Teeth Whitening: Yes or No?
Have you ever desired having bright smile like the models in toothpaste commercials?
Have you always wanted to try teeth whitening but hesitated because you were not sure of what to expect?
Well, you’re not alone.
All of us want to look presentable. In fact, nice teeth can help to complement our flawed complexion.
So let’s see what are the things you need to know before jumping the beauty wagon.
How does teeth whitening work?
The main active ingredient in tooth whitening material is a chemical called hydrogen peroxide/ urea peroxide. During oxidation, hydrogen peroxide breaks up and releases free radicals to break down stains on your teeth into smaller molecules.
These molecules have higher surface area to reflect more light, making your teeth brighter. Tooth whitening materials can be applied externally on the surface of teeth, or used internally within a cavity created in the desired tooth.
Why are my teeth stained?
To determine the type of whitening method that suits you, you need to know what caused your teeth to be stained.
Intrinsic staining is incorporated in the tooth while it’s still developing or has already erupted into mouth.
- Fluorosis: If you could remember yourself enjoy swallowing the toothpaste while you’re under 8 years of age, you’re at risk of having a condition called Fluorosis, where your teeth appear white and chalky, or if more severe, they could appear brownish and porous.
- Medication: Tetracycline or minocycline are examples of most common causes of medication-induced teeth staining and are not recommended these days for teeth-developing children.
- Disorders/ Diseases: Erythroblastosis fetalis (bluish/greenish), Jaundice(yellow-green), Porphyria (brownish-red),etc
- Genetic: Amelogenesis imperfecta, Dentinogenesis imperfecta,etc
- Filling material: Silver filling called amalgam might cause shadowing of your teeth.
- Tooth decay: Your teeth might appear brownish to blackish if you have decay.
Extrinsic staining is relatively easier to be removed if it’s not severely affected. It involves food particles which bind to the layer of plaque on your teeth surface and through microscopic cracks and fissures.
You’ve probably known that certain food and beverages such as coffee, tea, wine, berries and artificial colour containing food can stain your teeth.
If you’re a smoker, it’s not surprising that tobacco is the culprit that jeopardises your bright and clean-looking smile.
What are teeth-whitening products available now?
1. Over the counter : Whitening Toothpaste
These whitening toothpastes in the market contain only mild abrasives which remove MILD EXTRINSIC stains. It does not alter the original shade of the teeth. They might contain a very low concentration of hydrogen peroxides. Hence, the outcome is often slow and less noticeable.
The same can be said about whitening strips found in your local drug stores which yield much less effectiveness compared to the following products:
2. At-home Whitening
At-home whitening products are far more effective as it contains higher concentration of whitening material such as 10 to 20 % carbamide peroxide. It usually comes in the form of gel/paste in a custom-fabricated tray. The product operates under different systems (eg.Opalescence) depending on the manufacturers.
If you prefer to do it at home in your own comfort, you should consult a dentist prior to starting the procedures. Then, you can get the custom-made tray and apply the gel according to instructions. The process usually takes 1 to 2 hours (some products can be left overnight) and can be repeated until the desired shade is achieved.
The downside of this method is that it is time-consuming and may take up to a week to notice the results.
3. In-office Whitening
In comparison to at-home whitening, teeth whitening done by the dental professionals is more efficient. This is because it takes only about 15 minutes of application and the process can be repeated until you’re satisfied.
The results will be obvious within 1 hour. This is due to the much higher concentration of hydrogen peroxide (20 to 40%) that is only allowed to be applied by dental professionals. The whitening effect can last up to 3 years if you take the necessary precautions such as avoiding exposure to tobacco, coffee or tea.
Internal tooth whitening can be performed by dental professionals in cases where the tooth has “died”, ie. dental pulp has become non-vital or necrosed. This usually happens in traumatized tooth which is stained pinkish or grayish as the hemoglobin breaks down. It can be bleached after the root canal has been cleaned (root canal treatment completed) until maximum result.
What to expect after whitening?
Before you start thinking of whitening your teeth, there is a few things you have to be aware of. Dental fillings and decayed tooth CANNOT be whitened through any over the counter (OTC) products, at-home or in-office whitening.
You can only have the decayed tooth extracted by your dentist and replace it with tooth-colored fillings. You should never eliminate the discolouration via teeth whitening. Similarly, discolored non-vital tooth CANNOT be bleached without a proper root canal treatment followed by internal bleaching.
Also, you can NEVER alter the natural shade of your teeth by whitening it. With that said, if your teeth shade is yellowish in nature (when your outer teeth layer(enamel) is thin,the yellow shade from the inner layer(dentin) gets reflected more), you can’t expect your teeth to shine bright like a diamond after using the whitening products once.
In more severely stained or brittle teeth, other alternatives such as microabrasion, macroabrasion, crowns or veneers might be more suitable treatment options.
What are the side effects of teeth whitening?
Some of you might have heard of myths that teeth whitening may jeopardize the strength of teeth and cause sensitivity. The saying is not entire wrong. In fact, 75% of the patients have encountered sensitivity to varying degrees,especially when the teeth are in contact with cold beverages.
However, the sensitivity is transient and may only last up to 3 days. It will not cause any serious harm to the pulp (which contains nerve endings). You can avoid this through anti-sensitivity toothpaste which contains potassium nitrate and sodium fluoride.
- Gum/GI irritation
Gums may turn white colour if the whitening gel seeps through it. But the effect will resolve itself within 3 hours. You can avoid this by cleaning the excess gel off the tray.
Remember to not overfill it and make sure the tray fits. Rarely, irritation of stomach lining occurs if the gel is ingested.
How do I avoid them?
Firstly, try to apply the gel for shorter period if you’re using the products at home. You can begin by putting on the whitening gel in tray for 1 hour, slowly increasing the duration,and eventually leave it overnight (based on manufacturer’s instruction).
Next, try to keep longer time intervals between your whitening sessions. If you’re starting off on Monday, have the subsequent session on Wednesday to lengthen the exposure interval and minimize sensitivity. Once you’ve found your pace, feel free to repeat the procedures until the shade is up to your expectation.
When you’ve owned the perfect smile,don’t forget to flaunt it!
About the author
Dr.Heng (DDS U.K.Mal) is a dental practitioner who graduated from the National University of Malaysia (UKM). She is deeply passionate about dentistry and finds satisfaction in restoring dental health of her patients. She is now serving the people in a remote area in Penang, Malaysia.