Teeth Whitening

Are YOU interested in getting a whiter, and brighter smile?

The KEY ingredient for whitening teeth is Hydrogen Peroxide.

Hydrogen Peroxide is a chemical compound that is capable of passing through the crystalline structure of the enamel. This allows the hydrogen peroxide molecules to reach, and lighten teeth BELOW the surface!

All teeth whitening products and techniques use some form of Hydrogen Peroxide. Unlike polishing the surface of teeth, hydrogen peroxide is able to enter the crystalline structure of enamel and lighten the teeth below the surface. Hydrogen Peroxide comes in multiple different concentrations. Higher concentrations may require a different formulation to stabilize it and allow it to have a reasonable shelf life.

IS HYDROGEN PEROXIDE SAFE?

Yes!

As hydrogen peroxide breaks down it releases H2O (water) and O2 (Oxygen) molecules, both of these compounds are safe for your enamel!

Hydrogen peroxide has several by-products given off when it breaks down. They are water and oxygen. Hey, those are healthy molecules!

ARE THERE ANY SIDE EFFECTS?

Yes.

The most common side effect of hydrogen peroxide is short bursts of extreme sensitivity in your teeth.

The sensation of this sensitivity is comparable to holding ice against your teeth!

Not everyone experiences this sensitivity, however, people with sensitive teeth, people who grind their teeth, and young people are more likely to experience this.

The strength of the peroxide solution used may also increase your chances of experiencing discomfort. The stronger the concentration of peroxide, the more likely you are to experience this sensitivity.

Sensitivity after whitening your teeth will be the most uncomfortable on the day of whitening. Luckily, the discomfort should subside within 2-3 days!

Stronger peroxide (i.e. carbamide peroxide used in one hour bleaching systems)

It is a good idea to be prepared for these symptoms just in case.

A second possible side effect of teeth whitening is small white spots along your gums. When highly-concentrated peroxide comes in contact with your gums, it may temporarily "bleach" them.

However, this side effect only occurs when whitening your teeth at your local dentist, or with "take-home" bleach systems given to you by a professional dentist.

This discoloration should only last for a few hours before returning back to normal.

The most talked-about side effect is temporary short bursts of significant sensation. In my practice, we called these “zingers”. Not everyone experiences “zingers” but young people, people with sensitive teeth and people who grind their teeth are more prone to experiencing them. Stronger peroxide (i.e. carbamide peroxide used in one-hour bleaching systems) will have a greater likelihood of eliciting these zingers. Here is how I remember experiencing these zingers myself. After whitening my teeth, I would experience a sensation with the equivalent of holding ice to my lower front teeth until the experience would cause me to wince. This sensation would last a second or two and would repeat once an hour or so. After a day, I did not have these anymore. Everyone will have a different experience whitening their teeth. It is a good idea to be prepared for these symptoms just in case.
Another temporary side effect happens only with the stronger peroxide concentrations used by “in office” and “take-home” bleaching systems available only in dental offices. If some of the strong peroxide comes in contact with your gums, those small areas can become white for a few hours but then return to normal color.

HOW WHITE CAN I GET MY TEETH?

There are SO MANY products on the market that make claims to be able to transform your teeth into pearly whites.... but which of these products will EFFECTIVELY whiten your teeth?

Whitening can lighten the COLOR of your teeth, however, it will not affect the TONE of your teeth!

If you go to a paint store and ask for white paint, they will show you SEVERAL shades of white. Some shades have subtle blue tones while others carry yellow tones. The concept is the same with teeth. Human teeth generally carry either yellow or grey tones.

I have rarely heard anyone complain that their teeth became too light. Whitening is fun and can have a HUGE impact on how people feel about their smiles!

I have seen advertisements for various whitening products that make a claim that your teeth will become some number of shades whiter. To me, this is a ridiculous statement. First of all, each person will experience different results from the same formulation. Darker teeth with thick enamel might show a more dramatic result than someone who had exceptionally light teeth to begin with. Additionally, there are more than a few different shade systems that we dentists use and these companies could have even created their own to add excitement to their advertising. The reality is that it is very difficult to know for sure how much lighter your teeth have become. If you look in the mirror at home where you would normally see yourself in the same lighting and you realize with a startle that your teeth are indeed lighter, then I would call that success.

One last thing. If you have ever gone to a paint store and asked for white paint, they will show you the many shades of white. Some will have subtle blue tones and others might have yellow. There are many color combinations. This is the same with teeth. I might say that there are two general categories for human teeth. Some will display yellow tones and others will display grey tones. Whitening will lighten the color of your teeth but your teeth will remain in the same general tone.

Okay, a second one last thing. I have rarely heard anyone complain that their teeth became too light. Whitening is fun and can have a big impact on how people feel about their smiles.

WHITENING TECHNIQUES

In general, the more concentrated the peroxide, the faster the whitening result and also, the more potential for temporary post procedure symptoms and sensitivities. Here is a basic list of some of the common ways to whiten/lighten/bleach teeth:

Whitening toothpastes and rinses. These products are relatively low in peroxide concentration so any whitening effect will be slower but there will be little chance for post procedural sensitivities.
Peroxide rinse found in pharmacies in a brown bottle: This is a 3% concentration of hydrogen peroxide. The nice thing about any rinse is that all surfaces of all teeth are exposed to the peroxide. One thing that I notice when I rinse with hydrogen peroxide is a foaming on top of my tongue. Some people are put off by the taste or by the sensation of this foaming. The good news is that as high concentration of oxygen is liberated by the peroxide, this oxygen is hindering bacteria so this is actually great for gum health and the oral environment. The pros of this technique include: inexpensive, easy, effective and healthy for the gums. The cons of this technique is that it is very slow. In fact, you will not notice the subtle changes. After a year or so, your friends may start to comment on your teeth especially if they have not seen you in a while. The person that I know who has the whitest teeth is a hygienist who uses this technique.
Whitening strips. Crest “white strips” were the first developers of this that I can recall. My daughter became interested in whitening her teeth while my office was closed for shelter in place in early 2020. I purchased these whitening strips for her and she was delighted. The pros: Not too expensive, reasonable results. The cons: I have heard that some people had trouble manipulating the product ( not sure why ) and it would be difficult to bleach back teeth with this product if that was a concern to you.
Take home trays: This technique involves a dental office taking impressions of your teeth and fabricating custom trays. The office would then provide you with bleaching gel which you would dispense into the trays at home and insert them onto your teeth for the prescribed amount of time. The pros: Covers all teeth front and back. Stronger and faster than the above mentioned techniques. The cons: getting more expensive and some people will not follow through with multiple applications.
One hour treatments: With this technique, the teeth are isolated so that bleaching gel can be applied to the teeth without the risk of getting too much on the gums, lips or other tissues. This technique uses the most concentrated peroxides. It is therefore the most prone to the temporary side effects. Pros: People seem to like the immediate effect. If you would like your teeth whitened for an upcoming event, this might be the best option. This does not require “follow through” on the part of the patient. Cons: Potential temporary sensitivities, more cost and this will not reach the back teeth.

CAN ANYONE WHITEN THEIR TEETH?

Most people with a complete unrestored set of teeth can partake in teeth whitening with certain exceptions:

While there is no explicit minimum age for teeth whitening, there are several reasons why younger people might be better off waiting to whiten their teeth. First of all, younger teeth will have larger nerves and therefore could be more susceptible for sensitive teeth during the first day or two after the procedure. In addition, if not all of the permanent teeth are fully erupted, there could be a situation where teeth that erupt more fully later on do not have the same whitening effect as those teeth that were fully in during the process of whitening. By age 14, many children will have all of their permanent teeth fully erupted but certainly not all. Unless there is a pressing need, my suggestion would be to wait until children are older or perhaps begin with a milder form of whitening.
People with fillings, crowns or other restorations should be aware that any type of restoration will not become lighter. Some people who lighten their teeth and then notice that the teeth are now lighter than the previous fillings or crowns might then decide to change their dental work to match the new shade. Conversely, if someone was to consider getting dental work which would show in their smile, it would be prudent to consider if they might one day desire to have lighter teeth. If that were the case, the best option would be to lighten the teeth until the desired brightness is achieved and then proceed with the dental work which would then approximate the new color and brightness.
People with unrestored dental caries (cavities) or some stages of gum disease might have unwanted experiences with bleaching. Always consult your dentist before proceeding.

Will all teeth be good candidates for whitening?

Here are some things to think about:

Thin enamel will show the underlying darker “dentin” and therefore, may not lighten as much. Thin enamel can be hereditary, eroded away from repetitive acid exposures (sodas, lemonade, bulimia) or could happen over long periods of time from abrasive foods or dentifrices.
Teeth with internal dark coloration from “tetracycline staining” or other causes might not lighten as well as average teeth.

HOW LONG WILL MY TEETH STAY WHITE?

This is a million dollar question. There is no way to know this for sure. Some factors that can influence this would include the quality of the crystalline structure of your enamel and your diet (red wine, tea, etc. might darken the teeth)

Years ago a dental assistant that worked with me used to answer this question with the following. “Whitening is like a diamond engagement ring. When you first see the ring, it appears to have a certain size. After some years, it does not seem as big. Whitening is the same. After you first whiten your teeth, you will really notice the difference. After some years, you might feel like the effect is less than it really is.

Certainly to me, the people with the most pronounced bleaching results do tend to re-do or touch up their bleaching from time to time.

Good Luck and Have Fun!