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Question: What is Teeth Whitening (Teeth Bleaching)?

Answer: An estimated ten million People will spend a whopping 2 billion dollars on teeth whitening products and services this year to try and achieve that perfect “Hollywood” smile. Teeth whitening is the most common cosmetic service provided by dentists. There are also a growing number of over-the-counter teeth whitening products available as well. Teeth Whitening is a way to reverse the signs of age in teeth, and remove the years of cumulative stain from coffee, wine, soda, teriyaki sauce, tomato sauce, etc. These unsightly stains can be removed quickly, safely, and with minimal discomfort utilizing In-Office whitening systems, custom home trays, and over the counter products. You should first have a dental exam to find out which treatment, or combination of treatments is right for you.

Question: Do Whitening toothpastes, rinses, flosses and chewing gums actually work?

Answer: Over-the-counter whitening products such as the whitening toothpastes, rinses, flosses and whitening chewing gums are relatively ineffective at best, and some of these whitening pastes can be very abrasive, and actually cause damage to the enamel. Brushing with whitening toothpaste removes the extrinsic stains by mechanical means; little to no change in color actually takes place. The ‘whitening’ is deceiving on these products, because if it rubs off a little extrinsic stain, does that mean the teeth have been whitened? You need a bleaching agent, such as carbamide peroxide or hydrogen peroxide, in order to intrinsically whiten the teeth. These agents must remain in contact with the enamel for a certain period of time in order to be effective. Even toothpastes that claim to have these agents are not very effective, because they have a mild concentration of peroxide and they are not in contact for long enough duration to make any difference.

Question: Is whitening safe? Does Whitening harm your tooth’s enamel?

Answer: Teeth bleaching has proven to be a safe and effective way of achieving a more youthful and healthy-looking smile. In fact, the American Dental Association (ADA) has lent its support and approval for enhancing the esthetics of one’s smile via in-office and home bleaching, and has given its Seal of Approval to a number of whitening systems. The safety and effectiveness of this procedure is directly related to the dosage given, the frequency and duration of treatment, the concentration and type of the material used, and the type of tray or system utilized. Like anything, it can be abused, and cause adverse results. During the time that you whiten, the fluoride-rich layer of the enamel is broken down and the teeth become more porous, making them more susceptible to the acids and sugars in your mouth. Within 24-48 hours your tooth’s enamel will re-mineralize and build up that protective fluoride-rich layer again. If you become a whitening junkie, and never give your enamel the chance to re-mineralize, then you can cause long term adverse effects to your teeth.

Question: Which is a better way to whiten your teeth… using an In-Office or At-Home whitening system?

Answer: In office whitening (i.e. Zoom! or Britesmile) is a faster alternative for achieving that brighter smile, with a high degree of predictability. This method has been very popular with anyone whose free time is limited or who just wants instant gratification. Many times patients do the In-office whitening in combination with custom home trays. The home trays, when used beforehand, can be used to help condition the teeth for more dramatic In-office results. They can also be used for a period of time after an In-Office session in order to continue the whitening process, or to help lock in the shade that was achieved. It is recommended to keep your custom trays for periodic touch ups either before a big event, or to use a couple of times per year to maintain the shade you attained. In-office whitening procedures allow the dentist to whiten their patient’s teeth up to 15 shades in about an hour (the average shade change being 8 shades). Some individuals may choose not to wear a custom tray if they are more hypersensitive or prone to a gag reflex.

Question: Is it better to wear my home whitening trays during the day or when I sleep at night?

Answer: There are two basic options for home bleaching: daytime and nighttime intervals. Both forms of whitening involve wearing a customized, soft tray, which functions as a reservoir for the whitening gel. Patient compliance is usually better at night, although some people may not be able to tolerate going to sleep with these trays in their mouth. Night use affords the individual maximum benefit from each application because of the longer exposure time and diminished salivary flow. However, occasionally people may need to reduce the duration of their treatment as a result of sensitivity or personal preference. For these individuals, daytime wear is recommended for 1-2 hour intervals of treatment. It is imperative that your dentist professionally supervises this procedure, and that the whitening tray be custom made to ensure a perfect fit.

Question: What is the difference between an over-the-counter whitening strip and pre-formed trays versus a custom tray made in the dental office?

Answer: The importance of a custom-fitted tray cannot be over-emphasized; it allows for maximum patient comfort, reduces side effects, and maximizes efficacy. The over-the-counter versions may be ill-fitting and clumsy, or just may not cover all the desired tooth surfaces that you would want to whiten.

Question: How long does whitening last before I have to do it again?

Answer: With good oral care the procedure’s results may last over two years, and recent studies have shown that most patients experience only a one-shade regression after 6 months. Of course, those patients who smoke, drink dark teas and coffee, indulge in red wine and other readily staining foods and beverages are more likely to relapse sooner and require additional whitening sessions. Custom home-tray whitening usually tends to revert less than in-office techniques, but it takes longer to achieve desired results.

Question: Who are the best candidates for teeth whitening?

Answer: If your teeth are discolored by the natural process of aging, the prognosis for a beautiful, youthful smile is excellent. Individuals with yellower teeth will typically have a more dramatic result than those with teeth that are greyer. Individuals with a more even toned layer of enamel will have a much more predictable result than those with tetracycline stains or white spot formations. The best candidates are those who are whitening their own natural tooth structure. Those patients with restorations of any type, within or covering their tooth structure (i.e. bonding, fillings, veneers, crowns, etc.), must realize that those areas will not whiten. They may choose to still undergo a whitening procedure, but with the understanding that they may require a new restoration in order to match the newly whitened shade.

Question: Do I need to see my dentist first for a cleaning and exam before scheduling a whitening session?

Answer: Yes. It is imperative that one’s dentist performs a proper examination and diagnosis, in order to identify abscessed teeth, existing cavities, internal or external resorption, and other pathological problems before bleaching. Your dentist can help you to prevent the “corn-on-the-cob” effect (yellow tooth, white tooth, yellow tooth, etc.), by pointing out which of your teeth have restorations that will not whiten. A cleaning may be indicated to remove the plaque, tartar and extrinsic stains so that the whitening solutions can reach the tooth surface. A full series of x-rays and a detailed dental history should also help to determine if someone is more prone to having sensitive teeth.

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