Teeth whitening

Teeth whitening is not a medical procedure-it does not result in healthier teeth-but it can result in whiter teeth and a brighter smile. This in turn can make people feel better about themselves.

There are two types of teeth whitening:

• Bleaching your teeth changes the color of the tooth enamel and removes both surface stains and those deeper in the teeth. Your dentist can bleach your teeth at his or her office, or you can do it yourself with a kit your dentist gives you or with a kit you buy over the counter (OTC). The chemical used to bleach teeth is generally carbamide peroxide. Different products use different concentrations of this chemical.
• Whitening toothpastes use a rough (abrasive) material that "scrapes" off surface stains and polishes the teeth.

Bleaching

For in-office bleaching, the dentist often combines bleach with a laser or light to speed up the process. A visit usually takes from 30 minutes to 1 hour, and you may need more than one treatment. Your dentist will protect your gums with a gel or shield and then put the bleaching agent on your teeth. The bleach concentrate used for the in-office process is generally stronger than that used in other methods, because the dentist can watch how it is used.

Your dentist may also give you a kit with a mouthpiece and gel containing the bleach. Your dentist may make a custom mouthpiece to fit your teeth. These kits usually use a lower concentration of bleach than an in-office process. Your dentist will tell you how often to wear the mouthpiece and for how long.

An over-the-counter kit is similar to what your dentist gives you. The bleach concentration, how you use it, and how long you use it varies between products. For example, some products use a mouthpiece and others use strips you lay across your teeth.

All of these methods have different costs, and your insurance will usually not pay for them. You choose the method that works best for you and that you can afford.

Talk to your dentist before whitening your teeth. It does not work for everyone. Using a bleach product for:¹

• Yellowish teeth usually works well.
• Brownish teeth will work, but not as well as for yellowish teeth.
• Grayish-hued teeth may not work well at all.

Bleaching also may not work if you have had bonding or tooth-colored fillings in your front teeth. The bleach will not affect the color of these materials, and they will stand out if you whiten the rest of your teeth. Always talk with your dentist before you use tooth whitening, especially if you have many fillings, crowns, or very dark stains.

Bleaching your teeth may have side effects. Teeth can become sensitive when you are using the bleaching solution, but this usually goes away when you finish your treatment. A mouthpiece that does not fit well may hurt your gums.

Remember that whitening is not permanent; your teeth will slowly become discolored again. Some lifestyle choices, such as drinking coffee or using tobacco, will speed up how fast your teeth lose their new whiteness.

Children and teens

Children and teens with discolored teeth may have a negative self-image that can result in unhealthy behavior. Teeth whitening may help them with their self-image.

In children and teens, stained or discolored teeth may be the result of:

• An injury or infection.
• Fluorosis, which is using too much fluoride. This can change the color of the teeth.
• The antibiotic tetracycline. Using this antibiotic can result in stains on the teeth.

It is important to discuss teeth whitening with your dentist. If your child still has a mix of primary and permanent teeth, whitening all teeth may result in teeth being different shades of white. This is because the thickness of the tooth enamel is different in these two types of teeth. Colors may also change when the permanent teeth replace the primary teeth.

Citations

1. American Dental Association (2007). Tooth whitening treatments: Frequently asked questions. Available online: http://www.ada.org/public/topics/whitening_faq.asp.