Teeth Whitening
What is teeth whitening?
Step-by-Step (What to Expect): In-Office Whitening
1. Preparation: We’ll start by polishing your teeth to remove any surface plaque. Then we isolate your lips and gums – typically with a cheek retractor to pull lips and cheeks away, and a protective gel or rubber shield on your gums. This guarding is crucial because the whitening gel can irritate soft tissues. We also often place protective goggles or shades on you (and ourselves) if using a bright activation light.
2. Application of Whitening Gel: We apply a professional-strength hydrogen peroxide or carbamide peroxide gel to the front surfaces of your teeth. We usually do this for both upper and lower front teeth (the ones visible when you smile) – usually premolars forward. The gel will stay on for a specified period (about 15-20 minutes per session). Often a special blue LED light or laser is shone on the teeth to activate the gel and enhance the whitening process, though some gels work without light. During this time, you just relax; you may feel some tingling or bubbling on your teeth – that’s the peroxide breaking down stains.
3. Multiple Rounds: After the first session, we suction off the gel and may apply a fresh layer to continue whitening. In-office treatments often involve 2-4 sessions back-to-back in the same appointment, each lasting 15 minutes or so, depending on the product and your sensitivity. We will monitor your teeth and gums between sessions to ensure all is well. You can usually see your teeth lightening with each pass.
4. Rinse and Results: Once we’ve completed the final round, we’ll thoroughly rinse your mouth and remove all isolation materials. We’ll compare your teeth to the initial shade to note the improvement. It’s often 2-8 shades lighter on a shade guide. We’ll then discuss post-care (see below). Total time is about 1 to 2 hours for the whole process.
Step-by-Step (What to Expect): Take-Home Whitening
Tray Fabrication: We take impressions of your teeth to create custom-fitted whitening trays (thin, flexible plastic mouthguards molded exactly to your teeth). This ensures the whitening gel stays in contact with your teeth evenly and away from gums. Trays are ready in a day or two.
Usage Instructions: We’ll supply you with syringes of professional whitening gel (usually carbamide peroxide in 10-20% concentration, or hydrogen peroxide around 6-10%, depending on formula). At home, you’ll place a small dot of gel in each tooth compartment of the tray and then seat the tray over your teeth. Usually, wear times vary from 30 minutes to 1 hour per day, or sometimes overnight for lower concentrations – we’ll direct you on your specific product. You do this daily for about 1-2 weeks or until you reach desired results.
Monitoring: We might have you check in after a week to see progress, or you simply follow up at the end of treatment. You can keep leftover gel/trays for future touch-ups. We caution not to overdo whitening – use as instructed. Sensitivity is the most common issue (see below). Always rinse trays and your mouth after each session and avoid eating with the trays in place.
Common Risks and Side Effects:
– Tooth Sensitivity: The most common side effect is sensitivity to cold, air, or sometimes touch. Whitening agents can temporarily make teeth more porous, allowing stimuli to reach the nerves more easily. You might feel zings or heightened sensitivity during and after treatment. This is usually transient. In-office, we often have fluoride or desensitizing pastes to apply if needed. For take-home, if sensitivity occurs, you can skip a day or two or shorten wear time. Using a sensitive toothpaste (with potassium nitrate) before, during, and after the whitening period helps reduce this. Sensitivity generally subsides within 1-3 days after stopping whitening. If you have a history of sensitive teeth, we’ll approach more cautiously (maybe lower concentration gel).
– Gum or Soft Tissue Irritation: If whitening gel contacts the gums, lips, or tongue, it can cause a chemical burn manifesting as white patches or soreness. In-office, we guard carefully, but if any leaks, you might feel a tingle or sting – we stop and rinse it immediately. The affected gum tissue usually looks white and sloughs a bit, but it heals within a day or two. At home, if you overload trays, excess gel can ooze onto gums causing irritation. That’s why only a small dot of gel per tooth in the tray is advised. Wipe off any excess that seeps out. If you do get a sore, keep it clean; topical vitamin E or just letting it heal works. It’s short-lived discomfort if it happens.
– Uneven Results or Relapse: Not all teeth whiten evenly. If you have white spots (fluorosis spots or early enamel lesions), they can appear whiter initially (the surrounding tooth lightens and the spots blend more over time, but at first they stand out). If you have some crowns or fillings, remember they won’t whiten, which could result in color mismatch with natural teeth. We might need to replace visible fillings after whitening to match. Also, the degree of whitening varies per individual – some get a big change, others moderate. Typically, yellowish tones respond best, brownish next, and gray or bluish least. After whitening, it’s natural for teeth to “settle” a half-shade darker in the first couple weeks (initial dehydration effect wears off). Longer-term, teeth can re-stain – especially if you smoke or consume staining foods/drinks frequently. So results are lasting but not permanent; most people do touch-ups every 6-12 months or before big events.
– Existing Dental Work Considerations: We examine for cavities or leaky fillings beforehand because whitening can penetrate into a cavity and cause pain or sensitivity, and it won’t uniformly whiten a tooth with such issues. Also, if your enamel is thin or teeth are transparent at edges, excessive whitening can make them look more translucent or even bluish. We manage expectations in cases of intrinsic discoloration (like from trauma where dentin is darker, or tetracycline staining which may only improve partially). Over-whitening (frequently called the “bleached look”) can make teeth look unnaturally opaque or chalky; we caution not to overdo it. With professional guidance, we mitigate the risk of an unnatural outcome – we aim for a natural brighter smile, not a blinding “paper white” that doesn’t suit you.
Alternatives to Professional Whitening:
– No Whitening (Maintain Color): You may choose not to whiten and instead focus on cleaning and polishing for the best natural appearance. Regular dental cleanings can remove external stains to some degree. If your tooth color doesn’t bother you much or if you’re concerned about sensitivity, you might opt not to do whitening. Embracing the natural shade is perfectly okay; teeth aren’t meant to be pure white and vary per person.
– Whitening Toothpastes / OTC Products: Over-the-counter whitening toothpaste and strips are alternatives. Toothpastes have mild abrasives or low-level peroxide and can help remove surface stains but won’t dramatically change the inherent color. They can take a long time and overuse might cause abrasion. Whitening strips (like Crest Whitestrips) do work to an extent as they contain peroxides, but at a lower concentration than professional products. They may lighten a couple of shades over a few weeks of daily use. They’re a budget-friendly alternative but can cause some sensitivity and can be tricky to keep on or reach all areas evenly (especially between teeth or near the gumline). They also risk slight gum irritation if placed carelessly. Still, some people try these first to see if they get a mild improvement.
– Internal Bleaching (for a Single Dark Tooth): If one tooth is dark due to a root canal, an alternative is internal bleaching (where we open the tooth and place bleach inside the tooth). This is specific to non-vital teeth and wouldn’t be done for general whitening. If you have a singular tooth issue, we might do that in conjunction with external whitening of other teeth for uniformity.
– Porcelain Veneers or Bonding: If your discoloration is severe or due to intrinsic causes that whitening can’t fix well (like tetracycline staining, which can be gray-brown banding), or if you also want to change the shape/size of teeth, veneers might be an alternative. Veneers can permanently cover the color and also perfect the shape. However, veneers are more invasive and costly than whitening, and it’s a different path (cosmetic restoration versus bleaching). Dental bonding with tooth-colored resin can also cover spots or discoloration on a few teeth. But bonding can stain over time and may not uniformly change an entire smile’s shade like whitening can. We typically see whitening as the first, least invasive step – and then consider veneers or bonding for cases where whitening alone isn’t enough or for those looking for a full smile makeover.
Post Whitening Care Instructions
– Dietary Restrictions (first 24-48 hours): After whitening, especially in-office, your enamel might be more porous and prone to absorbing stains. We advise a “white diet” for the first day or two. This means avoiding deeply colored foods and drinks: coffee, tea, red wine, cola, berry juices, curry, soy sauce, tomato sauce, chocolate, beets, etc. If it would stain a white shirt, it can re-stain your teeth easily right after whitening. Opt for water, milk, lightly colored foods, chicken, pasta with white sauce, apples (no skins), bananas, potatoes, rice, etc. If you must have a colored beverage, use a straw to minimize contact. Also avoid tobacco use in this period for the same reason (plus smoking in general re-stains teeth quickly). After 48 hours, you can resume a normal diet, but keeping staining foods/drinks moderated will keep your smile brighter longer.
– Oral Hygiene: Continue good oral hygiene habits. Brushing and flossing will help maintain the results by keeping plaque (which attracts stains) off your teeth. It’s often beneficial to brush after consuming staining foods/drinks (but if you’ve had acidic foods or drinks, wait 30 minutes to brush to avoid enamel erosion – simply rinse with water immediately). Using a whitening or at least a non-colored mouthwash can also help (some mouthwashes have strong colors like green or blue; while they typically don’t stain if used briefly, you could switch to a clear or white one if concerned). There are also whitening maintenance toothpastes (low abrasive formulas with peroxide) that can help gently polish away new stains. Don’t overuse anything abrasive though, as that can dull the enamel. We can recommend products for maintenance.
– Sensitivity Management: If your teeth are sensitive after whitening, this usually subsides within a day. You can use a sensitivity toothpaste and avoid extremely hot or cold foods for a short while. If it’s very uncomfortable, taking an NSAID like ibuprofen can reduce the inflammation in the nerve. Also, applying a fluoride or desensitizing gel (we can provide one, or use an OTC fluoride rinse) will help. For take-home kit users: if sensitivity is an issue, whiten every other day instead of every day, and/or reduce wear time. You can also put sensitivity toothpaste in your trays and wear them for 10-15 minutes to soothe the teeth. Make sure your trays are cleaned out before next use of bleach.
– Touch-ups: Tooth color can naturally regress some. Many patients do a touch-up whitening after 6 months or a year. For example, if you have custom trays, you might use them for 1-2 nights after your dental cleaning every six months to refresh the brightness. If you had in-office whitening, we often provide take- home trays for maintenance, or you might opt to do another in-office boost in a year or two. Frequency depends on your diet and preferences; just don’t do it too often (no more than a few times a year lightly, or you risk sensitivity or diminishing returns). We’ll guide you on safe intervals.
– Watch for Spots: Occasionally, right after whitening, you might see white chalky spots or mottling on your teeth. These are usually areas of dehydration or where the whitening reacted differently (often spots that were already present but temporarily more visible). Don’t be alarmed; as your teeth rehydrate over a day or two, these spots generally blend in better. If any unevenness persists long-term, let us know – but almost always the uniformity improves after a short time.
– When to Eat or Drink Post-Whitening: If you did in-office whitening, wait at least 30 minutes before eating or drinking anything (besides water). This gives time for the teeth to recover some of their protective pellicle (protein layer) and for the pores to begin closing. Also, your gums might be a little tender; waiting avoids irritation from hot/cold or spicy foods. Stick to room temperature water initially. If you used take- home trays, after each session, rinse your mouth and don’t eat immediately with gel residue on your teeth – give it a half hour if you can.
– Checkups: Continue regular dental checkups. We’ll want to see how your teeth are doing, check for any areas of demineralization or any issues that could have been masked by whitening. Also, maintaining clean teeth via professional cleaning helps keep them bright. We can also track the shade change in your records to see how well it’s holding up and advise when a touch-up might be beneficial. If you have any concerns like uneven color or persistent sensitivity, these visits are a good time to mention them so we can address them.