Teeth Whitening: A Review of Products, Methods and Dentist Options

Over the last 20 years, teeth bleaching and whitening have become the most popular and common cosmetic dental treatment.

There are a few teeth whitening and bleaching options:

In-office-based teeth whitening
At-home teeth whitening kits

Both approaches, In-office-based teeth bleaching, and at-home care use peroxide-based whitening or bleaching agents. Bleaching agents used in at-home whitening contain a 3%-20% solution of peroxide (either hydrogen peroxide or carbamide), while in-office whitening utilizes 15-43 percent peroxide concentration.

In-office-based teeth whitening:

In-office-based tooth whitening, is performed by the dentist in a office setting, which can help in the faster brightening of teeth. The bleaching solution used in this approach is comparatively stronger than the method used for teeth whitening at home.

In this procedure, light, heat, or even a combination of these two can also be used to speed up the results and intensify the bleaching and whitening effect. During the several 30-60 minutes of the in-office visit, the most amazing results can be achieved, which can let the patient have about 3x to 8x brighter shade of teeth. In some clinics, the dentist can switch to a technique of 2-hour appointments in a single setting. The estimated cost of in-office teeth whitening is almost $500 – $1,000.

The dentist performs standard steps prior to the procedure:

The dentist makes a record of presenting tooth shade.
Plaque accumulated on the teeth surface is then removed, and the teeth surface is polished via pumice.
Teeth are then dried, and mouth is isolated through gauze.
A barrier is created over the surface of the gums to protect them from unwanted and additional exposure from the solution.
In this next step, teeth surface is coated with a prepared whitening solution, which is inclusive of carbamide peroxide or hydrogen peroxide used as a bleaching agent.
In most of the whitening procedures, laser light, or some specific curing light can be used for the activation of peroxide. After the solution has been applied for once, this is left on the teeth surface for half an hour to an hour.
After the achievement of optimal or required shade, teeth are then rinsed. In order to decrease any sensitivity, a fluoride solution is applied.
If the wanted shade is not obtained yet, the patient can be advised to have additional visits at the clinic.

After the completion of the procedure, dentists advise patients to avoid beverages or foods that contain high levels of pigment at least for about two days. Tea, coffee, yellow mustard, tomato juice, black grapes, beets, red wine, candies, tomato sauce, are strictly forbidden for a day post-procedure. Tobacco products or smoking should always be avoided after the procedure.

At-home teeth bleaching options:

As an alternative to in-office procedures, people prefer at-home whitening or bleaching procedures with the use of at-home whitening kits. These models can be obtained from dentists only and need modifications to make them custom-fitted according to individual requirements.

This procedure is not at all difficult or complicated to be performed by an individual. The whole process takes about an hour per day for about two weeks period. This procedure has better prognosis and better results than the commonly used over-the-counter whitening and bleaching brands.

This at-home kit is inexpensive and can give a fantastic alternative to people who are unable to afford professional treatments. Generally, there are several options for teeth bleaching and whitening at home. Some of these options are discussed below:

Tooth-whitening toothpaste:

Teeth whitening toothpastes are slightly abrasive. Every tooth whitening toothpaste can help in removing the stains from a plaque or yellowish teeth. These teeth whitening toothpastes contain certain chemicals or different agents for polishing, which can help in scrubbing the strains from damaged teeth without getting aid from bleaching agents. Teeth whitening toothpastes are comparatively cheaper and can effectively brighten the teeth by one time of the original shade. In some toothpastes, a specific concentration of peroxides is present, but they can’t be kept on teeth for a more extended period to gain a whitening advantage.

Try-based tooth bleaching system:

In this whitening technique, a mouth guard-like (appearance) tray is filled with paste or gel having a specific concentration of peroxide. This paste or gel is then placed over the surface of teeth ranging from one hour to several hours and even days. These trays can be bought over the counter or can be custom-altered according to requirements.

Tooth-whitening gels and strips:

These gels and strips are applied directly over the teeth with either a thin strip or with some brush. These products are generally peroxide-based and need an application of once or twice per day for about 10-14 days. The results obtained from this procedure can last for four or more months with an approximate cost of $10-$55.

Over the counter bleaching:

OTC whitening or bleaching gels
OTC whitening or bleaching strips
OTC tray-based bleaching (whitening materials can be purchased OTC or through the mail)
Dentists supervised tray-based whitening (whitening or bleaching supplies can only be purchased through the dentist’s clinic).

Difference between In-office bleaching procedure, OTC tray-based bleaching system, and at-home whitening:

Bleaching agent:

Products used in over-the-counter and at-home whitening procedures contain bleaching agents with low strength (ranging from 10 percent solution of carbamide peroxide, which is equal to 3% hydrogen peroxide to 22 percent carbamide peroxide).

While in-office whitening procedure, products that are used contain hydrogen peroxide solution ranging from 15-43 percent concentration for professional whitening.

Speed:

OTC and dentists-supervised home bleaching procedures generally need an application of one to two hours per day up to four weeks or a month.

In-office whitening procedures provide the most effective and immediate results for teeth whitening.

With the help of laser-enhanced bleaching systems, extraordinary results can be observed even after one treatment.

Protective measures:

The over-the-counter procedure generally lacks a little in terms of additional protection, which can be provided through in-office methods. In the correct settings, the dentist applies a barrier or a gel over the gum area to protect the gums from exposure of peroxide solution, which can not be observed through OCT procedures.

Supervision:

In the office settings, the dentist performs the professional oral examination before the treatment and takes the whole medical and surgical history into consideration, which can suggest the actual cause of teeth yellowing and discoloration. The dentist can recommend and opt for better treatment options for the individuals. These privileges can not be availed in at-home procedures.

Is teeth bleaching/whitening safe?

In most cases, teeth whitening is a safe procedure, but sometimes it can result in tooth discoloration, specifically some intrinsic stains. Materials used in bleaching agents can sometimes affect filling materials already present in the teeth, and color mismatch between crowns and persisting fillings.

In order to avoid these complications, a complete examination and evaluations are required to minimize the problems. Supervised or professionally performed whitening reduces the patients’ risks of inappropriate procedure of application, use of unsuitable products, and underlying or undiagnosed comorbidities.

Summary of Teeth Whitening Options:

Tooth whitening/bleaching is recently one of the most cost-friendly and conservative dental interventions to enhance or improve the individual’s smile. However, this process isn’t risk-free and should always be performed under professional supervision to minimize the risk of complications, which may occur as a result of negligence and inappropriate techniques. Patients who opt for OTC products should be encouraged to undergo a dental examination to have a beneficial effect regarding their teeth discoloration.