by Chris Edwards, DDS
TO MAKE THE BEST CHOICE you need a basic understanding of what goes into whitening teeth. Peroxide, the chemical that is responsible for the lightening, gets deep into the enamel’s interprismatic structure. Many tray systems use carbamide peroxide, however, not all teeth whiten the same.
A person’s smile is vital to their self-confidence and ultimately to their professional and personal life. In fact, a study by the American Academy of Cosmetic Dentistry revealed that 92 percent of respondents say an attractive smile is an important social asset, yet only 50 percent of adults are satisfied with their own smile. Whitening one’s teeth is an under appreciated, under utilized, and an inexpensive way to make a big difference in your smile and it is good for people of all ages.
To make the best choice in what kind of whitening is good for you, you need a basic understanding of what goes into whitening teeth. Peroxide, the chemical that is responsible for the lightening, gets deep into the enamel’s interprismatic structure. Many tray systems use carbamide peroxide. Not all teeth whiten the same. Yellow or brown stains respond the best. Tetracycline stains will improve with whitening but will still appear grey. It is possible to lighten teeth to match previous dental work. Whitening will not bleach any plaque or calculus that may be on your teeth or the tooth under it, and it will not be good for extremely sensitive teeth, especially teeth with exposed root structure.
Your teeth should be clean and healthy before undergoing whitening and there should be no active periodontal disease. It only works on natural teeth and will not work on previous dental work, crowns, fillings or bondings.
Applying the whitener only to the enamel and avoiding the root will control most sensitivity. In more severe cases, the use of fluoride gels in the trays can manage sensitivity, a good idea before Zoom or other light activated whitening. All whitening needs to be maintained, sometimes for only a few days every 6 months to a year.
Most dentists recommend either in-office or at-home tooth whitening systems. Both approaches work well. The in-office system, like ZOOM or Brite Smile, are light activated, and will cost more, but gives you immediate results. You will still need to maintain the result and custom trays are usually included. Expect a one and a half hour visit.
The at-home systems require custom made trays and whitening gels and only require an impression (mouth mold) of the teeth. These systems cost less and the whitening will generally take one to two weeks but can equal the results of in-office whitening.
A good candidate for tooth whitening is someone with the common yellow-brown teeth staining common in coffee and tea drinkers, and in smokers. Ten to Fifteen shades of whitening can be expected. During whitening it is recommended to avoid foods that are staining, like colas, coffee, tea, red wine and dark berries. It takes a few weeks after bleaching for the tooth to “mature” and reabsorb minerals from the mouth and look its best. It is best to wait until then to proceed with cosmetic dental work like veneers, bonding or crown and bridge.
The benefits of dentist-supervised whitening is that the gels that contain the bleach can be controlled on the surface of your teeth, prevented from leaching into your mouth thus minimizing exposure to the gums.
Dentist-prescribed gels have a higher concentration of the bleaching agent and work faster. Wearing them during sleep is the fastest way to whiten. Care must be taken to protect the exposed gum tissue that is sensitive to the oxidation process. The whitening gel lowers the protective antioxidant concentrations that cells in the gum tissue need to stay healthy. In fact, peroxide which is the main active ingredient in teeth whitening, is an oxidizer and releases cell damaging free radicals that have been identified as a cause of many diseases.
There are many causes why teeth get dark. The most common include genetics, aging, consumption of staining substances (smoking, coffee, tea, colas), tetracycline (antibiotic) staining, excessive fluoride, and old fillings. Whitening toothpaste can remove stain that is on the outside of the teeth. Dentists call this extrinsic staining. However, whitening toothpaste and professional dental cleanings will not change the color or intrinsic staining of the teeth. That is why tooth whitening (sometimes called tooth bleaching) is so popular.
There is nothing like white teeth to brighten your appearance, and the best way to whiten is to have an evaluation by your dentist and proceed with one of the options that work best in your mouth. Although you can achieve results from drugstore purchased products or sessions done at the mall or spa, there are too many variables, such as previous dental work, or dental disease, that may create a less than optimal result. Whitening toothpastes are helpful in maintaining the result, but do not expect to see your teeth get lighter.
If your teeth are permanently stained or deformed, your dentist has several options to whiten your smile, including the use of crowns or veneers. Your dentist can also determine if there are other cosmetic procedures, some as simple as reshaping the edges of the teeth, that can enhance a smile or be part of an overall cosmetic smile design. As always, daily brushing and flossing helps maintain a healthy white smile that goes a long way.
Dr. Edwards graduated from the United States Merchant Marine Academy and Temple University School of Dentistry. He completed a general practice residency at the Queens Medical Center in Honolulu. To reach Dr. Edwards you may call 321-751-7775 or visit www.SmileDesignCenter.us