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Whitening is among the most popular cosmetic dental procedures because it can greatly improve how your teeth look. Most dentists perform teeth whitening, or you can whiten your teeth at home.
What does teeth whitening do ? It lightens teeth and helps to remove stains and discoloration. First you need to know a few things about your teeth. The outer layer of the tooth is called the enamel. Under the enamel there is the dentin. The reflection and scattering of light off the enamel, combined with the color of dentin under it, creates the color of natural teeth. The natural color of your teeth is influenced by two factors, which depend on your genes:
- the thickness of the enamel, which allows more or less of the dentin (which is more yellowish) to show through;
- the smoothness of the enamel: having smoother or rougher enamel also affects the reflection of light and therefore the color.
Every day, a thin coating (pellicle) forms on the enamel and picks up stains. Tooth enamel also contains pores that can hold stains.
The most common reasons for teeth to get yellow or stained are:
- Using tobacco
- Drinking dark colored liquids : coffee, cola, tea and red wine
- Not brushing your teeth twice a day
With aging, teeth become less bright because the enamel gets thinner and the dentin becomes darker.
You can also have stains inside the tooth. These are called intrinsic stains. These have different causes than the usual stains :
- Exposure to too much fluoride as a child, while teeth are developing
- Tetracycline antibiotics. That can stain a child’s teeth if taken by a mother during the second half of pregnancy or by a child who is 8 years or younger. Teeth are still developing during these years.
- Trauma may also darken a tooth.
There are many teeth whitening systems and products: whitening toothpastes, over-the-counter gels, rinses, strips, trays, and whitening products obtained from a dentist.
Whitening Toothpastes. All toothpastes help remove surface stains, because they contain mild abrasives (hydrated silica and calcium carbonate). Some whitening toothpastes contain gentle polishing or chemical agents that increase the effectiveness of the stain removal. They contain solvents that go into teeth and break the stain molecular bonds and lift the stains off.
Whitening toothpastes can help remove superficial stains only and do not contain bleach; over-the-counter and professional whitening products contain bleach- hydrogen peroxide or carbamide peroxide- that lightens the color deep in the tooth.
Over-the-Counter Whitening Strips and Gels.
Whitening gels are clear, peroxide-based gels applied with a small brush directly to the surface of your teeth.
You must carefully follow the product’s instructions for use, which vary depending on the strength of the peroxide. Initial results are seen in a few days and final results last for about four months. You can find whitening gels here:
Whitening strips are very thin, virtually invisible strips that are coated with a peroxide-based whitening gel.
The strips are applied twice daily for 30 minutes for 14 days. Results appear in a few days and the bright color that you get from the treatment lasts for about four months; then your teeth start returning to their original color. You can find some good whitening strips here:
They are actually mouthwashes, and like most mouthwashes, they freshen breath and help reduce dental plaque. But they include other ingredients, such as hydrogen peroxide, which whiten teeth. You just swish them around in your mouth for 60 seconds twice a day before brushing your teeth. Rinses have a shortcoming: they are only in contact with the teeth for a short time – just two minutes, compared to 30 minutes for strips and several hours for other over-the-counter whitening systems; therefore they are less effective. They however contain sodium hexametaphosphate, which keeps stain from adhering to teeth.
Tray-Based Tooth Whiteners.
You can purchase them either over-the-counter or from a dentist. They involve filling a mouth guard-like tray with a gel whitening solution, which contains a peroxide-bleaching agent. The tray is worn for a period of time, generally from a couple of hours a day to every day during the night for up to four weeks, until the desired level of whitening is achieved. You can find an efficient tray based tooth whitener here:
In-office bleaching is the quickest way to whiten teeth. The whitening product is applied directly to the teeth and it is used in combination with heat, a special light, or laser. Results are seen in one, 30- to 60-minute treatment. That’s because professionally applied tooth whitening products contain hydrogen peroxide in a higher concentration than over-the-counter products and dentist-supervised at-home products. But to achieve dramatic results, several appointments are usually needed. This type of whitening is also the most expensive approach.
First, your dentist will apply a substance that covers and protects the gums around the tooth.
Then, the whitening agent will be placed on the teeth and the dentist will shine the light on the teeth.
If the teeth are badly discolored, the dentist may suggest that you continue the bleaching process at home for a few days or weeks. Your dentist will take an impression of your teeth and make a mouthpiece tray that is customized to exactly fit your teeth.
This customization allows for maximum contact between the whitening gel (that the dentist will provide) , which you will apply to the mouthpiece tray, and the teeth. A custom-made tray also minimizes the gel’s contact with gum tissue.
Over-the-counter whitening products also contain a mouthpiece tray, but this tray fits less securely, allowing more bleaching gel to seep onto the gums and soft tissues and irritate the gums. If you decide to use an over-the-counter whitening kit, you must select a product that allows the mouthpiece to be customized. Some kits come with a tray that can be molded to some degree. These are better than others that come with a standard mouthpiece.
How Long Do Whitening Effects Last ?
Tooth whitening is not permanent. People who expose their teeth to foods and beverages that cause staining may see the whiteness start to fade in as little as one month. If you avoid this kind of foods and drinks you may be able to wait one year or longer before another whitening treatment is needed. You must keep you teeth clean, because clean teeth won’t stain . You must use all the dental hygiene methods to get the plaque off. Wet baking soda is an excellent stain remover.
Re-whitening can be done in the dentist’s office or at home. If you have a custom-made mouthpiece and whitening agent at home, you can whiten your teeth as often as you need to. Discuss your whitening schedule with your dentist.
Be sure to follow directions to avoid overuse and possible damage to your teeth and mouth.
Before undergoing a whitening treatment, you should have an oral exam performed. Your dentist will consider your medical history and determine if bleaching is the appropriate course of treatment, based on the type and extent of stains and the number and location of restorations.
Is whitening risky ?
Whitening is not recommended in the following cases :
- children under the age of 16 (because the pulp chamber, or the nerve of the tooth, is enlarged until this age , and the tooth whitener can irritate the pulp);
- pregnant or lactating women;
- people with sensitive teeth and gums and/or defective restorations should consult with their dentist prior to whitening;
- people allergic to peroxide (the whitening agent);
- individuals with gum disease and teeth with worn enamel;
- cavities need to be treated before undergoing a tooth whitening procedure. That’s because the whitening solutions penetrate into any existing decay and the inner areas of the tooth, causing sensitivity.
- whitening procedures will not work on exposed tooth roots, because roots do not have an enamel layer.
- tooth colored fillings and resin composite materials used in dental restorations (crowns, veneers, bonding, bridges) do not whiten. Therefore, using a whitening agent on teeth that contain restorations will result in uneven whitening, making the teeth without restorations appear lighter than those with restorations. The teeth whitening should be done prior to the placement of restorations.
- darkly stained teeth. Yellowish teeth respond well to bleaching, brownish-colored teeth respond less well and grayish or purple stains are the most difficult to treat. Blue-gray staining caused by tetracycline is more difficult to lighten and may require up to six months of home treatments or several in-office appointments to successfully lighten.Your dentist can discuss the options best suited for you. For the dark stains he may suggest another lightening option, such as veneers, bonding or crowns.
The Two Side Effects of Whitening
The two side effects that can occur with teeth whitening are:
- a temporary increase in tooth sensitivity and
- mild irritation of the soft tissues of the mouth, particularly the gums.
Tooth sensitivity often occurs during early stages of the bleaching treatment. Tissue irritation commonly results from an ill-fitting mouthpiece tray. Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment.
Sensitivity can be reduced or eliminated using the following methods:
- Stop whitening your teeth for 2 to 3 days to allow teeth to adjust to the process.
- Ask your dentist or pharmacist for a high fluoride-containing product, which can help remineralize your teeth. Apply the fluoride product to the tray and wear for 4 minutes prior to and following the whitening agent.
- Brush teeth with a toothpaste made for sensitive teeth. These toothpastes contain potassium nitrate, which help to soothe the teeth’s nerve endings.