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 Facial
expressions are a large part of body language, and, like it or not, people
judge you by your smile. An attractive smile can take you a long way. So
what happens when your pearly whites aren’t so pearly and white anymore?
After years of eating, smoking, drinking coffee, wine or teas, teeth can
lose their brilliance.
Your dentist has a variety of methods for restoring a bright white smile,
including porcelain veneers, composite bonding, implants and whitening,
also known as bleaching. However, of all the advances made in dentistry to
enhance the appearance of the teeth, whitening is the easiest and least
invasive, and effective for 3 out of 4 cases. The procedure is safe, easy
to use, and more affordable than ever before. Because of these reasons and
more, whitening has become very popular.
How does
the process work?
The
bleaching gel is usually hydrogen or carbamide peroxide that
breaks down into oxygen molecules. These molecules go into the
tiny pores of the enamel and dentin, and break up the stains that
block out the light. As the stains are broken into smaller and
smaller pieces, more light passes through the teeth and makes them
look lighter. Stains that are accumulated over time that are
yellow to slightly brown produce the best results. Teeth that are
dark brown to blue-gray are the most difficult to bleach because
the stain is deeply embedded into the tooth’s structure. These
types of stains are usually caused by medications taken during the
development of the teeth such as tetracycline, and can take a
minimum of three weeks to see results, and as much as six months
for complete results.
Depending on the bleaching gel used and the length of time it is
worn, results can be seen within an hour, overnight or within
three to four days. Complete results can be achieved in as little
as a week or as much as several months depending on the source of
the stain and the ability of the teeth or tooth to be bleached.
The whitening procedure may last for up to three years -- even
longer in some cases, depending on personal habits. To brighten
the color back up, a simple process of bleaching for one or two
nights with a single syringe is usually sufficient.
What will
happen at the initial consultation?
At the
first visit with your dentist, you’ll be able to talk with
him/her about the changes you’d like to make in your appearance.
Your dentist will explain the different options available to you,
the procedure itself, and its risks and limitations.
Your dentist will begin with a complete medical history and
examine your teeth. He/she may also take photos and/or x-rays and
give you specific instructions on how to prepare for the
procedure. Any large cavities may need to be addressed before
bleaching can begin. Take this opportunity to ask all the
questions you have about the procedure. Learning everything you
can about your options, risks and benefits is the key to making an
informed decision. See Questions to ask your doctor below.
How are
the treatments performed?
There
are three types of bleaching procedures to choose from. Two of
them are performed in the dentist’s office, and the third is a
take-home, self-administered treatment.
In-office
whitening procedures:
For
laser and power bleaching, a dentist begins by applying a
protective material to your gums and lips in order to isolate the
teeth. A special bleaching solution – usually containing
hydrogen peroxide - is applied to the teeth. A high intensity
light or laser is directed at the teeth and activates the
bleaching agent, causing the gel to release the oxygen molecules.
Treatments for both power and laser bleaching can take as little
as 45 minutes, but usually last somewhere between one and two
hours.
These techniques work great for a single discolored tooth as well.
If the tooth has become dark due to trauma but has not had a root
canal, the bleaching solution is placed on the outside of the
tooth. If the tooth has had a root canal, the solution can be
placed on the outside as well as the inside of the tooth. Leaving
a bleaching solution inside the tooth and sealing the opening is
referred to as “walking bleach”. The solution inside the tooth
for a walking bleach is changed about once a week. Results can
take several weeks but nothing has to be worn in the mouth.
Take-home
whitening:
Home
bleaching is performed at home, under the indirect supervision of
a dentist. At the first appointment, the dentist takes impressions
of the patient’s teeth and then creates a perfectly fitted
mouthpiece. This mouthpiece will allow the patient to apply a
bleaching solution to the teeth while protecting the rest of the
mouth from contact with the bleaching chemicals.
The concentration of hydrogen peroxide or carbamide peroxide in
the gel is not as strong as that used in power or laser bleaching
procedures. No strong light source or laser is needed to activate
the bleaching agent. Instead, it is contact with something
organic, in this case the teeth, that causes the gel to release
oxygen. In most cases, home bleaching can take from one to three
weeks to achieve maximum results. During this time, the dentist
may want to check the progress of the treatment.
How
much pain is there?
The
amount of discomfort experienced varies from person to person, and
depends on the method used. Most adults usually experience little
if any discomfort, however, the discomfort should subside within
24 hours. If needed, an over-the-counter anti-inflammatory may
help. If the discomfort lasts for more than 2 – 3 days, consult
your dentist for more options.
Decreasing the sensitivity may be as easy as placing a gel
fluoride, under your dentist’s instruction, in your bleaching
tray for an hour or so. Other materials may be used to address the
sensitivity you may experience. Check with your dentist for the
best options for your particular needs.
You should discuss your goals, budget, and pain tolerance with
your dentist in order to help him/her determine the procedure, or
combination of procedures, that will produce the best results for
you.
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What can a
patient expect afterward?
The
results of bleaching your teeth are somewhat variable, but most
people are happy with the results. After any bleaching treatment,
patients should avoid foods that stain, such as tobacco and red
wine for about a week. Keeping teeth clean with flossing and
brushing can maintain whiteness. Tooth bleaching lasts, on
average, about 1-3 years. If you are not a regular tobacco user,
and do not eat many foods that are known to stain teeth, bleaching
may last even longer.
Decalcified spots are white spots that bacteria, not removed from
the teeth frequently by brushing, affects the calcium in the
enamel. These spots appear chalky white and are difficult to treat
with just bleaching. Your dentist may recommend a procedure called
microabrasion. This procedure can be done by itself or in
conjunction with bleaching. The microabrasion material is much
like the paste used to clean and polish teeth. The paste consists
of an abrasive combined with a hydrochloric acid used to
“polish” out the white or brown spots. The procedure can be
performed usually in one office visit and can be done without
anesthesia.
Ideal
candidate:
In
general, the best candidates for tooth bleaching are:
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Mature enough to
fully understand the procedure
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Experiencing
stained and marked teeth
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Knowledgeable
about the procedure
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Wanting to
improve their appearance and/or comfort
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Realistic in
their expectations
The above is only a
partial list of the criteria that your dentist will consider in
determining whether or not this procedure is appropriate for you.
Be sure to ask your dentist if he / she considers you an ideal
candidate for this procedure.
Alternatives:
In
addition to laser, power and home bleaching, there are
over-the-counter home bleaching kits available in pharmacies and
supermarkets. While these products are growing in popularity, some
dentists do not recommend using them because of the increased
risks. They are not as effective, and can be damaging to the gum
tissue and enamel. A dentist-supervised system is backed by many
safety tests and provides the patient with assurance if questions
or problems arise.
Patients interested in whitening their teeth should consult a
dentist before taking on any form of treatment whatsoever. A
consultation with an experienced dentist will help you understand
the benefits and risks associated with each of the options.
Risks
and Limitations:
Bleaching
can produce side effects ranging from increased tooth sensitivity
to pain and tenderness in the gums, tongue and other soft tissues.
There is also a possibility of over-bleaching. The result will be
a translucency that may appear gray from the shadows of the mouth.
There is a very low percentage of this occurring, and only if the
bleaching process is over-extended. Having a dentist supervise the
process can eliminate this risk.
With home bleaching, there is a small risk of ingesting the gel
administered by the dentist. The chances of this occurring are
relatively small since your bleaching tray should fit almost
perfectly around your teeth. However, if the gel is ingested, it
may result in nausea, vomiting or burning. Under these
circumstances, you should contact a doctor immediately.
Choosing a
dentist:
It is
very important you select a dentist adequately trained and
experienced in this procedure. We strongly recommend that you
consider choosing a cosmetic dentist. See our Locate a Specialist
feature to find a doctor in your area, including detailed profile
information for many of the listed doctors. Also read How to
Select a Cosmetic Dentist for a more detailed discussion on
choosing the right dentist.
Questions
to ask:
-
Are the desired
results I described realistic?
-
Is there an
alternative treatment that I should consider as well?
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How long will
the procedure take?
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How much does it
cost?
-
What is your
experience in performing this procedure? (How many he/she has
performed in the past year?)
-
What percentage
of patients have had significant complications? (The dentist
should provide this information to you.)
-
Will you repeat
or correct the procedure if it does not meet agreed upon
goals? And if the procedure must be repeated / corrected, will
I be charged again? (The dentist should provide you with
his/her policy on this issue.)
-
May I see
"before and after" photos of recent patients? (The
dentist may have a book that will provide many photos of
recent patients.)
-
Could I observe
the exact procedure I am considering before I decide to have
it done? (Either on videotape or live.)
-
What should I
expect after the procedure and what things should I avoid?
-
Do you offer
patient financing?
Be
sure to:
-
Tell your
dentist about any allergies you have (to foods, drugs, vinyl,
peroxide, or environmental elements)
-
Tell your
dentist about all medications you are taking (both
prescription and non-prescription)
-
Carefully follow
any instructions your dentist gives you.
The information on
this web site is only intended as an introduction to this
procedure. This information should not be used to determine
whether you will have the procedure performed nor as a guarantee
of the result. The best method of determining your options is to
consult qualified dentists who are able to answer specific
questions related to your situation.
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Advisory
This information is for
educational purposes only, and does not replace face-to-face
consultations with licensed medical professionals. In no event shall
Filipino Dentist.Com, or the featured doctor be liable to you or
anyone else for any decision made or action taken in reliance on such
information. |
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