All toothpastes help remove surface stains because they have mild abrasives. Whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach. Over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth. Whitening toothpastes can lighten your tooth`s colour by about one shade. In contrast, light-activated whitening conducted in your dentist`s office (see below) can make your teeth three to eight shades lighter.
Whitening gels are clear, peroxide-based gels applied with a small brush directly to the surface of your teeth. Instructions generally call for twice a day application for 14 days. Initial results are seen in a few days and final results can be sustained for about 4 months.
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. Initial results are seen in a few days and final results are sustained for about 4 months.
Over-the-counter kits are not recommended as they contain only a small amount of hydrogen peroxide which makes the product less effective. Some also contain mild acids, while others are abrasive.
Tray based tooth whitening systems, purchased either over-the-counter or from the dentist, involve filling a mouth guard-like tray with a gel whitening solution – which contains a peroxide-bleaching agent – and wearing the tray for a period of time, generally from a couple hours a day to every day during the night for up to 4 weeks and even longer (depending on the degree of staining and desired level of whitening).
In-office bleaching provides the quickest and most effective way to whiten teeth. With in-office bleaching, the whitening product is applied directly to the teeth. These products can be used in combination with heat, a special light, and/or a laser. The light and/or heat accelerate the whitening process. Results are seen in only 1, 30- to 60-minute treatment. But, to achieve dramatic results, several appointments are usually needed. However, with laser-enhanced bleaching, dramatic results can be seen after the first treatment. These results can be enhanced by using the home kits for about 5 – 10 days after the in-office treatment.
Whitening is not permanent. People who expose their teeth to foods and beverages that cause staining such as curry, red wine tea and coffee may see the whiteness start to fade in as little as 1 month. Those who avoid foods and beverages that stain may be able to wait one year or longer before another whitening treatment or touch-up is needed.
The degree of whiteness will vary from individual to individual depending on the condition of the teeth, nature of the stain, the type of bleaching system used and for how long.
There are differences between the home kit and the in–office kit. These include
Strength of bleaching agent. Over-the-counter home use products and dentist-supervised at-home products usually contain a lower strength-bleaching agent from 10% carbamide peroxide, which is equivalent to about 3% hydrogen peroxide, up to 22% carbamide peroxide. The in-office, professionally applied tooth whitening products contain hydrogen peroxide in concentrations ranging from 15% to 43%.
There are differences between the home kit and the in–office kit. These include
Mouthpiece trays. With dentist-supervised at-home bleaching products, the dentist takes an impression of the teeth and makes a mouthpiece tray that is customized to exactly fit the teeth. This customization allows for maximum contact between the whitening gel, which is applied 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 contain a mouthpiece tray, but the “one-size-fits-all” approach means that the fit will not be exact. Ill-fitting trays can irritate the gum and soft tissue by allowing more bleaching gel to seep onto these tissues. With in-office procedures, the bleaching agent is applied directly to the teeth.
Additional protective measures. In the office setting, the dentist applies either a gel to the gum tissue or use a rubber shield (which slides over the teeth) prior to treatment to protect your gums and oral cavity from the effects of the bleaching. Over-the-counter products don`t provide these extra protective measures.
Costs. Over-the-counter bleaching systems are much cheaper than the in-office ones
Supervised vs. unsupervised process. Dentist-supervised at-home bleaching and in-office treatments offer additional benefits compared with over-the-counter procedures. First, the dentist can perform an oral examination and consider the complete medical history, which can be helpful in determining how the teeth became discoloured and if bleaching is an appropriate course of treatment based on your type and extent of stains and type, number and location of restorations. The dentist can then better match the type of stain with the best treatment, if appropriate, to lighten those stains. With dentist-supervised bleaching procedures, the dentist will likely want to see the patient a couple of times to ensure directions are being followed, make sure the customized tray is fitting properly, inspect the gums for signs of irritation, and to generally check on how the teeth whitening process is proceeding. With over-the-counter bleaching products, you are on your own!
There are differences between the home kit and the in–office kit.
Age and pregnancy issues. Bleaching is not recommended in children under the age of 16. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age. Teeth whitening under this condition could irritate the pulp or cause it to become sensitive. It is also not recommended in pregnant or lactating women.
Sensitive teeth and allergies. Individuals with sensitive teeth and gums, receding gums and/or defective restorations should consult with their dentist prior to using a tooth whitening system. Anyone allergic to peroxide (the whitening agent) should not use a bleaching product.
Gum disease, worn enamel, cavities, and exposed roots. Individuals with gum disease or teeth with worn enamel are generally discouraged from undergoing a tooth whitening procedure. Cavities need to be filled before undergoing any whitening procedure. This is because the whitening solutions can penetrate into any existing decay and the inner areas of the tooth, which results in sensitivity. Whitening procedures do not work on exposed tooth roots because roots do not have an enamel layer.
Fillings, crowns and other restorations. Tooth-coloured 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 results in uneven whitening. In this case, the teeth without restorations appear lighter than those with restorations. Any whitening procedure should be done prior to the placement of restorations. Individuals with numerous restorations that would result in uneven whitening may be better off considering bonding, veneers or crowns rather than a tooth whitening system. The dentist will know the best strategy for you.
Unrealistic expectations. Individuals who expect their teeth to be a new “blinding white” may be disappointed with their results. Smokers need to be aware that their results will be limited unless they refrain from continued smoking, particularly during the bleaching process. A healthy guide as to a reasonable degree of whiteness to achieve with a whitening process that would give a natural appearance to a person`s teeth is a slightly whiter colour than the whites of your eyes.
Darkly stained teeth. Yellowish teeth respond well to bleaching, brownish-coloured teeth respond less well and greyish-hue or purple-stained teeth may not respond to bleaching at all. Blue-grey staining caused by tetracycline is more difficult to lighten and may require up to 6 months of home treatments or several in-office appointments to successfully lighten. Teeth that have dark stains may be better candidates for another lightening option, such as veneers, bonding, or crowns. The dentist will discuss the options best suited for you.
The two side effects that occur most often 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 most commonly results from an ill-fitting mouthpiece tray rather than the tooth-bleaching agent. Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment.
Stop whitening your teeth for two to three days to allow your teeth to adjust to the whitening 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 your teeth with a toothpaste made for sensitive teeth. These toothpastes contain potassium nitrate, which helps soothe your teeth`s nerve endings.
Some bleaching products dispensed through dentists` offices as well as professionally applied (in-office) bleaching products have received the ADA Seal of Acceptance, which indicates that the product has met ADA guidelines for safety and effectiveness. Currently, only dentist-dispensed home-use products containing 10% carbamide peroxide and office-applied products containing 35% hydrogen peroxide have received the ADA Seal of Acceptance. No over-the-counter products have received the Seal of Acceptance. Over-the-counter bleaching products are not endorsed by the ADA because the organization believes that professional consultation is important to ensuring safe and effective use. No whitening products using lasers currently are on the ADA`s list of accepted products. Several whitening toothpastes that are available over-the-counter have received the ADA Seal of Acceptance. For a list of specific toothpastes that have gained the ADA`s Seal of Acceptance, visit: www.ada.org
It should be noted that not all manufacturers seek the ADA`s Seal of Acceptance. This is a voluntary program that requires considerable expense and time on the part of a manufacturer. Just because a product does not have the ADA Seal of Acceptance does not necessarily mean that the product is not safe and effective. You can be assured, however, that products that do carry the seal have meet the ADA`s standards for safety and effectiveness when used as directed. Teeth whiteners are not drugs and therefore are not regulated by the FDA.
Try to select a kit that allows some customization of the mouthpiece. Some kits come with a mouthpiece that can be molded to some degree. These are better than others that come with a standard mouthpiece.
Try to gain the opinion of others who may have already tried the kit you are considering.
If at any time you experience a prolonged change in the color of your gums or an increased tooth sensitivity to hot or cold foods and beverages, stop wearing the mouthpiece and see your dentist immediately.