeth to appear darker and tinted. With long term exposure to these pigments, the teeth may begin to appear yellow and aged. Diligent oral hygiene alone cannot remove the stains accumulated within the enamel.

A reasonable recommendation would be to limit exposures to staining food and products. However, it isn't realistic to expect that we can sustain a proper diet, let alone enjoy variety in life, by eating only white or clear foods. Fortunately, the technique of teeth whitening acts on the light absorbing pigments in the teeth and can help to reverse some of the natural darkening that has occurred.

Over the counter whitening products - scrubbing and scratching action

There are numerous products on the market that promise whiter teeth. Some products are included in a toothpaste, while others are either painted on the teeth or held on the surface of a plastic membrane. Much of the action of whitening toothpastes may be down to the addition of abrasive particles to polish off external stains. Be careful. Discuss with your Victoria dentist prior to using over the counter whitening products as they can cause problems in certain patients with unrecognized decay or excessive wear of the teeth. You should also avoid whitening toothpastes if you have porcelain veneer work because the abrasive ingredients can remove the shiny glaze on the porcelain.

Take home whitening trays - use precision trays supervised by your dentist 

Home whitening trays are a very effective way to whiten your teeth and maintain their whiteness over a period of time. Your dentist will take a mould of your upper and lower teeth and a custom set of trays will be made in a laboratory to accurately conform to the shape of your teeth. When these trays are used, less whitening agents will be needed because of the accurate fit against your teeth and the greater proportion of the gel staying next to the tooth enamel where it works.

Included with the trays will be the whitening agents, typically in a syringe form. The whitening systems take between 7 and 14 days of use for between one hour each day to overnight, depending on the system you choose.

Transient (up to 24-48 hours) side-effects in some patients include tooth sensitivity, blanching or bleaching of the gums or other soft tissue. These symptoms typically disappear within 1 to 2 days. Blanching or bleaching of the gums can be minimized or avoided by not over-filling the bleaching trays in order to keep the whitening agent off of gum areas.

In-office whitening – Let the professionals do the work

In-office whitening uses a much stronger concentration of the whitening agent and allows the treatment to be carried out in 45 to 60 minutes, rather than over multiple sessions at home. The whitening agent may be used in conjunction with a light to help speed up the whitening process. However, because of the higher concentration of the whitening agent, it is essential that this procedure be carried out by a qualified dentist. There are a number of whitening products available such as Zoom! ®, Opalescence ®, PolaOffice ®, and Brite Smile ®. There does not appear to be independent evidence showing significant differences in the results between products.

Combination whitening – the best of both

For ultimate results, both in-office and at home techniques can work together. To both increase the efficacy and the longevity of the whitening, in-office whitening can be followed either immediately or after a number of months by use of the take-home whitening trays. This merges the immediate effects of the in-office whitening with the simplicity and lasting effects of the whitening trays at home. For example, a patient may have a session of in-office whitening and see an immediate improvement in his/her tooth color. After three to six months or more, when the patient begins to notice the whiteness fading, a few sessions of at home whitening can bring back the whiteness that was achieved at the first in-office whitening.

Remember: teeth whitening and good oral hygiene go hand in hand.

Do not forget brushing, flossing and a regular professional cleaning. Teeth whitening agents will penetrate into the enamel to break down dark pigments that have been absorbed into the teeth. However, if the teeth have external stains or buildup of plaque and calculus then this will significantly impair the final result.

Call your cosmetic dentist in Victoria, BC to see if you are a candidate for teeth whitening.

References:

CDA Position on Tooth Bleaching and Whitening 2007 (http://www.cda-adc.ca/_files/position_statements/bleaching_whitening.pdf)

CDA Tooth Whitening (http://www.cda-adc.ca/en/oral_health/procedures/teeth_whitening/)

Thosre D, Mulay S. Smile enhancement the conservative way: Tooth whitening procedures. J Conserv Dent 2009;12:164-8 (http://www.jcd.org.in/article.asp?issn=0972-0707;year=2009;volume=12;issue=4;spage=164;epage=168;aulast=Thosre)

Tooth Whitening: What you should know JADA (http://jada.ada.org/cgi/content/full/140/3/384)

Tooth Whitening/Bleaching: Treatment Considerations for Dentists and Their Patients - ADA Council on Scientific Affair (http://www.ada.org/sections/about/pdfs/HOD_whitening_rpt.pdf)

High-tech dentistry - What is necessary and what is not JADA (http://jada.ada.org/cgi/content/full/137/11/1592)