Teeth Whitening, Laser Teeth Whitening, Professional Tooth Whitening

WHAT IS TEETH WHITENING?

The term “whitening,” refers to restoring a tooth's surface color by removing dirt and debris that appear as stain on the tooth surface. Therefore, any product that cleans (like a toothpaste) is considered a whitener.

HOW DO THE TEETH STAIN?

Initially we all start out with sparkling white teeth, due to their porcelain-like enamel surface. Composed of microscopic crystalline rods, tooth enamel is designed to protect the teeth from the effects of chewing, gnashing, trauma and acid attacks caused by sugar. But over the years enamel is worn down and becomes porous. The gaps between enamel rods begin to open, allowing food particles to get passed the surface. During routine chewing, dentin remains intact while millions of micro-cracks occur in the enamel. It is these cracks, as well as the spaces between the crystalline enamel rods, that gradually fill up with stains and debris. As a result, the teeth eventually develop a dull, lackluster appearance.

Teeth Whitening removes the stains and debris, leaving the enamel cracks open and exposed. Some of the cracks are quickly re-mineralized by saliva, while others are filled up again with organic debris.

Tooth Discoloration: The Two Types of Tooth Stains:

There are two categories of staining as it relates to the teeth: extrinsic staining and intrinsic staining.

Extrinsic stains are those that appear on the surface of the teeth as a result of exposure to dark-colored beverages, foods and tobacco, and routine wear and tear. Superficial extrinsic stains are minor and can be removed with brushing and prophylactic dental cleaning. Stubborn extrinsic stains can be removed with more involved efforts, like teeth bleaching. Persistent extrinsic stains can penetrate into the dentin and become ingrained if they are not dealt with early.

Intrinsic stains are those that form on the interior of teeth. Intrinsic stains result from trauma, aging, exposure to minerals (like tetracycline) during tooth formation and/or excessive ingestion of fluoride. In the past, it was thought that intrinsic stains were too resistant to be corrected by bleaching. Today, cosmetic dentistry experts believe that even deep-set intrinsic stains can be removed with supervised take-home Teeth Whitening that is maintained over a matter of months or even a year.

TYPES OF TEETH WHITENING:

Three major Teeth Whitening options are available today. All three rely on varying concentrations of peroxide and varying application times. All types of whitening require hydrogen peroxide or carbamide peroxide at various concentrations.

Professional In-Office Teeth Whitening:

Significant color change in a short period of time is the major benefit of in-office whitening. This protocol involves the carefully controlled use of a relatively high-concentration peroxide gel as the peroxide could be very toxic to the gums and soft tissue if not applied by a traind technician or the dentist, Generally, the peroxide remains on the teeth for several 15 to 20 minute intervals that add up to an hour (at most). Those with particularly stubborn staining may be advised to return for one or more additional bleaching sessions, or may be asked to continue with a home-use whitening system.

Professionally Dispensed Take-Home Whitening Kits:

Many dentists are of the opinion that professionally dispensed take-home whitening kits can produce the best results over the long haul. Accurate impressions of the teeth allows for making custom made bleaching trays that enable maximum exposure of the whitening gel to all surfaces for an hour or longer (sometimes overnight). This type of whitening has to done under the approval of the dentist since high concentrations of peroxide is used.

Over-the-Counter Whitening:

The cheapest and most convenient of the Teeth Whitening options, over-the-counter bleaching involves the use of a store-bought whitening kit, featuring a bleaching gel with a concentration lower than that of the professionally dispensed take-home whiteners. The gel is applied to the teeth via one-size-fits-all trays, whitening strips or paint-on applicators. Due to the lower concentration, in many cases this may only whiten a few of the front teeth unlike custom trays that can whiten the entire smile.

Hydrogen Peroxide vs. Carbamide Peroxide:

The bleach preference for in-office whitening, where time is limited, is powerful and fast-acting hydrogen peroxide. When used in teeth bleaching, hydrogen peroxide concentrations range from approximately nine percent to 40 percent.

By contrast, the bleach of preference for at-home Teeth Whitening is slower acting carbamide peroxide, which breaks down into hydrogen peroxide. Carbamide peroxide has about a third of the strength of hydrogen peroxide. This means that a 15 percent solution of carbamide peroxide is the rough equivalent of a five percent solution of hydrogen peroxide.

FACTORS INVOLVED IN TOOTH STAINING:

Starting color: We are all equipped with an inborn tooth color that ranges from yellow-brownish to greenish-grey, and intensifies over time. Yellow-brown is generally more responsive to bleaching than green-grey.
Age: There is a direct correlation between tooth color and age. Over the years, teeth darken as a result of wear and tear and stain accumulation. Teenagers will likely experience immediate, dramatic results from whitening. In the twenties, as the teeth begin to show a yellow cast, Teeth Whitening may require a little more effort. By the forties, the yellow gives way to brown and more maintenance may be called for. By the fifties, the teeth have absorbed a host of stubborn stains which can prove difficult (but not impossible) to remove.
Translucency and thinness: These are also genetic traits that become more pronounced with age. While all teeth show some translucency, those that are opaque and thick have an advantage: they appear lighter in color, show more sparkle and are responsive to bleaching. Teeth that are thinner and more transparent – most notably the front teeth – have less of the pigment that is necessary for bleaching. According to cosmetic dentists, transparency is the only condition that cannot be corrected by any form of teeth whitening.
Eating habits: The habitual consumption of red wine, coffee, tea, cola, carrots, oranges and other deeply-colored beverages and foods causes considerable staining over the years. In addition, acidic foods such as citrus fruits and vinegar contribute to enamel erosion. As a result, the surface becomes more transparent and more of the yellow-colored dentin shows through.
Smoking habits: Nicotine leaves brownish deposits which slowly soak into the tooth structure and cause intrinsic discoloration.
Drugs / chemicals: Tetracycline usage during tooth formation produces dark grey or brown ribbon stains which are very difficult to remove. Excessive consumption of fluoride causes fluorosis and associated areas of white mottling.
Trauma: Falls and other injuries can produce sizable cracks in the teeth, which collect large amounts of stains and debris.
Grinding: Most frequently caused by stress, teeth grinding (gnashing, bruxing, etc.) can add to micro-cracking in the teeth and can cause the biting edges to darken.

WHAT BRANDS ARE AVAILABLE? WHICH IS THE BEST?

There are several brands available in the market that resemble each other very closely. At the top of this list “Zoom” remains the strongest and most popular, probably not because of the results but due to excellent marketing skills performed by the company owners. According to Dr. Pedram Sooferi DDS, the brand “Nevious” has been able to produce the best results over the years, as the teeth gain a natural pearl looking shade rather than a unnatural dull white colored shade after the procedure. Even though, the procedure is a little more time consuming the satisfaction of the patients out weights its disadvantages over faster methods.

HOW WHITE CAN I GO?

Teeth whitening results are subjective, varying considerably from person to person. Many are immediately delighted with their outcome, while others may be disappointed. Before you embark on any whitening treatment, ask your dentist for a realistic idea of the results you are likely to achieve and how long it should take to achieve them. Expectations play a major role in teeth whitening.

WHITENING SHADE GUIDES:

In the dental office, before-and-after tooth color is typically measured with shade guides. These are hand-held displays of wide ranges of tooth colors. (Dentists also use them in choosing crown and other restoration shades.)

The standard-setter among them has long been the Vitapan Classic Shade Guide. This shade guide standard incorporates 16 shades, systematically arranged from light to dark into four color groups, and provides a universal tooth-color terminology.

While whitening can occasionally lighten tooth color by nine or more shades, most of those who bleach their teeth are likely to see a change of two to seven shades.

IS TEETH WHITENING SAFE?

Teeth whitening treatments are considered to be safe when procedures are followed as directed. However, there are certain risks associated with bleaching that you should be aware of:

Sensitivity: Bleaching can cause a temporary increase in sensitivity to temperature, pressure and touch. This is likeliest to occur during in-office whitening, where higher-concentration bleach is used. Some individuals experience spontaneous shooting pains (“zingers”) down the middle of their front teeth.

Individuals at greatest risk for whitening sensitivity are those with gum recession, significant cracks in their teeth or leakage resulting from faulty restorations. It has also been reported that redheads, including those with no other risk factors, are at particular risk for Tooth Sensitivity.

Whitening sensitivity lasts no longer than a day or two, but in some cases may persist up to a month. Some dentists recommend a toothpaste containing potassium nitrate for sensitive teeth.

Gum irritation: Over half of those who use peroxide whiteners experience some degree of gum irritation resulting from the bleach concentration or from contact with the whitening trays. Such irritation typically lasts up to several days, dissipating after bleaching has stopped or the peroxide concentration lowered.

MAINTENANCE OF THE WHITENED TEETH:

To extend the longevity of newly whitened teeth, dentists are likely to recommend:

Avoid frequent consumption of Caffine such as coffee, tea, coke, and etc. since they have a direct effect in discoloring the teeth back to the base color.
Dark-colored foods and beverages need to be avoided for at least a week after whitening.
Avoid smoking.
Whenever possible, sipping dark-colored beverages with a straw.
Practicing excellent oral hygiene (brushing and flossing after meals and at bedtime).

WARNINGS: Patients with high levels of flourosis on their teeth should consult with their dentist before doing teeth whitening, since the surfaces that are fluoridated will whiten more effectively than other areas, creating patchy, chalky teeth, making patients very unhappy with their looks. However, the patchiness will subside dramatically after a few days.

CONCERNS AND CAVEATS:

In addition to the aforementioned risk factors, a number of caveats should be considered before undergoing teeth whitening:

No amount of bleaching will yield “unnaturally” white teeth.
Whitening results are not fully seen until approximately two weeks after bleaching. This is an important consideration if you are about to have ceramic restorations and want to be sure the color matches that of your newly bleached teeth.

If cosmetic bonding, porcelain veneers or other restorations are part of your treatment plan, they should not be placed until a minimum of two weeks following bleaching to ensure proper adhesive bonding, function and shade matching.

To avoid the technicolor effect, tooth-colored restorations will likely need replacement after bleaching.
Recessed gums often reveal their yellowish root surfaces at the gum line. That yellow color has proven difficult to bleach.
Pregnant or nursing women are advised to avoid teeth whitening. The potential impact of swallowed bleach on the fetus or baby is not yet known.

Procedures

Contact and Location

Los Angeles Dentist