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Teeth Whitening: What Works and What Doesn't

Aug 16, 2012
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Last Updated 8/16/2012 - Teeth whitening has become the most popular cosmetic procedure in the world for people who want to look younger, more confident and attractive. However, it's important to understand that this popular practice has its own limitations and drawbacks and, in fact, is not for everyone. Women who are pregnant or nursing are advised against whitening, as are people who are suffering from gum disease. Whitening is also not recommended for people with cracked teeth or cavities in the areas that they want to be whitened. And, of course, it's also important to remember that most teeth whitening procedures only work with natural teeth; veneers, crowns, bondings and fillings don’t usually respond to whitening agents.

So, if you can whiten your teeth, how white will they be? Results are subject to their existing undertone. Most people have a slight undertone to their smiles ranging from palest yellow, to palest brown to palest gray. According to the American Dental Association, people who have a yellow undertone have higher degrees of whitening success than people with a brownish undertone. For people with gray undertones, however, there's some disappointing news. These teeth are generally the least responsive when it comes to bleaching. (Exceptions occur, however, so speak with
your dentist).

Ideal bleaching candidates are those whose teeth have discolored or stained due to the consumption of tea, coffee, wine or cola. Dentists can also help people with stains or discoloration caused by either genes or antibiotic use, but results may not be as dramatic. Dentists say that they can frequently lighten such stains, but not as much as many patients would like.

So, if you’re a good candidate for tooth whitening - what works and what doesn’t? Here's a rundown featuring do-it-yourself methods and professional procedures.

Do-It-Yourself Whitening Toothpastes

Over-the-counter teeth whitening toothpastes are the most popular whitening products around, but the truth is “you get out of it, what you put into it.” The success of any teeth whitening technology lies primarily in the amount of time the teeth are in contact with a bleaching agent - and the concentration of the bleaching agent being used. Since toothpastes contain a very low concentration of bleach and remain on the teeth for mere minutes - or even seconds - they deliver only a small degree of visible change under ideal circumstances.

What's available in the market?
Today, many oral care brands have their own versions of whitening toothpastes, such as: Crest Extra Whitening toothpaste, Rembrandt Whitening Toothpaste and Colgate Whitening Toothpaste. The companies that manufacture these whitening pastes do not make false claims, and consequently, promise only modest whitening results.

How do whitening toothpastes work?
Almost all the whitening toothpastes work on the same principle. They use hydrogen peroxide or other whitening agents in very small quantities to gently remove surface stains caused by tea, coffee, wine, etc.

Some dentists believe that teeth whitening toothpastes are a complete waste of time and money and aren’t any better at whitening teeth than ordinary toothpastes. Other dentists believe that whitening toothpastes can help improve the color of teeth, albeit to a very small degree. However, in some cases, people do experience considerable improvement in their tooth color, largely due to individual dental characteristics. Overall, however, the whitening results obtained from teeth whitening toothpastes are almost negligible.

Do-It-Yourself Over the Counter Whitening

If you’re looking for more dramatic results than those delivered by teeth whitening toothpastes, then you’re apt to consider Over-The-Counter Whitening, such as Crest 3D Whitestrips Intensive Professional Effects. These products feature mouth trays, whitening strips or paint-on applications - and are widely available at grocery, drug and discount stores nationwide.

How do they work?
While more expensive than teeth whitening toothpastes, these inexpensive whitening options (compared to dentist-prescribed whitening solutions) typically involve the use of a low-concentration bleaching gel with detailed, daily use instructions that you follow at home. You'll wear the trays, strips or painted-on bleach for up to 60 minutes a day (in two or more individual applications) and for the suggested period of time - 1-2 weeks depending on the product.

Most people with simple surface stains will experience a multi-shade change, primarily on their front teeth. While the technology of at-home over-the-counter whitening is designed for ease-of-use; most people will find it very difficult to follow the directions exactly, particularly with regard to reaching and whitening the back teeth.

Kiosk Whitening

Kiosk whitening is a blend of do-it-yourself and "professional" whitening techniques that's currently under intense criticism from both many state dental boards and the American Dental Association. You'll find whitening kiosks in malls all over the country and they claim to offer "professional results" at a fraction of the cost of in-office bleaching techniques.

How do they work?
Kiosk whitening is "legal" because you do most of the work yourself. You’ll first be given the materials to make an impression of your own teeth. When the trays are ready, you’ll then fill them with a peroxide bleaching gel (less concentrated than the strengths prescribed by dentists). You’ll then insert the trays into your mouth, followed by application of the accelerator lights by the whitening assistant.

Most kiosk whitening franchises will not make a claim about how much whiter their procedure will make your teeth. Some, however, say that their procedure will work on up to 93% of people. Again, the procedure works best on the best whitening candidates.

Because whitening kiosks aren't staffed by people who've undergone any accredited dental training, there is no real screening involved to eliminate unlikely whitening candidates. So while someone with severe stains may not experience any whitening - someone with cavities, cracked teeth or serious dental disease may actually experience pain, or worse. Read more about kiosk whitening in this article:Teeth Whitening at the Mall. Unsafe, but is it Illegal?

Professional Take Home Trays

Take-Home Tray Whitening is tooth whitening in a kit that can be used at home, usually under the supervision of a dentist. Dental-supervised tray whitening is very effective and is considered the "gold standard" in its class.

How do these kits work?
Dentists make a mold of your teeth in the office and then have custom-fitted trays created to fit each arch of your mouth. When you’re home, you fill the trays with a peroxide bleaching gel and place them over your teeth. The concentration of peroxide will determine how long you wear the trays and how quickly you achieve results. Some people use the trays for 30 to 90 minutes a day over a two-week period, while others wear the trays overnight for 1 to 2 weeks. During this period, dentists check for any sensitivity to the gel.

The results obtained from such kits usually last for years. If the teeth start staining again, re-touch bleach will help restore teeth to a whiter shade.

Bottom Line: Although professional take-home tray whitening are very time-consuming, they offer good, long-term results. In general, Take Home Tray Kits are more effective than any other home whitening treatment, and are less expensive than in-office whitening treatments. Read more about whitening trays here.

Professional In-Office Whitening

Dentist-administered in-office bleaching is the quickest, easiest and least painful method of teeth whitening. But it is also the most costly way of dramatically improving your smile.

What is In-Office Bleaching all about?
Today, there are two primary types of in-office bleaching - light-activated bleaching and non-light activated. Light-activated procedures (Zoom, Sapphire etc.) claim to produce a 9-shade improvement in 60 minutes with the use of a laser or LED-powered light.

Non-Light Activated bleaching systems (e.g. Pola Office+, Opalescence Xtra Boost) eliminate the light and use advanced bleaching gels with a variety of procedures. Non-light activating whitening can occur in a single office visit.

Generally speaking though, dentists appear to be moving away from light-activated whitening - due to a number of reasons: lack of supporting clinical data, the expense of lights and concerns for patient safety.

Advantages: There are various advantages to in-office treatment as opposed to other forms of teeth whitening. Dentist-administered whitening procedures permit higher concentrations of bleach and can assure proper bleach contact with teeth - improving the chances of maximum whitening.

Results: The results of in-office whitening can last up to several years. Usually it lasts for about 3-4 years, although Deep Bleaching has been known to last 5+ years. Some people have reported the loss of one shade in about 6 months. However, maintaining the color is easy by using recommended toothpastes and mouthwashes.

In-Office treatments are painless for most, but can cause some increased sensitivity to the gum line for some. (Dentists recommend treating sensitivity with Tylenol). The average cost of an in-office teeth whitening treatment depends on your area, dentist and choice of method (anywhere from $500 to $1500+) and usually include the price of aftercare products like toothpaste and mouthwash.

Bottom Line: If you want good results in a very short time and are willing to pay for it, then in-office whitening treatments are for you. All you have to do is select the right dentist and method for your needs.

Reviewed by Dr. Alan Zweig
Dr. Alan Zweig runs a private dental practice in Beverly Hills, CA. With over 30 years of experience in cosmetic dentistry, Dr. Alan Zweig is a teeth whitening veteran. He’s been trusted by major celebrities, business leaders, and patients from over six different continents.

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