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All about Tooth Whitening When used appropriately, tooth whitening is a popular, simple cosmetic procedure that can rapidly enhance your smile. WHAT CAUSES TEETH TO DISCOLOUR? SURFACE DISCOLOURATION: This type of discolouration is due to a build up of staining on the outer surface of the tooth structure e.g. tea / coffee, tobacco, and some medications e.g. Corsodyl dental gel. It generally affects all teeth Surface staining can usually be simply removed by a scaling and polishing procedure with the hygienist. Regular visits to the hygienist can prevent this staining recurring and help keep your teeth in good condition. Use of whitening toothpaste can help prevent the return of this type of staining. INTERNAL DISCOLOURATION: is due to an accumulation of staining within the tooth structure itself. This can be due to abnormalities of tooth structure during their development e.g tetracycline staining, dental fluorosis, or from a lifetime of heavily staining food, drinks e.g red wine, black coffee and habits e.g. tobacco use. It generally affects all the teeth. Teeth also darken naturally with age due to thinning of the enamel and thicker dentine layer within the tooth, which makes them appear darker in colour. Internal staining can occur in individual teeth usually when the nerve supplying the tooth has been damaged e.g. sports accident. Internal staining can now be reduced using tooth-whitening procedures to make your smile brighter. Details of these procedures are outlined below. WHAT TYPES OF TOOTH-WHITENING SYSTEMS ARE AVAILABLE TO ME HERE IN THE UK? There are different tooth whitening systems available on the market to be used in dentistry. Restrictions in the UK allow dentists to offer a limited range of systems compared to other countries e.g. USA. · Single visit in office tooth whitening e.g. Britesmile, Luma arch [not available at Smile] This involves the single application of a strong whitening gel to the teeth for 1 hour whilst in the dental chair. The whitening gel is usually activated with a strong light. This treatment costs approximately £750. This method seems appealing and convenient but has many disadvantages. Results are initially good. However, research has suggested that most of the whitening effect that results at the end of the treatment session can be attributed to the dehydration effects of the teeth being isolated from saliva for 1 hour. There have also been reports of marked tooth sensitivity and rebound discolouration of the teeth. Repeat sessions are often needed for lasting results. For these reasons, we chose not offer this treatment at Smile. · At home tooth whitening using trays [available at Smile] This involves having custom-made whitening trays created from an impression of your teeth at a dental appointment. Once your dentist has checked the fit of these trays, you use them to apply a gel to your teeth at home for a fixed period of time (minimum of 4 hours per day). Most patients find application every night most convenient. Treatment time varies depending upon the
intensity and type of staining of the teeth, but usually a marked
improvement can be observed within 10-14 days. Costs for this treatment
at Smile start at £250 for upper and lower teeth. In some
cases e.g. staining resulting from tetracycline antibiotics or certain
types of brown fluorosis, treatment may require more prolonged time
periods, a few months in the most severe cases. What whitens the teeth? The most commonly prescribed gel is Carbamide peroxide 10%. Available research shows this gel provides the most effective whitening with the least side effects. For this reason this concentration of gel is the only officially licensed product for use by UK dentists. Gels with concentrations of 15% and 35% are available for severe staining. Patients who chose to use this gel must do so on the understanding that it is not licensed in the UK but is freely available in the USA, Australia and New Zealand. How does the whitening work? Currently the precise mechanism by which the tooth is lightened is not completely understood. We know that the gel penetrates the tooth and alters the colour of the teeth from within, most likely by a process of oxidation of the pigments. Does tooth whitening damage my teeth? No - Tooth whitening does not appear to have any effect on the tooth hardness or structure. Ten year follow up studies of patients who whitened their teeth have shown no increase in sensitivity, root canal treatments, internal or external resorption of tooth roots compared to baseline patients. Are there any side effects of whitening? Sensitivity – this is by far the most commonly reported temporary side effect. Sensitivity can vary from mild to severe. Using 10% whitening gels compared to stronger concentrations with slow and steady whitening can reduce the likelihood of sensitivity. Desensitising gels can be used to treat undue sensitivity. Sensitivity usually lasts for the duration of treatment, leaving teeth no more sensitive than before. Initial patchy appearance of teeth – teeth vary in colour naturally and may have white spots within them before treatment. At the start of whitening these patches may become more noticeable, the so-called ‘splotchy phase’. This is due to the variation in response of different areas of colour to the whitening gel, some being more responsive than others. These patches generally blend back into the general tooth colour once treatment is completed. Restorations becoming more visible –
Tooth-coloured composite and porcelain restorations are unaffected
by whitening gels. Restorations of this type may become more visible
after whitening treatment. This is usually only a concern at the
front of the mouth. See section below on timing your whitening treatment. When should I have tooth whitening? As restorative dental materials are unaffected by the whitening gel, tooth whitening should always precede any cosmetic dentistry e.g. new tooth coloured restorations, crowns or veneers, especially at the front of the mouth. It is recommended that a minimum 2-week interval exists between the completion of whitening treatment and the placement of any cosmetic restorations to allow optimum shade matching and bonding of restorative materials to the tooth structure. For severe staining e.g. tetracycline, a course of tooth whitening as a first line treatment can reduce the amount of restorative treatment needed. More aggressive treatments can be employed should tooth whitening alone not produce satisfactory results. For patients who have had veneers many years ago, tooth whitening can rejuvenate the cosmetic effect without the need for replacement veneers. How long does it last? Results of whitening are reported to last between 12-24 months depending on the lifestyle of the patient. Stain-inducing habits can cause staining to build up again. You can buy additional gel to ‘top up’ your whitening every 6-12 months. This ‘top up’ may only take one or two sessions. You can reuse your custom trays provided our mouth has not changed shape. We recommend the use of enzymic whitening toothpaste e.g. Janina® or Rembrant®, or Colgate Whitening® to prolong the effects. Can children have whitening? We do not currently recommend that children under 16 have tooth whitening. If you have concerns about the colour of your child’s teeth, please speak to the dentist who can advise you appropriately. What about whitening I can buy over the internet? Products purchased from beauty salons or
over the internet are usually unregulated. Whitening teeth without
first ensuring that your mouth is healthy can cause serious complications.
We do not advise that you purchase o ruse any products bought outside
of a dental surgery. |
 the gentle dental centre |