Teeth Whitening

Effects of Bleaching On Teeth

Bleaching is one of the most popular ways of whitening your teeth. Almost every one desires a whiter, more beautiful smile, especially those whose teeth are heavily stained and discolored or simply just yellow.

Bleaching involves the use of bleaching agents such as Hydrogen Peroxide and Carbamide Peroxide on the teeth. Hydrogen peroxide is used in concentrations of 3-16% while Carbamide peroxide concentrations range between 10-44%. The latter is usually preferred by dentists as it is considered more stable and less harmful to tooth substance.

These bleaching agents are added to gels, which are applied to the teeth. A tray that fits around the teeth contains this gel, and is placed over the teeth. A blue activating light such as a plasma arc, halogen or LED light is used to activate the bleaching agents. This is a way to provide heat energy to the bleaching agents, to cause movement of the molecules in the gel and in turn, cause teeth to whiten.

What happens during bleaching is that when the gel is activated by light, the bleaching agent is given enough energy to release free- radicals. A free radical is an unpaired electron, and is highly reactive and unstable. In order to stabilize, it must combine with another electron. So, the free radicals in turn react with other stable molecules to take an electron, thus producing more free- radicals and starting a vicious cycle of damage to the surrounding tissues. During bleaching, the free-radicals attack the pigment molecules in the teeth and break them down, hence making the teeth appear white. This does cause internal damage to natural tooth structure and demineralizes their enamel, but it isn’t significant enough to cause major harm to the teeth unless it is done too often.

When colored foods and drinks are ingested such as red wine, coffee and tea, the teeth can pick up on the color and return to their previous yellowish, stained form. Unless these foods are avoided, bleaching does not last long. Patients usually get teeth bleaching done once in a year or every two years, which isn’t too harmful as the teeth have an intrinsic ability to remineralize when given a an environment of high calcium and fluoride (such as while brushing teeth or drinking milk).

To summarize, teeth bleaching can be harmful when done too frequently, if the concentration of the bleaching agent is too high or if the bleaching agent is used improperly. Teeth bleaching is otherwise not harmful to the teeth and can be done once in a while to maintain that beautiful, white smile we all want.

Fluorosis vs. Teeth Whitening

(What Is it and Can I Get My Teeth White Despite it)

As a parent, we notice the little things in our infant’s development- the first words, the first steps.  As the child grows, we share in the joy of each new milestone and notice new and exciting changes.

So when your child smiles and you start to notice spots or white streaks on your child’s teeth or discoloration, it is time to consult with your dentist.  Your child may be affected by fluorosis!

What is Fluorosis

This is an aesthetic problem as opposed to a disease process caused by an excess intake of fluoride while the teeth are developing (prior to the age of 8).  The effect is one of appearance unlike a condition that promotes cavities or other dental disease.

Too much fluoride introduced into the system typically comes from taking fluoride supplements as young children, fluoridation in the water at excessively high concentrations or ingesting fluoride toothpaste.

Tooth changes range from mild color changes to irregularities of the enamel surface.  White lines, spotting or streaking are found in mild fluorosis while more severe fluorosis produces grayish, brown or black spots on the exterior of the teeth with atypical enamel shapes.  These spots and discolorations may progress and darken with age but the stains are permanent.

Diagnosis

There are several medical conditions that may mimic fluorosis in appearance and must be ruled out.

These include:

  • Craniofacial abnormalities in development  (involving the bones of the skull or face, creating problems with tooth enamel and dentin formation)
  • High fevers in infants or toddlers
  • Trauma in infants or toddlers
  • Genetic abnormalities
  • Hormonal dysfunction
  • Chronic antibiotic usage in early childhood

A thorough history must be taken (with the parents of the child affected by teeth discoloration) to determine fluoride exposure during early childhood.

X-rays are taken to rule out any defects or cavities, which are then attended to.

Therapy

Occasionally fluorosis is limited to back teeth which are not readily visible when the individual smiles.  Should that be the case, no treatment is necessary.

A small number of cases are severe with dental pitting, black and brown spots of the front teeth.  For those individuals, the options are crowns, veneers or bonding.

However, most of the cases that involve the front teeth are mild.  The extrinsic surface stains can be removed with tooth whitening agents or with laser therapy. Techniques vary among whitening gels and trays, strips, whitening pens and toothpastes.

The most effective and quickest way is the bleaching with light therapy performed in the dentist’s office.

While this is not a disease, the sooner the condition is eradicated, the less likely that the child will suffer from a lack of confidence and self-esteem in the future.

Your Options for Dental Bleaching

Teeth whitening or bleaching is currently the most popular cosmetic dental procedure. By lightening the dentition, our sparkling smile makes us appear more confident and gives us higher esteem.  It also gives us a more youthful glow.

Staining or discoloration of teeth comes with age due to the tooth’s change in mineral structure as well as exposure to:

o     Tobacco

o     Highly pigmented food and beverages

o     Bacterial pigments

o     Antibiotics

o     Drugs

o     Illness

There are several bleaching options to teeth whitening:

o     Strips

o     Pen

o     Gel

o     Toothpaste

o     Laser Therapy

At Home Kits

At home kits typically use either strips that fold over the front teeth or gel applied to the teeth using guard trays. Hydrogen peroxide or carbamide peroxide are the two most commonly used oxidizing agents.  These infiltrate the pores of the enamel, oxidizing the interprismatic stain sediment. As time goes on, the bleaching progresses to the dentin layer underneath the enamel as well.

The bleaching effect can be hastened in a professional dental office by supplementing light energy to the bleaching process. Benefit duration depends on usage of tobacco or intake of highly pigmented foods and beverages.

Intrinsic Staining

Teeth can be discolored internally and at-home-whitening kits would not work.  There are however two easy solutions to mask the discoloration:

o     Bonding

A thin layer of composite is applied to the front surface of the tooth and then bonded or adhered using a blue light

o     Veneers

A thin restorative layer is placed over the front of the tooth with an adhesive to mask the staining

There are many options available today with bleaching options include applications done with at-home kits, dental offices and spas.

Bleaching with Power Lights

Using a power light (of plasma arc, halogen or LED) is a new technology used in a dentist’s office to hasten the bleaching process. A high energy is focused on the teeth, stimulating the peroxide molecules and accelerating the whitening.  It is done in a single, painless session of between 30-60 minutes thereby decreasing the exposure time to hydrogen peroxide that the patient would ordinarily have.

Risks and Adverse Reactions of Bleaching

o     Pain from sensitive teeth caused by exposed dentinal tubules

o     Increased sensitivity to extreme temperatures (hot/cold)

o     Overbleaching (which changes the color of the teeth)

o     Chemical burns if the oxidizing agent in the gel used is too highly concentrated

o     UV lights can cause harm to eyes and skin

o     Increased risk of tongue cancer

o     Allergic reactions

Although bleaching can be beneficial enjoyed by the patient, the risks and side effects highlight the need for individuals to get an examination and consultation from a professional dentist before undertaking or considering any procedure.

Any dental cavities or gingivitis must be addressed and corrected.  A thorough evaluation will also determine whether a person is a candidate for a bleaching technique. X-rays may be needed to determine the depth and extent of any problem along with the depth needed for teeth whitening.

If all the above has been taken into consideration, and this is something that appeals to you, by all means- Go for it!

It can be life changing.

Treating Dental Flourosis In Children

Have you seen tiny white streaks on your children’s teeth?

This is the first sign of dental fluorosis.  Staining and spotting which may darken progressively as a result of fluorosis, are permanent.

What exactly is dental fluorosis?

This is a condition elicited by taking too much fluoride into the system during tooth formation.  The critical exposure time is between 1 and 4 years of age. Early symptoms involve white specks or streaks on the teeth but in the severe form, black and brown stains with mottling and pitting of the enamel are witnessed

Excess fluoride exposure can come from:

  • Exposure to fluoridated water (in high concentrations)
  • Excessive use of fluoride toothpaste
  • Swallowing fluoridated toothpaste in young children
  • Formula mixed with fluoridated water
  • Exposure to pollution from fluoride coal
  • Consuming brick tea chronically.

Fluorosis occurs prior to the time the teeth have erupted.  Scientific studies show that when children between 3-9 months have consumed a significant amount of fluoride from excessive fluoride in water and infant formula, the risk of mild enamel fluorosis is elevated.

Once teeth have broken past the gums into the oral cavity, fluoride significantly cuts down on cavities and enamel erosions. Because teeth decay is a global health problem, it has not been advised to remove fluoride from toothpaste or to decrease the usage.  Research has born out the findings that fluoride in toothpaste, mouthwash and public drinking water is one of the most important techniques to prevent dental decay. Studies show that fluoridated water consumed by children have improved dental health as adults.

Fluoride acts to strengthen the enamel but it also breaks down bacteria adherent to teeth and improves damaged teeth from the decay proess.

Fluorosis occurs more in rural regions where drinking water (at higher levels than 1 ppm-part per million) comes from shallow wells or hand pumps

Prevention of Teeth Staining and Discoloration

  • Until after the first year of life, infants should have formulas reconstituted with non-fluoridated water to diminish fluorosis risk. If possible, breast-feeding is more advantageous.
  • Parents are advised to limit toothpaste to pea-sized amounts or less on the toothbrush.  It is further advised to carefully watch the child’s tooth brushing to ensure that the toothpaste is not swallowed.
  • Brush twice daily with fluoride toothpaste.
  • Decrease sugar and sugary foods in the diet.

Treatment

Superficial stains are treated by:

  • Bleaching
  • Microabrasion

Internal stains are treated by:

  • Porcelain veneers
  • Composite restorations

Teeth Whitening Frequently Asked Questions

Questions to Ask About Teeth Whitening

Teeth whitening is one of the most popular procedures asked of cosmetic dentists today.  However, before considering this procedure for yourself, it would be a good idea to prepare for your consultation with the dentist by having a list of questions to ask and have answered.

Q. What method of teeth whitening is my best option?

A.  The method that gets the best result with the greatest whitening in the least amount of time is one that is done by the dental specialist directly.

However if money is an issue, or time is not a factor, there are many options available to you for home use.  After a thorough dental examination, a consult with your dentist can offer the option that appeals to you the most.  Custom made whitening trays with a high percentage of carbamide peroxide works well at home if the teeth are not severely stained.

Q. How long do the teeth whitening last?

A. When performed by a professional or under dental supervision, whitening may last up to 5-7 years.  However if smoking or consumption of deeply pigmented foods and beverages are used frequently, this will be considerably shortened.  Touch-ups can prolong the treatment life.

Q. How many times can I bleach my teeth?  Is there a limit?

A. Over use of bleaching agents can cause damage to the enamel of teeth with erosions, which will then start making them vulnerable to staining by pigmented foods and decay.  Once the white shade is obtained, and the recommended protocol is finished, do not repeat without consulting a dentist.

Q. Are tooth whitening products safe?

A.  When the products are used as directed, typically the whitening agents are safe.  However if the bleaches are used excessively or too frequently, problems can arise. To avoid problems, it is prudent to have the whitening agents used either by dentists or under their supervision.

Q. What causes tooth staining and discoloration?

A. Dental discoloration may be hereditary or due to medications your mum took that when she was pregnant.  Certain antibiotics are also associated with dental discoloration.

Smoking and consumption of deeply pigmented foods and beverages containing tannins and chromogens such as  wines, coffee, tea and berries cause staining of teeth over time.

Q. What is the difference between carbamide peroxide and hydrogen peroxide?

A. Carbamide peroxide is a weaker formula of hydrogen peroxide and is generally the form that is used in home kits because it is more stable and has a longer shelf life. Carbamide peroxide does not work as rapidly as hydrogen peroxide, nor is it as strong.

Q. Can I whiten veneers, crowns or bonding?

A. Generally, only natural teeth can be whitened.  However, deep whitening techniques may lighten veneers that have been worn over time.

Q. Are there natural ways to whiten my teeth?

A. The best way is to avoid foods and beverages that are deeply pigmented.  Eating foods with fiber like carrots, pears, apples and celery help scrape the teeth surface ridding them of debris and particulate matter.

By asking these questions, there will be no confusion and you will understand everything about the whitening procedure so that you can make a more informed decision.

 

Tooth Bleaching

Most tooth bleaching products or methods use a gel that contains a tooth bleaching agent, either hydrogen peroxide or carbomide peroxide.

Which tooth bleaching gel depends on whether you get treatment from your dentist, or try it at home, with one of several methods available.

Dental office tooth bleaching procedure

Your dentist will usually use hydrogen peroxide as the main tooth bleaching gel. And your treatment is faster because the hydrogen peroxide is stronger and subsequently provides faster results. While at the dental office, you’re under controlled circumstances. Everything is done just so, by a professional that’s experienced in the procedure, so there’s less chance of side effects.

Fill out the form on the right for more information or to book a tooth bleaching procedure in your area.

At-home tooth bleaching

Companies that sell tooth bleaching products to be used at home use carbomide peroxide because it’s more stable.  And actually, when exposed to water, as in the oral environment, carbomide peroxide breaks down into hydrogen peroxide, which is what does the tooth bleaching. These carbomide peroxide concentrations generally run between 10% and 38%.

It’s interesting to note that a 6% hydrogen peroxide gel has the same concentration as a 22% carbomide peroxide gel.

There are some tooth bleaching products available with no peroxide, but they’ll only work on very mild staining. So if you want to get rid of more serious staining, you will have a bleaching gel in your procedure.

What are the other tooth bleaching ingredients?

You should always be aware of ALL the ingredients in your whitening gel, in case of mouth tissue irritation.  And most companies selling online don’t like to advertise their ingredients on their website. So it may be difficult to get the information you need.

Here are the most commonly found tooth bleaching ingredients.

Glycerin  acts as a filler to thicken the gel so it won’t wash out of trays.

Carbopol enhances the whitening power of carbomide peroxide. So, if that is your bleaching agent, this would be a good ingredient to have.

Potassium nitrate is a desensitizing agent. It will reduce any tooth sensitivity. And a 5% potassium nitrate gel is best. However finding that information will be a challenge!

It IS possible to purchase potassium nitrate separately to apply either before or after you use the gel.

Humectants are something to be concerned about. They help prevent drying out of the gel. Propylene glycol is one. It’s also found in antifreeze! So it could very easily be a cause of gum and other mouth tissue irritation.

Fluoride is found in lots of teeth whitening systems. While it’s touted as being good for tooth health, it can possibly worsen discoloration and even cause health problems if the concentration is too great.

A good cosmetic dentist that we would recommend will be forthcoming with information on all the tooth bleaching ingredients in the gel being used with his/her procedure. Also, the dentist will know what concentration of bleaching agent you require.  And all care will be taken to minimize any tissue irritation or sensitivity issues that may arise.

Guide To Whiter Teeth

Regardless of how you obtained your pearly white look, the results of any treatment do not remain forever, especially if you revert to consuming foods and beverages that are known to stain and discolor teeth. Doing so can start to discolor dentition in as little as four weeks.

If you adhere to a strict diet, eliminating all those teeth-staining foods, your treatment result may last as long as 12 months or longer.  Another therapy or touch-up would be permissible at that time.

Helpful Guidelines To Get Whiter Teeth

1) Eliminate foods and beverages that stain the teeth:

  • Wine*
  • Coffee
  • Tea
  • Tomatoes
  • Berries (black currant, blueberries, pomegranates, cherries) as well as the juice made from them
  • Richly-colored sauces (e.g. soy, curry, tomato sauce)
  • Soda and carbonated beverages**

*Tannins and chromogens are richly pigmented molecules found in red wine and are responsible for teeth staining.  Although this is missing from white wine, this is very acidic, leading to discoloration as well.

**Soda and carbonated beverages contain chromogens which discolor teeth.  However, worse than this, the drinks are extremely acidic leading to enamel erosion.  This breakdown encourages staining of the flavored soda additives as well as all other ingested foods.

Avoid acidic beverages that can wear away enamel, thereby causing discoloration. Sports and energy drinks can be highly acidic and substitution of water would be healthier.

If total elimination is not possible or desire overcomes discipline, use a straw so that the beverage bypasses the front row of teeth thereby reducing unsightly stains.  Once the beverage is in the mouth, swallow quickly, preventing the  responsible liquid from lingering in the mouth.

2) Gargle and rinse mouth after intake of stain-causing drinks and foods.

3) Brush teeth after they have been exposed to stain-causing drinks and foods.

4) The teeth are especially vulnerable for a half hour after ingesting foods and beverages. If the situation or location does not allow for brushing teeth after eating, try chewing on sugarless gum after eating the responsible teeth-staining agents.  It will also aid in removing any remaining acidic remnants.

5) Floss once daily to remove food debris and plaque from between teeth and brush at least two times each day to remove food particulate matter and surface stains which will avert yellowing.

6) Touch-up treatments done twice a year will prevent the progression of yellowing or teeth discoloration. Depending on tobacco usage, touch-ups may be needed more frequently.

Following these guidelines will provide you with those beautiful whiter teeth for years to come.

Teeth Whitening Strips

There are several ways to whiten your teeth. You could go to your dentist for a fast, in-office treatment, or try it at home with kits, rinses, toothpastes and gels that whiten.  Another way to whiten your teeth is with teeth whitening strips.

Just what exactly ARE teeth whitening strips?

Teeth whitening strips are thin, almost invisible plastic strips that are coated on one side with a bleaching agent containing peroxide.

There are several brands, in stores or online, that you can use at home.

How are they used?

You simply apply the strip to your teeth, and gently press to secure it to your teeth. Do this twice a day and leave it on for 30 minutes. The strips have a type of tacky bleaching gel that adheres to the surface of the teeth. After the 30 minutes, you pull it off and discard it. You generally do this daily for 14 days–or for as long as instructed by the directions.

After four months or so, the treatment is repeated, to maintain the results.

There ARE dissolving teeth whitening strips that some manufacturers sell. These, however, probably aren’t as good, since the dissolving action starts breaking down the strip in 5 to 15 minutes. You therefore don’t get the full 30 minutes of bleaching time. But you can’t deny they’d be more convenient.

Advantages of teeth whitening strips

  • They’re inexpensive.
  • They’re easy to use, and not messy.
  • There’s no danger of over-application, since the whitening gel is pre-applied to the strips by the manufacturer
  • They are at least as effective, if not more so, than other teeth bleaching methods.
  • They can be used at home.

However, with any at-home whitening project, you should include your dentist in your plans. This is important because you need to be evaluated to address and document any issues that may be present, such as why the staining is even there. Also, you may have crowns, or other dental work that won’t be affected by the bleaching agent. It may mean your whitening goals aren’t realistic.

Disadvantages of teeth whitening strips

  • Only the front teeth, from eye tooth to eye tooth, are whitened. However, the back teeth aren’t usually seen much in smiling or talking.
  • You have to be careful and place the strips accurately, to make sure the teeth are completely covered.

Any side effects?

As with all teeth whitening products, there is always the possibility of gum or mouth tissue irritation.

If this occurs, cut down on the daily applications, or just take a break and try again later.

It’s a general rule that about a half of all people who undergo whitening strips will experience a certain degree of side effects. However, it’s usually mild.

In a nutshell, strips deserve a thumbs up. As with any at-home whitening system, you won’t get the results you’d get with a cosmetic dentist. But it just might be what you’re looking for.