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Teeth Whitening

Whitening Systems
    Many teeth whitening systems are available, including whitening toothpastes, over-the counter gels, strips and trays, and whitening agents obtained from a dentist. Teeth whitening is ideal for people who have healthy, unrestored teeth (no fillings) and gums. Individuals with yellow tones to their teeth respond best. But this cosmetic procedure is not recommended for everyone.




Whitening Toothpastes
    All toothpastes help remove surface stains because they have mild abrasives. Some whitening toothpastes contain gentle polishing or chemical agents that provide additional stain removal effectiveness. Whitening toothpastes can help remove surface stains only and do not contain bleach; over-the-counter and professional whitening products contain hydrogen peroxide (a bleaching substance) that helps remove stains on the tooth surface as well as stains deep in the tooth. Whitening toothpastes can lighten your tooth's color by about one shade. In contrast, light-activated whitening conducted in your dentist's office (see below) can make your teeth three to eight shades lighter.


Over-the-Counter Whitening Strips and Gels
    Whitening gels are clear, peroxide-based gels applied with a small brush directly to the surface of your teeth. Instructions generally call for twice a day application for 14 days. Initial results are seen in a few days and final results are sustained for about 4 months. Whitening strips are very thin, virtually invisible strips that are coated with a peroxide-based whitening gel. The strips are applied twice daily for 30 minutes for 14 days. Initial results are seen in a few days and final results are sustained for about 4 months. The retail cost for this product ranges from $10 to $55 for a 14-day treatment.


Tray-Based Tooth Whitening Products
    Tray based tooth whitening systems, purchased either over-the-counter or from your dentist, involve filling a mouth guard-like tray with a gel whitening solution - which contains a peroxide-bleaching agent - and wearing the tray for a period of time, generally from a couple hours a day to every day during the night for up to 4 weeks and even longer (depending on the degree of staining and desired level of whitening).


In-Office Whitening
    In-office bleaching provides the quickest and most effective way to whiten teeth. With in-office bleaching, the whitening product is applied directly to the teeth. These products can be used in combination with heat, a special light, and/or a laser. The light and/or heat accelerate the whitening process. Results are seen in only 1, 30- to 60-minute treatment. But, to achieve dramatic results, several appointments are usually needed. However, with laser-enhanced bleaching, dramatic results can be seen after the first treatment.


How Long Do the Whitening Effects Last?
    Whitening is not permanent. People who expose their teeth to foods and beverages that cause staining may see the whiteness start to fade in as little as 1 month. Those who avoid foods and beverages that stain may be able to wait one year or longer before another whitening treatment or touch-up is needed. The degree of whiteness will vary from individual to individual depending on the condition of the teeth, nature of the stain, the type of bleaching system used and for how long.



Over-the-Counter At-Home Teeth Whitening Vs. Dentist-Supervised Teeth Whitening Products
   
There are differences between the two, including:
  
 Strength of bleaching agent
- Over-the-counter home use products and dentist-supervised at-home products usually contain a lower strength-bleaching agent from 10% carbamide peroxide, which is equivalent to about 3% hydrogen peroxide, up to 22% carbamide peroxide. In-office, professionally applied tooth whitening products contain hydrogen peroxide in concentrations ranging from 15% to 43%.
   
Mouthpiece trays - With dentist-supervised at-home bleaching products, your dentist will take an impression of your teeth and make a mouthpiece tray that is customized to exactly fit your teeth. This customization allows for maximum contact between the whitening gel, which is applied to the mouthpiece tray, and the teeth. A custom-made tray also minimizing the gel's contact with gum tissue. Over-the-counter whitening products also contain a mouthpiece tray, but the "one-size-fits-all" approach means that the fit will not be exact. Ill-fitting trays can irritate the gum and soft tissue by allowing more bleaching gel to seep onto these tissues. With in-office procedures, the bleaching agent is applied directly to the teeth.
   
Additional protective measures - In the office setting, your dentist will apply either a gel to the gum tissue or use a rubber shield (which slides over the teeth) prior to treatment to protect your gums and oral cavity from the effects of the bleaching. Over-the-counter products don't provide these extra protective measures.
   
Supervised vs. unsupervised process - Dentist-supervised at-home bleaching and in-office treatments offer additional benefits compared with over-the-counter procedures. First, your dentist can perform an oral examination and consider your complete medical history, which can be helpful in determining how your teeth became discolored and if bleaching is an appropriate course of treatment based on your type and extent of stains and type, number and location of restorations. Your dentist can then better match the type of stain with the best treatment, if appropriate, to lighten those stains. With dentist-supervised bleaching procedures, your dentist will likely want to see you a couple of times to ensure you are following directions, to make sure the customized tray is fitting properly, to inspect your gums for signs of irritation, and to generally check on how the teeth whitening process is proceeding. With over-the-counter bleaching products, you are on your own.