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Teeth Whitening – Need | Types | Procedure | Care

Teeth whitening is a conservative and effective method to lighten discolored teeth that has been practiced for many centuries. Tooth whitening or teeth bleaching is a way to improve the color of the teeth using bleaching agents such as hydrogen peroxide (perhydrol). Teeth whitening is a safe procedure when it is done under the supervision of a dentist with proper tools and protocols. 

Teeth polishing, on the other hand, removes surface stains caused by consumption of beverages like coffee, cigarettes, red wine, and tobacco chewing. Dentists use polishing or special pastes or gels to take out the stains. Routine teeth polishing may remove surface stains from the teeth but does not change the color of the teeth. However, teeth whitening removes both surface and inner stains. Hence, teeth polishing and teeth whitening are very different procedures.

Teeth whitening causes no harm whatsoever to either the teeth or general health. However, a common side effect can be the sensitivity of teeth to hot and cold food or some minor irritation inside the mouth. All side effects usually disappear within a week or two from the date of the treatment.

What are the different kinds of stains that make teeth whitening necessary:

Teeth discolorations are broadly classified as extrinsic or intrinsic, depending on the origin of the stain.

1. Extrinsic Stains

Extrinsic staining is more conventional than intrinsic staining and arises due to the accumulation of chromogenic substances on the enamel surface. Extrinsic stains may occur due to poor oral hygiene, ingestion of chromatogenic food and drinks such as coffee, tea, red wine, smoking and regular use of tobacco. These stains are generated by the reaction between sugars and amino acids or acquired from the retention of exogenous chromophores in the pellicle.

2. Intrinsic  Stains

Main culprits that cause intrinsic staining or intrinsic discolorations are incorporated during tooth formation or after the eruption and are attributable to the presence of stain molecules within the enamel and dentin. The first is through a high intake of fluoride (fluorosis) during the development of the tooth.

  • Medication is one of the leading cause of intrinsic staining, more specifically the antibiotics tetracycline and minocycline. Use of these antibiotics during tooth formation can cause a bluish-grey stain on the portion of the tooth developing at the time of application. The severity of staining will differ.  
  • Other causes of intrinsic staining are inherited developmental defects of enamel or dentin are associated with amelogenesis imperfecta, dentinogenesis imperfecta, and enamel hypoplasia. Discolourations due to developmental defects often become worse over time as the rough surfaces allow stains to accumulate more easily and quickly.
  • Numerous other factors can also adversely affect the ameloblast and cause enamel hypoplasia, including nutritional deficiencies, viral exanthematous diseases, trauma to developing teeth, birth trauma, metabolic diseases, hemolytic diseases in newborns, local infection, ingestion of chemicals, and other genetic factors.

Different types of dental bleaching procedures for teeth whitening are:

1. Vital tooth bleaching:

Vital tooth bleaching is when a chemical solution is applied to the tooth surface to achieve a lightening effect.  Below are three common types of techniques.  They are dentist-applied or patient-applied bleaching methods.

a. In-office or high power bleaching

Here you have to rely on the dentist who has complete control throughout the procedure and stops when the desired color or shade is desired or achieved.

b. At-home or dentist supervised night-guard bleaching

The patient usually does this treatment and managed by the dentist regular visits. It is the most widely used technique. Here the low concentration of whitening agent is used, (10–20% carbamide peroxide which is equal to 3.5–6.5% hydrogen peroxide).

c. Over-the-counter (OTC)  Bleaching or Whitening

OTC has increased in recent times.  They are gum shields, strips or paint-on products. Usually applied twice a day for two weeks and self-administered and highly questionable on safety.

2. Non-vital bleaching techniques:

Usually performed by the dentist in the dental office; non-vital tooth bleaching is when the dentist uses strong peroxide agents and high concentration of hydrogen peroxide. When executed effectively, non-vital or internal tooth-bleaching is used to lighten a discolored tooth that previously received root canal therapy.

To remove teeth discoloration, a chemical oxidizing agent is placed within the interior portion of a tooth.

a. Walking bleach and modified walking bleach

Advantages over other treatment options such as full veneer crowns.  It is less time consuming and economical.  A bleaching agent is placed inside the tooth.  A temporary filling is placed for protection, and this allows the bleach to work for one week. 

b. Non-vital power bleaching

Also known as non-vital whitening is a whitening procedure or technique done on a tooth that has had a root canal and it is dead.  The stain is from inside, so it needs a dentist to drill and place a whitening agent inside. The bleaching material is removed after the desired color is achieved and a white composite filling is used to replace. 

c. Inside/Outside Bleaching Technique

In this technique, bleaching takes place within and outside the tooth simultaneously. The gel is placed on the internal and external of a non-vital, root filled or discolored tooth and refreshed regularly.  

Teeth Whitening procedures primarily happen in the following ways:

1. In-Office Whitening

In-office care is recommended for the most dramatic results. A whitening gel with a much stronger concentration of peroxide is used to achieve the best results.  The dentist uses products that are in combination with heat, a special light, or even a laser. In just thirty to sixty minutes of treatment, results are achieved and are visible. Sometimes, several dentist appointments may be needed depending on the level of severity. 

2. Home-whitening with custom fabricated trays

One of the most recognized and highly used is at-home whitening with specialized custom trays made by the dentist who uses a replica of patients own teeth.  Usually applied overnight, the gel is of varying percentages of hydrogen peroxide or carbamide peroxide. 

3. Over-the-counter products

Many teeth whitening products are available on the counter, from different kinds of toothpaste, over-the-counter gel, rinses, strips, trays, and whitening products directly from the dentist. Gels are peroxide-based, applied with a small brush directly to the entire surface of the teeth.  Strips are thin virtually transparent and invisible coated with peroxide-based whitening gel. The over the counter strips are recommended over gels because they stay in place. Rinses or mouthwashes generally used to freshen the breath are also sometimes used to whiten teeth.  A whitening rinse contains ingredients such as hydrogen peroxide which helps whiten teeth.

4. Do-it-yourself (DIY) whitening

Several homemade solutions, from baking soda to coconut oil are used to mix with small amount of hydrogen peroxide which is very useful. Apple Cider Vinegar a household product has natural whitening properties. Usually, the apple cider is used with baking soda for a period of weeks to see the whitening results. Coconut oil with crushed peppermint leaf is applied and since it has stain-decreasing properties which help remove some surface bacteria that yellows teeth, many people use it.  Coconut oil’s pleasant taste is a popular choice.  To scrub away surface stains backing powder brushing helps.  A diet with fruits and vegetables is not only good for health and body but also your teeth. Particularly strawberries and pineapples have been claimed to help whiten teeth. Whitening teeth with strawberries and baking soda mixture is useful to remove mild stains.  Brushing with charcoal, rubbing orange and lemon or banana peels on your teeth is claimed to make teeth whiter. Brushing twice a day coupled with flossing will undoubtedly make a difference in maintaining the whiteness of the teeth.  

How long does it take for the process of Teeth Whitening?

The duration for teeth whitening treatment varies among different people. Tooth whitening treatment is a gradual process and could last a few weeks or months to achieve the desired result. The time may vary with the amount of the decoloration of the patient’s teeth. The dentist would generally take 30-90 minutes per visit, and there can be one to ten visits over some time. 

How to prevent teeth your teeth from discoloration?

Brushing after every meal will help prevent some types of stain. The dentist usually recommends that you rinse your mouth after every cup of coffee, tea, wine or other liquid drinks that can stain your teeth.  Regular cleanings in the dental office help prevent surface stains.  To keep it bright avoid smoking and drinking dark-colored beverages and minimize taking food where food colors are used. Brushing with fluoride toothpaste morning and before bed at night and flossing daily to remove dental plaque thoroughly is a good habit. Oral hygiene habits promote healing of mild gingival inflammation. 

Teeth whitening or bleaching to make teeth brilliant white is a normal dental treatment which boosts your confidence significantly.  It is a form of dentistry and must be carried out by a dentist in a professional way. However, Teeth whitening is not permanent. Continuous oral care is a must if you want to maintain those white and bright teeth after your teeth whitening procedure.

When you visit Dr. Mohamed Ali at our San Francisco office, he will thoroughly examine your mouth and will present you different options and also advise you on the best option, suited for you. The billing experts will check your insurance benefits and offer a complete treatment plan with the financial arrangements. We accept all major dental and medical PPO insurance plans. We also have an in-office Plan For Health for those who don’t have insurance. Additionally, we have partnered with various financial institutions like Care Credit, The Lending Club, Healthcare Finance Solutions to make your treatment extremely affordable. We will be happy to answer all your questions. So just sit, relax, and get your teeth whitened. To schedule your free consultation, call us at 415.391.7751.

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