Tooth whitening
Advice for patients considering tooth whitening.
Background.
We provide this information to give you an insight into professional tooth whitening. Your co-operation and understanding of this material is necessary as we strive to achieve the best results for you. The safety of professional tooth whitening is generally very high but like all professional healthcare there are limitations and risks (which will be discussed later), and absolute success is variable and cannot be guaranteed.
What is tooth whitening?
Dental bleaching or tooth whitening is a method of lightening the colour of natural teeth. The colour of teeth varies between individuals and at different ages - teeth can gradually darken naturally over time. Tooth colour is influenced by a person’s genetic make up and by any surface stains or deposits in or on the teeth. If teeth are dark due to external stains or deposits they will need to be cleaned before tooth whitening is undertaken.
Candidates for professional tooth whitening.
Eligibility for treatment is determined through information you provide on this questionnaire and is gathered during your consultation and screening. While many individuals will qualify for treatment, not all people are deemed candidates for the procedure. If this is the case the dentist will discuss their finding with you and advise on other possible treatment options.
Different techniques available.
A gel, normally carbamide or hydrogen peroxide, is used to whiten teeth. Chlorine Dioxide whitening products are never used in this practice as they strip the surface off the teeth, making the teeth much more prone to further staining.
We offer 4 different tooth whitening procedures:
1 - Whitening Strips. The brand of whitening strips we use have been tried by ourselves and have proved easy to use, stay firmly in place when fitted and they can even be used “on the go”. Other strips we found were difficult to place and moved around as they did not stick to the teeth. The adhesive strips containing the active ingredients are applied to the teeth as per the detailed instructions and left in place for 30 minutes. Patients are initially supplied with 14 days of strips. The teeth will become gradually lighter over time. Results may vary depending on the initial darkness of the teeth and some patients may need to purchase further strips to extend the treatment time to get the required result over a longer period or to top up the result already achieved.
2- Tray Systems. Impressions are taken of your teeth to make a flexible whitening tray (similar to a very thin gum shield) that fits over and around your teeth. The gel is placed in the tray and worn as advised by the dentist, usually over night for a number of nights. The teeth will become gradually lighter over time. A course of treatment takes a variable number of weeks and results may vary depending on the initial darkness of the teeth, the concentration of the gel used and the frequency of application. As all whitening treatments fade over time we recommend following treatment you purchase further whitening gel to allow you to top up the new colour of your teeth and keep them looking as bright as they were when you finished your whitening treatment.
3- Enlighten System. Impressions are taken of your teeth to make a more specialised whitening tray. This tray is constructed differently and helps keep more of the gel in the tray and thus give a more predictable result. This tray MUST be worn every night for 14 nights and the gel used conditions the teeth for the second stage. On the 15th day the dentist or hygienist then uses the same tray to place a different and higher concentrate gel on the teeth for 20 minutes and then repeats this for another 20 minutes. This system guarantees to get your teeth to shade B1 though it may take longer with very dark teeth than the time scale just discussed. As all whitening treatments fade over time we recommend following treatment you purchase further whitening gel to allow you to top up the new colour of your teeth and keep them looking as bright as they were when you finished your whitening treatment.
4- Britesmile Power Whitening. You attend for an appointment where your gums are isolated using special materials. A gel is placed directly onto your teeth and a special high intensity light focused on the teeth for 20 minutes. This is then repeated up to three further times (all in the same appointment) with the appointment taking between 90 minutes and two hours to complete. No home treatment is necessary using this technique. As all whitening treatments fade over time we recommend following treatment you purchase either whitening strips or better still whitening trays. Either of these systems can be used to top up the new colour of your teeth and keep them looking as bright as they were when you finished your whitening treatment.
Is it safe and what are the risks?
Tooth whitening is the safest thing to do to teeth apart from doing nothing. There is a risk that the whitening process will not work quickly and the dentist will discuss the possible reasons why this might not work particularly well or why it might take longer than average. Not all teeth whiten to the same extent, particularly deeply discoloured teeth. Some teeth lighten more effectively or more quickly than others. Teeth which are already quite white only lighten a little further. Some teeth do not whiten evenly. This can be a problem where the gum has receded and the darker root surface is exposed. Such teeth or worn teeth can become sensitive with whitening. Certain types of tooth discolouration do not respond easily and require special treatment by a dentist. Fillings, veneers, crowns and bridges that match the existing teeth will not change colour with whitening. The cost of replacing these so that they match the new lighter colour of the natural teeth can be considerable and must be discussed with the dentist before whitening is undertaken. Extensive clinical data continues to support the safety and effectiveness of tooth whitening but during the process teeth may become sensitive for a period of time. This is usually only temporary and a fluoride gel or special sensitive type tooth paste can be placed in the tray and worn for up to 30 minutes before and after each whitening period to minimise the sensitivity. Temporary irritation of the soft tissues in the mouth, particularly the gums, is rare but can occur if too much gel is loaded into the trays. The dentist will advise how to help avoid this problem.
How long does the lighter appearance last?
Teeth that have been whitened have a tendency to eventually return to their original colour. The time this takes depends on a patient’s diet and whether they smoke. The colour obtained would be expected to be maintained for between two and four years but patients who regularly eat darker foods and smoke will darken their teeth more quickly. Teeth will require to be “topped up” from time to time. Patients can purchase further whitening strips, Britesmile pens or tubes of gel and use their original trays when required to maintain the desired whiteness. Because the gel used in the whitening process, when exposed to air, degrades fairly rapidly we now provide gel in sealed compules, pens or strips to prolong its shelf life.
What is the current legal situation?
Under European legislation, brought out to control hair bleaching by hairdressers, certain products containing hydrogen peroxide cannot be supplied for cosmetic purposes because of “cosmetic regulations”. Most European countries are agreed that these products should be available to dentists. Changes in European Laws are anticipated but have not yet taken place. Meanwhile supervised whitening techniques are widely used throughout the world. Tooth whitening materials are perfectly safe when used under professional supervision.
