Know All About Teeth Whitening

CONTENTS

How To Whiten Teeth?                

The pellicle, a thin coating that forms on the enamel of the teeth after chewing, picks up stains of the food and drinks that we ingest. The enamel present on the teeth also contains pores which hold stains. Most common causes for stains include:

  • Drinking coloured liquids like coffee, cola and wine often.

  • Chewing and smoking tobacco.

  • Not maintaining good dental hygiene.

  • Ageing; which causes the enamel to get thinner and the dentin to get darker.

  • Trauma; during accidents or sports related injuries.

  • Exposure to excessive fluoride as a child.

  • Tetracycline antibiotics as well as chemotherapeutic drugs, known to darken teeth.


What Is Teeth Whitening?

Whiter teeth results in brighter smiles and a boost in confidence, as noted by the American Academy of Cosmetic Dentistry. Even with brushing and flossing regularly, with time most people note a change in the colour of their teeth. Today, a lot of options are available for people to whiten their teeth. 

Conducted either at home or in a dentist’s office, teeth whitening, makes use of a bleaching gel, that helps mask stains and provide brighter and whiter teeth. The results depend on the strength of the bleaching agents, which is higher when conducted in a dentist’s office, under a supervised setting.


Who Are The Ideal Candidates For Teeth Whitening?

This procedure provides dramatic effects based on the type of bleaching process opted for. 

A patient who has had teeth stained with tobacco and food colourants generally have good results.

Patients with tougher stains might require deep bleaching as well as more frequent appointments to receive the required results.

In general, anyone with stained teeth can opt for this procedure.


What Are The Different Type Of Teeth Whitening Techniques?

BriteSmile: This method involves use of hydrogen peroxide whitening gels as well as water and glycerin, which minimizes tooth dehydration.

Sapphire Professional Whitening: This kind of procedure combines the hydrogen peroxide gel with a desensitizing enhancer, which increases the effectiveness of the peroxide. After the enhancer and gel is placed on the tooth, a light known as the “Whitening Crystal’ is positioned directly in front of the tooth, to activate the gel. After this, the gel and desensitizer is removed and the results of the process is assessed.

Zoom Chairside Whitening: This system uses 25 percent hydrogen peroxide as well a Zoom Advanced Power Chairside Lamp. This is said to accelerate the bleaching process.

Deep Bleaching: This method uses the regular procedure for chairside bleaching as well as bleaching at home. Deep bleaching requires two office visits as well as a 14 day bleaching process to be continued at home. It is the one of the more costly procedures and is used for highly resistant stains, caused due to aging and antibiotic usage.


What To Do Before A Tooth Whitening Procedure?

  • A full dental examination is conducted prior to the procedure to find out tooth decays or any other oral problems that can increase the sensitivity of the whitening procedure.

  • Smoking needs to be stopped two weeks before the procedure as new stains are more resistant to treatment.

  • Teeth have to be brushed and mouth rinsed with a mouthwash before the procedure. This removes any debris in the mouth.

  • Over the counter pain medications can be started before the procedure, for patients who have highly sensitive teeth. 

  • Comfortable clothing is required during the operation as the procedure can take a few hours in the dentist’s office.


What Is The Post Operative Care For Teeth Whitening?

  • A patient is advised not to smoke for at least twenty fours after the procedure as it can prolong recovery time. It is better to stop the habit before the procedure to sustain long lasting results.

  • Coloured toothpaste, primarily red and blue needs to be avoided a day or two after the procedure.

  • Mouth rinses that contain Chlorhexidine, should be avoided for up to 48 hours in the initial stages of healing.

  • Sensitivity in the gums and teeth is prevalent amongst some patients during the recovery. Over the counter medications can help ease this discomfort. Special toothpastes are recommended by dentists for after care to assist with the sensitivity.

  • A follow up appointment is generally scheduled about a week after teeth whitening to assess the effects of the bleaching process and requirement of any further bleaching treatment.


What Is The Post-operative Diet For Teeth Whitening?

Foods and beverages that could stain the teeth need to be avoided for up to 48 hours after the procedure.

Avoid citrus fruits and juices, as this can aggravate the sensitivity of the teeth and gums.

Chewing sugarless gum, helps with sensitivity and reduces peroxide levels.


What Are The Realistic Expectations From A Teeth Whitening Procedure?

  • The gel used for whitening has a buffer that protects the tooth enamel from damage, and can transform teeth in a single office visit. Your teeth can become up to 10 shades lighter in about an hour.

  • Results of tooth whitening last according to your habits, and the stains may come back. If you smoke or consume a lot of coloured foods or drinks, you may see the whiteness start to fade within a month. If you avoid these sources of staining, the effect of your whitening treatment may last for 6-12 months.

  • Whitening will not work on cosmetic dental restorations like caps, veneers, crowns or fillings, or restore color of fillings, porcelain, and other ceramics when they become stained by foods, drinks, and smoking. These products are only effective on natural tooth structure. 

  • Whitening is not as effective if your tooth discoloration is caused by medications like certain antihistamines, antipsychotics and high blood pressure medications. Stains due to antibiotics like tetracycline and doxycycline, chemotherapy and head and neck radiation or a tooth injury are only partially resolved.


What Are The Pros And Cons Of Teeth Whitening?

  • Pros

  • Cons

  • Teeth whitening gives a better and brighter smile and boosts the self esteem of the patient.

  • The procedure leads to a lighter and even colour of teeth by removal of stains; though it doesn’t make the teeth brilliant white, it can lighten the existing colour by several shades.

  • Teeth whitening provides a more youthful look to the patient’s face. 

  • With today’s dentist-supervised systems, even people with sensitive teeth can benefit from the procedure.

  • Whiteners may not correct all types of discoloration. For example, yellow teeth will probably bleach well, brown teeth may not respond as well and teeth with gray tones may not bleach at all. Be sure to discuss your clinical options thoroughly with your dentist before having the procedure done.

  • Other dental problems like cavities and gum recession need to be treated before teeth are whitened. Whitening solution can pass through decayed areas and reach the inner parts of the tooth. If your gums have receded, the exposed roots of your teeth may appear yellow or discolored. Whitening products will not make them whiter. 


Who Should Avoid Undergoing Teeth Whitening?

  • Dental problems like the ones mentioned below should be treated before a teeth whitening procedure.

    • Acid erosion

    • Receding gums 

    • Gums sensitive to hydrogen peroxide

    • Defective dental restorations like visible white fillings or crowns

    • Tooth decay

  • White-spots as a result of loss of calcium may become more noticeable directly following a whitening process, but with further applications, the other parts of the teeth usually become more white and the spots become less noticeable.

  • Children under the age of 16 should avoid the procedure. The pulp chamber, or nerve of the tooth, gets enlarged until this age. Tooth whitening could irritate the pulp or cause it to become sensitive. 

  • People prone to asthma attacks. The psychological and physical stress of a dental visit can precipitate an attack. If your asthma is well controlled, you may decide to proceed with the treatment, but make sure your dentist knows your complete medical history before your treatment. Ask whether nitrous oxide or conscious sedation may prove beneficial for you.

  • Patients with heart diseases, kidney failure, or a transplanted organ. While they might not need to avoid the treatment entirely, patients may require antibiotics to prevent infections that may arise as a result of dental treatment. These would offer protection against an infection in the blood and inner lining of the heart muscle, and reduce the risk of spreading hepatitis, which is common in patients with renal failure. 


What Are The Alternatives To Teeth Whitening?

Whitening toothpastes
All toothpastes help to remove stains whilst using a toothbrush. Toothpastes with the ADA seal are safe whitening toothpastes, that have special chemical and polishing agents that provide additional stain removing benefits. The toothpaste isn’t effective on strong stains caused due to tobacco smoke or aging.

At-home bleaching
Peroxide containing bleaches bleach the enamel of the tooth. These are trays which contain a gel, and these fit onto the teeth. Sometimes strips are used which can also be placed on the teeth. Conducting this process at home without supervision doesn’t provide optimum results. The peroxide used in this process can irritate and harm the gums if not used properly.

Porcelain veneers 
These are porcelain shells that completely cover the teeth. They also cover flaws like chips, cracks and gap in the teeth.

Bonding 
This works in a similar manner as veneers. To whiten teeth, a dentist would place composite resin on the teeth. This material covers up colours and flaws.

Snap-On Smile
This is a customized set of teeth that fits directly on a patient’s set of teeth. It can completely transform a smile without extensive treatment. When this is put on, it affects the teeth, thinning out the enamel and worsening any oral damage already present.


Does Teeth Whitening Lead To Scarring?

This process is minimally invasive with almost 100% effectiveness. Due to the nature of the bleaching agent, slight burning and irritation of the gums may occur after the procedure. But in the hands of a professional dentist, these effects are rare. 


What Are the Temporary Side-effects Of Teeth Whitening? 

Whitening is unlikely to cause serious complications. Some minor side effects that can occur are-

Sensitivity : Teeth may become more sensitive for a short while. This happens when the peroxide in the whitener gets through the enamel to the soft layer of dentin and irritates the nerve of your tooth. In most cases, the sensitivity is temporary. You can delay treatment until this subsides, and then try again. 

Gum irritation : Improperly fitting trays may cause the tooth whitening gel to leak, causing gum irritation. Consult your doctor if you notice any discomfort.

Overuse of whiteners carries the risk of damaging the tooth enamel or gums, so talk to your dentist before the procedure, about the permissible extent of whitening.


How To Choose A Surgeon For A Teeth Whitening Surgery?

Teeth whitening is a form of dentistry and should only be performed by a dentist or another qualified dental professional like a dental hygienist or therapist, on the prescription of a dentist.

Consult with your dentists to determine the most appropriate whitening treatment, particularly for those with tooth sensitivity, dental restorations, extremely dark stains, and isolated dark teeth. 

Tooth discoloration may be caused by any specific problem that may not be affected by whitening agents and/or may be a sign of a disease or condition requiring endodontic therapy, restorations or dental surgery. Such diagnoses can only be made by a dentist or any other licensed health care professional, depending on local licensing regulations. Hence, it is important to wisely choose your surgeon.

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