It happens to all of us. At 16 years old, our teeth are untainted and pristine: a virgin to the world of teas, coffees, and red wines. Over time the Starbuck’s coffee and the Pal’s tea will begin to taint those pearly whites.
The idea of whitening teeth began in the 1800’s. However, the initial focus was to whiten teeth with previous trauma. Today, they are referred to as “non-vital” teeth (aka not living). The late 80’s ushered the first at-home bleaching system. Since that time, several different compounds have been attempted, but they have all circled back to Carbamide Peroxide and Hydrogen Peroxide.
Sometimes, the age of the teeth is also a factor in discoloration. Throughout life, the outer layer of tooth, enamel, is worn away. Underneath enamel is darker tooth structure called dentin. It is a natural phenomenon that you will begin to see the dentin shades later in life.
The exception to the rule is stain due to genetics or medications prescribed early in life. Although rarely administered now, the antibiotic tetracycline caused discoloration of adult teeth forming during early childhood. Other genetic issues, such as dentinogenesis imperfecta, amelogenesis imperfecta, and dentinal dysplasia are a few of the conditions leading to discoloration.
So how does it work?
As we eat and drink things with dark colors, our teeth absorb some of these molecules over time. The more molecules absorbed, the less light reflected, the darker the tooth appears. The safest and most effective compound to whiten teeth is Hydrogen Peroxide.
Most in-office and Dentist prescribed bleaching systems are Carbamide Peroxide, which bleaches 3x’s longer than hydrogen peroxide.
10% carbamide peroxide yields approximately 3.5% hydrogen peroxide.
As consumers, we continually are inundated by products that “enhance” our smile. We will walk you through a few of the truths and myths of bleaching.
Over the Counter products:
The most well known is Crest white strips. We have several patients that have used these, some with marked success and some without. The strips vary in strength from 4 – 14% Hydrogen Peroxide.
The downside? They are NOT customized. The bleaching material leaks onto the gums and into the mouth. It can cause burning to the gums and also be cytotoxic (caustic to the cells) if in contact for extended periods.
Also, the strength is restricted significantly, as professional bleaches in comparison can be as high as 50%.
The upside? It’s over the counter. Due to the fact that they aren’t customized, they also are cheaper.
Toothpastes that advertise for whitening are removing stains. I’ve talked about this in previous a previous post, so I won’t spend long here. Although many contain hydrogen peroxide, the concentration is not significant or the time long enough to whiten. These pastes are filled with abrasives particles. I would be wary of using these long-term because they can wear away enamel and cause sensitivity.
Anything that advertises as “light-activated” bleaching is HIGHLY speculative. The research does not support the idea of UV activation. I hope you caught my hint here…light doesn’t do anything.
Our office provides 3 levels of bleaching.
Ultradent’s Opalescence “On The Go” trays are great for teenagers or people that wish to brighten their smile, but don’t have a lot of existing stain. As stated with over the counter trays, on the go trays are not customized.
However, they come in concentrations higher than over the counter strips, and the price is comparable to the strips. They come in 10% and 15% concentrations
Ultradent Take Home Whitening
is are mid-range bleaching system. Along with higher concentrations of Carbamide Peroxide (derivative of Hydrogen peroxide), we fabricate customized bleaching trays.
These trays ensure that the whitening gel stays where we want it and doesn’t leach out onto your gums and mouth. Although it’s more expensive on the front-end, it is a much better long-term investment. If patients plan to re-whiten their teeth again (which most do) patients can purchase additional bleaching gel, while reusing the custom trays already fabricated. Additional tubes are cheaper than over the counter strips. The gels come in 10,15,20, and 35% concentrations.
Kor Whitening is our upper end bleaching system…and for good reason. The Kor system combines at home bleaching (with custom trays) with in-office bleaching visits using ultra concentrated carbamide peroxide. The Kor technique provides optimum results for hard to tackle stains. The in-office gels are 35% and 50% concentrations, and the at home gel is 20%.
#1. When whitening, you need to keep in mind where and what restorations you have in your mouth. Unfortunately, we can’t bleach veneers, crowns, white fillings, or bonding. We always ask our patients if they like the shade of their existing teeth. If they would like to whiten, we always like to go ahead and whiten before completing crowns or veneers because the final restorations will not change color.
#2. Any whitening system involving “light activation”, where you teeth sit under a heat lamp to enhance bleaching, is not worth your money.
If you have questions, feel free to email me at firstname.lastname@example.org.