Why should I be concerned?*
Teeth Whitening is a controversial procedure when not done in a Dental office. Currently, “dentist dispensed and Over the Counter (OTC) home-use tooth whitening bleaches are eligible for the American Dental Association’s (ADA) Seal of Acceptance. The products in this category that currently bear the ADA Seal contain 10% Carbamide Peroxide (which should decompose to yield a maximum of 3.5% H202). Hydrogen Peroxide (H2O2) in concentrations of 10% or greater are known to be “corrosive to mucous membranes or skin causing a burning sensation and tissue damage”. Furthermore, “transient mild to moderate tooth sensitivity can occur in up to 2/3 of users during early stages of bleaching treatments”, and should be monitored by a Dentist. Many “in-office materials utilize 25% or greater H2O2, and can cause severe mucosal damage if the tissue is not protected and the material is not applied appropriately. This is where the Doctor of Dentistry has unique knowledge and training. Only a dentist can diagnose whether the discoloration in the tooth is caused by simple surface stain or is the result of underlying pathology. “Dental caries or leaking restorations may also cause teeth to appear dark”.
A dental examination with necessary radiographs will identify the presence of decay as well as existing restorations that may be leaking and as a consequence be the source of discoloration. Grey areas in a tooth may be deep decay and will not change color. Deep decay that is exposed to these chemicals could further damage the pulp of the tooth and require a root canal. Existing restorations will not change color and the knowledge of the need to replace the fillings and the costs and risks associated with these procedures must be understood.
The greatest concerns about at-home bleaching, mall kiosks, hair salons or similar type settings is the lack of discipline surrounding the concentrations of these materials, and the lack of a diagnosis and examination for existing oral diseases by competent Dental Professionals. “Concerns regarding tooth bleaching in non-dental settings have been raised. Non-dental personnel lack the knowledge, resources (such as radiographs), education and license needed to provide dental examinations. The facilities generally lack effective infection control capabilities and protocols, personnel are not trained in standard infection control precautions and may not be prepared to provide emergency care for allergic reactions.”
How should I choose a whitening product?
A whitening product is best chosen after complete examination by and discussion with your Dentist.
What is the shelf-life and wearing time of Teeth Bleaching Gel?
The shelf life is specific to each manufacturer’s formulation and they are generally affected by whether they are stored under refrigeration or not. Wearing time depends, again, on the formulation and they are specifically determined by percentage of Carbamide Peroxide, concentration of the chemicals, and whether the gel has been formulated for short term exposure or long term exposure. Each manufacturer will have specific data for their material.
Some bleaching gels are for overnight wear and others can be worn for up to two hours at a time, once per day. Duration is dependent on what shade you are trying to achieve. Many discolorations of tooth structure that are the result of genetics, exposure to certain medicines as a child or to natural minerals ingested as a child, cannot be easily overcome in a typical bleaching cycle of one to two weeks, and may not be affected by bleaching materials at all. Once again, these are problems best addressed in discussions with your Dentist.
What about whitening toothpastes?
Whitening toothpastes will not in themselves demonstrably whiten teeth. However, they are excellent maintenance toothpastes once you have achieved a level of whitening you desire. It is always important to use any toothpaste that contains a proper level of fluoride.
Can a single tooth which has been root filled be whitened?
This is a procedure that does not have a predictable outcome. Yes, a root canal tooth can have bleaching material sealed inside the tooth and internal bleaching can be effective in lightening the tooth. This may take several treatments and the outcome, while being a lighter shade of tooth, may not match the adjacent vital teeth. This is more significant as a problem if it is one of the front teeth in your smile.
*All quotations are from American Dental Association publications. If your seek more in depth information please utilize the ADA link.
