Summer is a time I see an increased demand for cosmetic dentistry, often due to weddings and family photos. Teeth whitening is the most common cosmetic procedure in dentistry and can be a safe and effective way to brighten smiles and improve self-esteem.
Teeth whitening has a long history but advanced greatly and gained popularity in the past 30 years. In this article, the different options will be briefly reviewed.
Whitening toothpastes are the most common method of teeth whitening. All toothpastes will help remove surface stains from items such as coffee, tea, and wine. Whitening toothpastes are typically more abrasive and have extra chemicals added to make teeth look whiter. The abrasiveness can be damaging and only a few fall into the safe category on the ADA abrasiveness scale. Opalescense Whitening and Arm and Hammer Whitening are the safest available currently. The effectiveness of whitening toothpastes varies greatly but typically is minimal. However, it is the easiest and most cost-effective option if it works for your teeth.
Natural teeth whitening can include anything from baking soda, charcoals, or apple cider vinegar. These options are usually inexpensive and have mixed results. There is a risk of damage to teeth, especially with acidic an abrasive whitener such as charcoal. The effectiveness of most of these techniques will be like that of whitening toothpastes.
Modern teeth whitening uses the chemicals of hydrogen peroxide and carbamide peroxide. These chemicals oxidize discolored molecules in the two outer layers of your teeth, the enamel and dentin to lighten them. The enamel is the thin outer layer that is lighter and more transparent in color. Enamel wears thinner as we age due to both routine chewing and due to external abrasiveness, such as brushing, grinding, or acid erosion. The next inner later is dentin, which is naturally darker than enamel, so the thinner the enamel layer the darker your tooth appears as the dentin shines through the transparency of the enamel.
Over the past few decades, several different methods to allow the hydrogen and carbamide peroxides to remain chemically stable and sticky enough to work effectively. Currently there are numerous over the counter and professional options available.
Over the counter options include Whitestrips, which are the most common, and many other variations of whitening gels. The strength of the over-the-counter products can be effective but typically take longer with more treatments with shorter lasting results. Several of these products are marketed with lasers or special whitening lights. This was an early claim for professional whitening products before studies showed the lights had no long-term effect. Lights used during whitening dehydrate teeth making them look whiter initially, but after a week of rehydrating there is no difference in results. All long-term whitening comes from the chemicals so be careful when you see immediate before and after photos.
Professional whitening costs more but typically have quicker and significantly better results that last longer. There are custom whitening trays, semi-custom whitening trays, and in office treatments that most cosmetic focused dental offices provide.
As you consider teeth whitening, you should be aware of potential side effects. First, the most common complaint with teeth whitening is sensitivity. It is advised to use a sensitive toothpaste before and after you decide to whiten and follow the instructions. Another potential pitfall is whitening teeth and not considering existing dental work. Fillings and crowns will not whiten; therefore, you could cause your teeth to stand out and require replacing dental work to match the whitened teeth. Even though whitening is generally safe and effective, it is best to discuss with your dentist or hygienist before beginning.
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