I WANT WHITER TEETH!
Have you met many people who want to lose weight slowly, so they would not cause medical problems and their final weight would be more stable? There are not many people like that. When people try to lose weight, they want to be thin YESTERDAY, if not sooner. The number of fast weight loss diets and clinics are a testimonial to this impatience.
The desire to make teeth whiter is a lot like the desire to lose weight. Everyone wants whiter teeth IMMEDIATELY. To satisfy this desire, quick whitening treatments are advertised all over the consumer media, but with no mention of the disadvantages.
We always seek what is ultimately in the best interest for patients. Patients often ask us about in-office “power bleaching,” and we discourage it. I have done teeth whitening both ways during many years. Now I only do the slower tray bleaching. Would you like to know why?
Despite all the advertising hype, all forms of tooth bleaching use either hydrogen peroxide or urea peroxide as the active agent. The only difference is the strength of the chemical. In-office bleaching uses a very concentrated solution over a short time, and at-home bleaching uses a less concentrated solution over a longer time in custom trays.
Can you tell that this patient has both upper and lower
bleaching trays in her mouth?
Studies have shown that both kinds of bleaching are equally effective in whitening teeth. Why don’t we favor the quick, in-office power bleaching method? Here are the reasons:
1. Power bleaching often creates a lot of sensitivity to cold. With tray bleaching patients can control sensitivity by using weaker solutions, or alternate nights using fluoride in the trays.
2. Power bleaching costs about four times as much as tray bleaching.
3. Some of the impressive whitening from power bleaching results from dehydration of the teeth, which dissipates in 24 hours.
4. It is nearly impossible to completely isolate the gums from the powerful solution when power bleaching. The chemical often leaks past the rubber dam and burns the gums, turning them temporarily white as well.
5. The whitening effect from bleaching always reverses somewhat with time, and needs to be refreshed. Power bleach patients have to do tray bleaching later to “refresh” the lighter color, and must pay for this. Tray bleaching patients can just buy more solution and use it in their trays for a few days.
6. The trays can also be used to hold prescription fluoride, to reduce cavities in decay prone patients.
Sometimes slower is better. Tray bleaching shows results in as little as a week after using the solution every night. Maximal effect takes about six weeks.
This patient bleached his upper teeth by four weeks of sleeping with a solution in a comfortable clear vinyl tray made in our office. Note the color difference between upper and lower teeth. Extremely pleased with the results, he will now proceed to bleach his lower teeth. One of these days, he may have us do braces to straighten his teeth!
Some things you may not have thought about when bleaching:
• Only natural teeth get whiter with bleaching. Fillings and crowns will stay the same color. If you have a lot of porcelain crowns and white fillings in your mouth, you may want to think twice before bleaching. Otherwise, you may have to redo them in order to match your new tooth color.
• There is no practical way to bleach just one dark tooth in your mouth, unless it has had a root canal.
• The new color should be given time to stabilize before undergoing any further esthetic dental treatment. If you bleach for six weeks, you should wait another six weeks for the color to stabilize before having any tooth-colored dental work. People who utilize power bleaching must wait a similar period, as well.
• Some unsightly stains virtually disappear with bleaching, making expensive crowns or veneers unnecessary.
Bleaching teeth is the most commonly performed esthetic service in our office. We do it almost every week. At-home tray bleaching is the most cost effective way to improve the color of your teeth, while minimizing the side effect of sensitivity.
Kim Henry, D.M.D.
October 31, 2005
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