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Teeth Whitening. The Good. The Bad and the Evil.

Tuesday, May 4, 2010

The world is full of teeth whitening products. So, we chose to write this blog to answer some of the most commonly asked questions are our clinic (Aria Dental Studio in Vancouver)

Which are the best whitening products to use? Drug store versus Professional office kits/procedures?

Which one causes more sensitivity? Do they all cause sensitivity?
Is it bad for the teeth?

First off, let’s talk about why people want whiter teeth. Most people aren’t aware of the subconscious reaction they get when they see a beautiful white smile. They just think it’s a beautiful smile but may not pin point exactly what makes it beautiful.

White teeth are considered beautiful because they are associated with good health and youth.

There are different types of stains that can discolour our teeth:

1) Superficial stains: that can be removed by brushing or polishing before they become set into the enamel. They are caused by coloured foods or drinks (ex. Red wine, chocolate, beef etc)

2) Deep Stains that have sunk below the enamel and cannot be removed by polishing or brushing but can be removed with hydrogen peroxide. They are also caused by foods and drinks we eat but if they are not removed immediately from the surface of the tooth they get into the matrix of the enamel and can only be removed by hydrogen peroxide.

3) Inorganic stains are stains that are incorporated into the structure of the tooth while the tooth was developing, they may be caused by certain medications or fluoride that were ingested by the pregnant mother or the child as the teeth were in the development stage. These are stains that cannot be removed by whitening products (some tetracycline stains will fade with repeated in home hydrogen peroxide treatments used over long periods of time). There is still hope for these types of stains as they can be dealt with by the dentist by either placing bonding or veneers.

So, it’s important to ask your dentist what type of stains you have before going ahead and trying to whiten your teeth. It’s also important to brush and floss after eating and drinking to avoid staining your teeth as much as possible. Also, keeping regular hygiene appointments where your teeth are polished will also keep your teeth at their brightest.

Breaking down the products:

1) Whitening toothpaste: most toothpastes that claim to whiten your teeth contain a pumice like material to polish your teeth as well as titanium dioxide (which reflects light). The pumice like material works to polish off superficial stains while the titanium oxide will give a reflective light thus creating the illusion of whiter teeth.

a. The pros: very affordable in comparison to any other product, toothpaste + whitening promises into one product

b. The cons: the pumice like material is harsh on your enamel. The more you use this product the more of your enamel you brush off therefore exposing the more sensitive part of your teeth which is right under the enamel. Also, the titanium dioxide is not safe to ingest in large amounts and will not provide any true whitening effect.

Our conclusion: save your money for something better!

2) Whitening Strips or brush on from the Drug Store: they claim to contain a very low, un-labelled or undetermined concentration of carbamide peroxide.

a. Pros: cheaper than the in office or professional take home kits cost about $30-50 versus $100-500 in office or professional grade take home kits. May provide some whitening action if used correctly over a very long period of time.

b. Cons:

i. Very low efficacy. The concentration of carbamide peroxide is very low and then breaks down to the active ingredient hydrogen peroxide yielding even less of the active ingredient needed to whiten the teeth.

ii. No Desensitizers provided into or incorporated with the product. So, if you have sensitive teeth you will have to either purchase desensitizer from your dentists’ office or keep rubbing sensodyne or orajel on your teeth

iii. Must be used long term to see results, thus; prolonging sensitivity. You will need to pay for a few kits before seeing very little results.

iv. No Dental Assessment. If you have any cracks or hairline fractures in your teeth that aren’t detectable by you, you will experience extra sensitivity or damage to the pulp of your teeth. Only a dental professional can properly assess your teeth and recommend the type of product and concentration of hydrogen peroxide.

Our conclusion: proceed with caution.

Professional Grade Whitening products contain higher concentrations of hydrogen peroxide ranging from 6-9% to about 35%.

The procedure goes as follows:

1) Assessment of your teeth:

a. Determining your current shade on the shade chart

b. Determining the type of stains you have

c. Providing you an estimate of how many shades lighter you should expect to see

d. Ruling out any contra-indications to whitening

Zoom Whitening:

a. This is a very powerful way to get teeth to whiten by up to 8 shades in one office visit

b. It is a 1.5 hour session performed at our office by the dentist

c. The procedure involves the following steps:

i. Isolation of your gum tissues by the dentist using liquid dam as well as guaze and mouth retractors

ii. Polishing of your teeth by the dentist – freshly polished teeth allow better penetration of the hydrogen peroxide into the enamel and therefore better results!

iii. Hydrogen peroxide application by the dentist

iv. The Zoom Advanced Power Light Activation to synergize the way hydrogen peroxide cleaves the stains on your teeth – this is much more powerful that hydrogen peroxide gel alone. This occurs in three to four 15minute light sessions until we achieve the desired result

v. Application of desensitizer

vi. Take home after care instructions

2) Take home whitening kit: contains professional grade hydrogen peroxide concentration. It is a lower concentration than the in office system; however, still contains a higher concentration than drug store brands as well as a specified concentration unlike the drug store brands. Some of the products we carry even contain a desensitizer for those who have sensitive teeth unlike the drug store brands. The product is to be applied daily for about 14 days to achieve about 4-6 shades difference than your starting shade.