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Teeth whitening is a process of lightening the color of your teeth. It is also referred to as “teeth bleaching”.
Bleaching vs. Whitening
According to the FDA, the term “bleaching” is permitted to be used only when the teeth can be whitened beyond their natural color. This applies strictly to products that contain bleach – typically hydrogen peroxide or carbamide peroxide.
The term “whitening,” on the other hand, refers to restoring a tooth’s surface color by removing dirt and debris. So any product that cleans (like a toothpaste) is considered a whitener. Of course, the term whitening sounds better than bleaching, so it is more frequently used – even when describing products that contain bleach.
Teeth Whitening Options
Three major teeth whitening options are available today. All three rely on varying concentrations of peroxide and varying application times.
In-Office 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, applied to the teeth by the dentist or trained technician after the gums have been protected with a paint-on rubber dam. 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. Take-home kits incorporate an easy-to-use lower-concentration peroxide gel that remains on the teeth for an hour or longer (sometimes overnight). The lower the peroxide percentage, the longer it may safely remain on the teeth. The gel is applied to the teeth using custom-made bleaching trays that resemble mouth guards.
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. 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.
Teeth Whitening Risks
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 and zingers.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.
- Technicolor teeth: Restorations such as bonding, dental crowns or porcelain veneers are not affected by bleach and therefore maintain their default color while the surrounding teeth are whitened. This results in what is frequently called “technicolor teeth.”