The easiest stains to remove are also the most common. These are the result of external factors, such as drinking coffee or tea and smoking. Also, teeth tend to get slightly more yellow as we age because of changes that occur within the dentin (the layer under the enamel) that can be seen through the enamel. Whitening is most effective and generally quite successful on these types of stains.
Other types of stains result primarily from internal factors, such as stains from tetracycline use or too much fluoride during the tooth forming years. The gray and black discoloring that results from these factors are much harder to successfully whiten.
There are both in-office and at-home whitening options available. Most whitening products use the same whitening agent, carbamide peroxide, though the concentrations will vary, depending on the process and product used.
In-office procedures use stronger whitening agents and/or a light source to speed up the whitening process. These methods produce the quickest results but are also the most expensive whitening options. Products containing more than 15% peroxide should only be used in a dental office where the process can be monitored.
The at-home option generally takes several days to a couple of weeks to complete, allowing for a slower, more gradual shade change. For this method, your CDA member dentist will take an impression of your mouth and fabricate a custom-made tray to hold the whitening solution. You will receive instructions on the proper method for placing the solution in the tray and the length of time to wear it for each whitening session. Usually, each session lasts just a couple of hours.
While there are several over-the-counter (OTC) whitening products that claim to whiten your teeth, it is best to complete the whitening process under the guidance of a dentist. In some instances, whitening would not be recommended, and your CDA member dentist is best able to advise you if your teeth and gums are healthy enough for whitening to be safe and effective. Also, as cosmetic products, OTC whitening agents are not regulated so do not undergo the same governmental oversight as medical devices or drugs do.
If you decide to use an OTC whitening product, the ones offered by large, well-known manufacturers have a good record of safety and efficacy, though they use lower peroxide concentrations and results will take longer than the products your CDA member dentist may offer.
For OTC whitening systems that rely on a tray to hold the whitening solution, often the tray is not custom-fit enough to hold the solution in place and prevent it from running out onto gums or from being swallowed.
Whitening toothpaste often resorts to abrasives to keep teeth clean and whiter. However, frequent use of high abrasives on tooth enamel usually results in excessive enamel wear and less shine and luster over time. If these products are used at all, they should be used with care.
If a whitening toothpaste does contain a peroxide ingredient for whitening, the amount of time the toothpaste contacts the teeth is generally much too short to provide muchwhitening effect. These products are most useful in maintaining a whiter color once it has been achieved through a more effective whitening method.
Always consult your CDA member dentist before you use an OTC oral care product to make sure it will be safe and effective for your situation.
Mild tooth sensitivity is a somewhat common side-effect of whitening. This can be reduced with the use of prescription-strength fluoride gels, though not everyone needs this. For most people, sensitivity usually lasts only a few days. Your CDA member dentist will advise you on the appropriate steps to take if your teeth become sensitive during the whitening process.
Additionally, the whitening solution may irritate your gums so be sure to wipe away any excess solution. Custom-fit trays and avoiding overfilling the tray will help prevent excess solution runoff.
Whitening is very effective for many people. However, your teeth and gums should be healthy before whitening. Consult with your CDA member dentist to discover the safest and most effective tooth whitening method for you.