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Whitening |
Tooth whitening is a procedure that lightens teeth and helps to remove stains
and discoloration. Whitening is among the most popular cosmetic dental
procedures because it can significantly improve the appearance of the patient’s
teeth at much less cost and inconvenience than other techniques. The majority of
dentists perform tooth whitening. Every day, a thin coating forms on the
patient’s teeth and it picks up stains. Also, the outer layer of each tooth,
called the enamel, contains pores that can hold stains. Whitening is not a
one-time solution. It will need to be repeated periodically if the patient want
to maintain the brighter color. The most common reasons for yellowing or stained
teeth are aging, tobacco, tea and coffee, which can stain the surface of the
teeth. It is also possible to have stains that are inside the tooth. These are
called intrinsic stains. For example, intrinsic stains can be caused by exposure
to too much fluoride as a child while teeth are developing. Other causes include
tetracycline antibiotics taken during the second half of pregnancy or given to
children 8 years old or the younger when the teeth are still developing. Tooth
whitening is most effective on surface stains caused by age, foods or drinks.
Cavities need to be treated before teeth are whitened because the whitening
solution can penetrate decay and reach inner areas of the tooth, which can cause
sensitivity. Also, whitening will not work on exposed tooth roots, because roots
do not have an enamel layer. Receding gums can cause roots to become exposed.
Whitening also does not work on crowns or veneers. Whitening can be done in the
dental office or at home. For in-office whitening, the patient’s dentist
probably will photograph the patient’s teeth, which will help him or her to
monitor how the treatment is progressing. Whitening in the office may involve
two to six visits of approximately 45 minutes each. He or she also will examine
the patient’s teeth and ask the patient questions to determine the type and
severity of staining. When the examination is complete, the dentist or a dental
hygienist will clean the patient’s teeth. Once this is completed, the whitening
procedure begins. For whitening at home, the patient’s dentist will direct the
patient to use custom trays that are made in the dental office and fit the
patient’s teeth precisely. Home whitening usually takes two to three weeks.
Over-the-counter kits also are widely available for home use. The patient should
talk to the patient’s dentist about using these products, and use them according
to directions to avoid overuse and possible damage to the patient’s teeth and
mouth. There are two main types of whitening procedures. When whitening is done
on a tooth that has had root-canal treatment and no longer has a live nerve, the
process is called non-vital whitening. Vital whitening means that the procedure
is being done on teeth that have live nerves. Vital whitening may not improve
the appearance of a tooth that has had root-canal treatment. If this is the
case, the patient’s dentist will use a different procedure that whitens the
tooth from the inside. He or she will place a whitening agent inside the tooth
and will place a temporary filling. It will be left this way for several days.
The patient may need this done only once, or it can be repeated until the tooth
reaches the desired shade. The most common type of vital tooth whitening
involves placing a gel-like whitening solution, which usually contains hydrogen
peroxides, in a tray that resembles a night guard or mouth guard.
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The tray is then placed over the teeth for a certain period of time — anywhere
from an hour or two to overnight. Tooth whitening can be done in the dentist's
office or at home. In-office whitening (also called chairside whitening) has the
advantage of allowing the patient’s dentist to supervise the process — and the
patient’s progress — more closely. In-office whitening usually takes between 30
and 90 minutes and can require up to three appointments with the patient’s
dentist. The number of visits required will depend on the type of discoloration
and how white the patient wants his/her teeth to be. The patient’s dentist will
start by asking about the patient’s medical history to learn how the patient’s
teeth became discolored. Different types of stains will respond differently to
the treatment. The patient’s dentist will apply a special gel to the gums to
protect them from the whitening agent. Then the whitening agent is applied. The
most common substance used for chairside whitening is hydrogen peroxide. Some
whitening agents are activated by special lights or by heat. After the whitening
agent is applied, the dentist will shine the light on the patient’s teeth for a
short time. Some dentists have started to use lasers as a high-speed alternative
to conventional whitening procedures. Consumers like the high-tech aspects of
laser treatments, but the technology is still too new — and too expensive — to
justify its general use. If the patient’s teeth are badly discolored, the
patient may need more extensive whitening than can be done in the office. Or the
patient may decide the patient would prefer to whiten the patient’s teeth at
home. For in-home whitening, the patient’s dentist will take impressions of the
patient’s teeth and will make one or two custom mouthpieces to fit the patient,
depending on if the patient are having both upper and lower teeth whitened. It
is important that the mouthpiece fit well so that the whitening agent remains in
contact with the patient’s teeth and doesn't irritate the patient’s gums.
Over-the-counter mouthpieces are unlikely to fit correctly and can cause gum
irritation if the whitening agent seeps out. At home, the patient will fill each
mouthpiece with a whitening gel the patient’s dentist provides, and wear the
mouthpiece for several hours every day. Many people achieve the amount of
whitening they want within a week or two, but the patient may need to wear the
mouthpiece for four weeks or longer. The patient’s dentist may want to see the
patient a few days after in-office whitening to check the patient’s gums. If the
patient’s gums were exposed to the whitening agent, they can become irritated.
If the patient are whitening the patient’s teeth at home, the patient’s dentist
will want to check to make sure the process is working properly, usually after a
week. Whitening is not a permanent solution. The stains will come back. People
who expose their teeth to a lot of staining may see the whiteness start to fade
in as little as one month. Those who avoid staining foods and drinks may be able
to wait six to 12 months before another whitening treatment is needed.
Re-whitening can be done in the dentist's office or at home. If the patient have
a custom-made mouthpiece and whitening agent at home, the patient can whiten the
patient’s teeth as frequently as the patient want to. The patient should discuss
the patient’s whitening schedule with the patient’s dentist, and talk about what
whitening products would work best for the patient. Whitening is unlikely to
cause serious side effects, although some people’s teeth may become more
sensitive temporarily. There may be mild gum irritation as well. Whitening
procedures should not be done while a woman is pregnant because the effect of
the whitening materials on the development of the fetus is not known. Since the
procedure is cosmetic and option, it should be postponed until after delivery. | |
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