Teeth Whitening

General Overview
Over the past few years there has been major advancements made in the science and techniques for teeth whitening. Originally, it was discovered quite by accident that certain chemicals had the ability to whiten enamel tooth structure. This discovery quickly evolved into what is now a very sophisticated industry involving both professionally directed techniques and over-the-counter methods for whitening teeth. Almost all whitening products whether over-the-counter or professionally performed or supervised, contain the active ingredient carbamide peroxide.

Contra-indications to teeth whitening (reasons you shouldn’t), include: existing cosmetic dental restorations (fillings won’t lighten in color), gum inflammation, periodontal disease, and ‘dirty’ teeth. Prior to teeth whitening it is best to have your teeth cleaned and to discuss recent or planned dental work.

All teeth whitening methods utilize an oxygenating agent (such as carbamide peroxide) in varying concentrations to whiten tooth enamel. Factors that influence success include the beginning intrinsic shade of the teeth, the degree of oral/dental cleanliness, past dental injuries, oral habits, history of tetracycline antibiotic use, the native hue and color of tooth structure, and the general state of dental health. Yellow-brown tooth colors generally whiten easier than gray-blue teeth colors.

Teeth bleaching procedures are mainly of two types: 1)- commercially available over-the-counter OTC, and 2)- professionally supervised. Of the later, there are in-office and at-home versions, each with its advantages and disadvantages.

What follows is a brief summary of each method and their applications.

1. OTC (over-the-counter) products: These methods are widely available in grocery stores, pharmacies, shopping malls, TV and internet, etc. They consist of strips, paint on gels, or general purpose (one-size-fits-all trays which attempt to hold bleaching gel against the teeth.

2. Professional Supervised

a. Tray Systems: Thin custom made plastic trays are fabricated from stone models of your teeth. These trays fit intimately to the teeth and allow for smaller quantities of prescription strength (higher concentrated) whitening agent to be used. Trays are used for a few hours each day (or night) or until the desired degree of whitening is achieved. Trays can then be stored and used later for touch-ups as desired.

b. Power Bleaching: New technology has brought “one-hour” whitening techniques. The advent of more powerful bleaching gels and special accelerating lights (to accelerate the action of oxygenation with the bleaching gel), now gives a significant whitening result while comfortably reclined in the dental chair watching your favorite movie or TV program.

Teeth Whitening Theory
Everyone’s teeth have a natural biologic limit of how white they can get. Once you have reached this limit, no amount of additional bleaching would whiten teeth further. However, by the time this limit has been reached, the results are not very becoming or cosmetically desirable. In other words, it is possible to carry bleaching too far – too much! The results can look opaque, “refrigerator white”, and mono-chromatic (one color throughout, and without the subtle natural gradations of coloration). This is another important reason why professional supervision is very desirable.

Time in contact with bleaching gel is one of the key factors for success. It is the principle reason why weaker over-the-counter techniques are largely unsuccessful or short-lived with their results. It also explains why tray systems are so successful and popular. However, when custom trays are used in conjunction with in-office “power bleaching” lights, the results are synergistic and profound.

Combination or “Deep Bleaching”
Having reviewed the mechanism behind bleaching and the methods outlined above, there is one more teeth whitening technique that has been developed to get teeth their absolute whitest. This method, called “Deep Bleaching” combines the two professional based methods listed above to create an even more stunning and brighter smile. This Deep Bleaching technique generally consists of three steps: 1)- an initial in-office “power bleaching” session, followed by 2)- one to two weeks of home tray treatments, followed by 3)- a final in-office power bleaching session. Some modifications of this process now eliminate one (or more) of these steps depending on the concentration and type of bleaching agent used, and the degree of difficulty anticipated in obtaining the results desired.

Regardless of the specific steps involved, combination bleaching achieves a much brighter and whiter result than any other bleaching technique that has been developed or invented to date.

The key to these better results is in understanding that tooth enamel responds best to whitening efforts when it is first “conditioned”. This means that the enamel surface of the teeth is first conditioned or prepared to absorb the oxygen molecules of the peroxide bleaching agent more readily. The subsequent whitening efforts with custom trays and the final in-office Power Bleaching session allows the oxygenating effects of the whitening gel to be more pronounced and work deeper, resulting in longer lasting and more pleasing results.

The first session of Deep Bleaching will start with a one-hour power whitening session done in the dental office. This conditions tooth enamel to absorb oxygen. Do not expect a tremendous color change from this first ‘conditioning’ visit. Following this visit, custom whitening trays will be worn for a number of nights, usually two weeks. After about two weeks of at-home Deep Bleaching, the final Deep Bleaching session will be performed back in the dental office. This will provide significant additional whitening over what has already been accomplished. The result will in most cases be a significant WOW!

Bleaching of the teeth with at-home trays is accomplished by wearing bleaching trays with bleaching gel in them. The trays are made of a clear thin flexibly vinyl or plastic. They are custom fit to precisely fit over your teeth, with a space or reservoir made directly over the tooth enamel surface (to hold an extra amount of gel), and custom fit to safely protect and follow your gum line. Most patients find these trays very comfortable to wear.

Too often “normal” bleaching trays made in dental offices do not seal in the bleaching gel at the gum line to prevent leakage and dilution from saliva. The result is very little depth of bleaching. Properly made custom trays will decrease dilution and will keep the whitening gel in contact with tooth surfaces for longer periods of time.

Summary
Teeth Whitening is an efficient and cost-effective way to achieve a new whiter smile and take a few years off your face. Please feel welcome to contact Dr. Ostler’s office and make an appointment for a free cosmetic consultation to see if you are a good candidate for whiter teeth.

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