Tooth whitening is one of the most common procedures of cosmetic dental treatment that is continuously growing in popularity. It is one of the simplest and most easily accessible methods for everyone to improve a smile. A beautiful, shining smile is one of the first most noticeable facial features we notice when we meet new people; furthermore, it gives us more self-confidence and boosts self-esteem. Modern tooth whitening, when performed following all the recommendations for tooth whitening, is a safe and effective procedure and does not cause any damage to teeth.
There are many causes that can lead to tooth discoloration. Discoloration can be caused by several factors, such as individual hereditary characteristics of a tooth structure, advanced age, some chronic diseases, dental trauma, gum inflammation, untreated teeth and their canals, or those treated with older generation materials, and excessive use of fluoride-containing products or certain medications (for example, antibiotic tetracycline). A frequent consumption of stain-causing products, such as coffee, tea (especially black), red wine, and tobacco, has a huge impact as well.
What Are the Methods of Tooth Whitening Offered in the Clinic?
Endodontically Treated Tooth Whitening
Endodontically treated (nonvital) tooth whitening differs from healthy tooth whitening. By applying a special whitening system for nonvital teeth, the dead teeth are whitened inside by placing a special bleaching agent into the tooth canal and sealing it with a temporary filing material. After a certain time period, the whitening material is replaced with a new one until the desired result is achieved.
Before any whitening procedure of the endodontically treated teeth, it is necessary to assess the quality of the root canal treatment. If endodontic treatment is questionable, it is recommended to retreat the root canals and fill them with a resin-like material called gutta percha in combination with an adhesive cement to ensure complete sealing of the root canal system.
• In-Office Tooth Whitening
This tooth whitening procedure is done in a dental practice, and it takes 30 to 60 minutes to complete. During in-office tooth whitening, a whitening material is applied to the teeth, and it is activated with an LED curing light. In order to achieve maximum whiteness it is recommended to perform 2-3 whitening procedures. In-office tooth whitening is a good option for refreshing the previously performed tooth whitening.
• At-Home Tray-Based Tooth Whitening
First, the dentist takes the impressions or moulds of the patient’s teeth that are used to cast custom-fitted models. In a dental laboratory, vacuum-molded whitening trays are made of transparent plastic by applying it over the models. During the next visit, the dentist adjusts the whitening trays as necessary to fit the patient’s teeth perfectly and gives instructions how to use them. ĮA bleaching gel is placed in the tray, and it is worn overnight or for 2 hours during the day. Such tooth whitening can take 7 to 14 days. PoIt is advisable to visit a dental practice after 2–3 weeks in order a dentist or a dental hygienist would evaluate the effectiveness of tooth whitening and the condition of teeth and mucosa. Tray-based tooth whitening can cause the teeth to become more sensitive, but this side effect is temporary and disappears over time.
Laser-Assisted Tooth Whitening
Unique monochromic laser characteristics and a wavelength-specific photon-activated gel allow gentle, safe, quick, and effective whitening of your teeth just in a single visit to your dentist or dental hygienist. The whitening gel used in laser-assisted tooth whitening an activator that is activated by light of a particular wavelength via a photochemical reaction. The main component of the bleaching gel is hydrogen peroxide that has been used in tooth whitening for more than 100 years. The gel contains approximately 35% hydrogen peroxide. The gel fully absorbs a monochromic laser light; therefore, all heat is eliminated, and there is not direct heating that could negatively affect dental tissues.
The laser energy emitted accelerates the generation of free radicals from hydrogen peroxide; therefore, the bleaching gel is applied only for 16–24 minutes. It is the most effective and fastest method of tooth whitening.
What Is Recommended Before the Procedure?
- Before the tooth whitening procedure, it is very important to consult with a dentist or a dental hygienist. Only a thorough oral examination of the condition of dental tissues and teeth and determination of the causes of tooth discoloration allow selecting the most suitable whitening method and predicting the possible results;
- Before the tooth whitening procedure, a professional hygiene treatment has to be done;
- Only healthy and filled teeth can be whitened; otherwise, the teeth may become very sensitive.
What Should Be Known After the Whitening Procedures?
- The efficiency of whitening depends on the thickness of enamel and its inherited shade, age, diet, bad habits, and oral hygiene.
- After the tooth whitening procedure, the teeth always become brighter and remain brighter as they were before. The patient can expect especially good results to last for 2 years if he/she practices proper oral hygiene, reduces consumption of stain-causing products, and quits smoking if he/she is a smoker;
- After the procedure, the teeth may become more sensitive. This side effect is temporary and usually disappears within a few days. If the sensitivity persists longer, it is recommended to use a fluoride-containing remineralizing toothpaste as well as a remineralizing gel placed in a tray;
- An improperly fitted tray or tooth whitening done without supervision of a dentist can cause damage to the gums. This complication is temporary and it disappears after a few days as soon as the whitening procedure is discontinued.
The procedure is not recommended for:
- Children under the age of 16 as the pulp chambers of their teeth, containing the nerves, are enlarged, and dentin tubules are very wide. Tooth whitening can damage the nerve of the tooth or cause permanent sensitivity;
- Persons wearing braces;
- Pregnant or breastfeeding women;
- Persons who have numerous fillings or crowns as the materials used in these restorations do not whiten. Therefore, it is advisable to perform the tooth whitening procedure first, then to fill and restore the teeth, and match the color of a new restorative material to the whitened teeth; otherwise, old restorative materials will likely need replacement after the tooth whitening procedure;
- Persons with hypersensitive teeth or receding gums. Whitening does not have any effect on the exposed roots of the teeth as they do not have any layer of enamel;
- Persons who are allergic to peroxide or other substances in a bleaching gel;
- Persons with gingival (gum) diseases or decay-damaged teeth.
Consultations are provided and procedures are performed by Sandra Burčikaitė a dental assistant and a dental hygienist