Tooth whitening is an effective way of removing stains and discolouration from teeth, and lightening the natural colour of the teeth, through a bleaching process. The degree of whiteness achieved will vary from patient to patient and with the type of bleaching process chosen.
The colour of a person's teeth varies just as the colour of their hair does. Very few people have naturally bright white teeth! As you get older teeth can become discoloured due to changes in the mineral structure of the teeth; coffee, red wine and other heavily pigmented foods and drinks can cause staining. Smoking stains teeth even more. Tartar due to poor oral hygiene can affect the colour of teeth, as can some antibiotics such as tetracycline.
A simple scale and polish from a dental hygienist can often improve matters but this may not result in the brilliant white smile you would like, so you may wish to have your teeth whitened.
If you have sensitive teeth, sensitive or receding gums, gum disease or other dental health problems, you may not be suitable. Sensitivity during tooth whitening can be overcome, and your dentist can advise on this. Decay and gum disease are normally treated before tooth whitening is carried out.
Also, the teeth whitening process does not change the colour of crowns, veneers or fillings so it is important to understand that you may need to change these to match the colour of your whitened teeth.
Tooth whitening uses a peroxide-based bleaching gel of varying strength. The higher the concentration of peroxide in the gel, the more powerful it is and therefore the more effective at whitening the teeth; however the higher concentration also has greater potential to cause side effects such as tooth sensitivity and damage to the surrounding gum tissue and lips. Because of this potential for damage, tooth whitening should always be carried out under the supervision of a dentist.
Nowadays many dental practices offer two types of whitening:
Light-accelerated whitening (incorrectly known as 'laser whitening' since actual laser light is not involved nowadays) uses light energy to accelerate the bleaching process.
Once you have fully discussed the procedure with your dentist and understood its risks, the first step is a thorough scale and polish of your teeth; your dentist will then record the colour of your teeth at the start of the procedure using a shade chart.
Next your gums are carefully protected, cheek retractors are used to position your lips and cheeks away from contact with your teeth, and goggles are placed over your eyes; the whitening gel is then applied to the surface of your teeth. A special light is positioned to activate the gel and the whitening process is allowed to continue for several minutes. Most techniques involve several gel applications.
The gel is then washed off and gum protection removed before recording the improvement in whiteness of your tooth colour. Results can be obtained in less than 1 hour.
Many patients' teeth can be sensitive immediately following this procedure so you should avoid hot or cold drinks for a while. Some dentists offer fluoride treatment following teeth whitening to reduce this effect. Sensitivity rarely lasts more than 48 hours, if symptoms persist for longer than this then contact your dentist.
For home whitening, your dentist takes impressions of your upper and lower teeth and a dental technician uses these to make custom made mouth trays into which your teeth fit perfectly, a process usually taking 5-10 days. Your dentist provides you with professional whitening gel; you apply this to the trays which you then wear for short periods during the day, or while asleep, depending upon the whitening system and the concentration of the gel. Results are usually seen over 2-4 weeks.
Combination techniques
Professional home whitening kits provide more permanent results over a longer time scale, whereas laser tooth whitening offers immediate results. A combination of the two provides the perfect solution to both immediate and long-term whitening needs.
New EU regulations from 1/11/12 have stated that all whitening products contain no more than 6% hydrogen peroxide or equivalent. It also states that these products should not be used on anyone under the age of 18 and can only be provided by a dentist or under their direct supervision.
You may experience some kind of sensitivity during or after the initial treatment, often in the form of tingling in your teeth. Your dentist may give you a special desensitizing or remineralizing gel or mousse to apply to your teeth to help with the sensitivity. It is advisable to avoid hot or cold food and drinks within the first 48 hours of your whitening treatment, after which time the sensitivity should have disappeared.
You may also experience discomfort in the gums, a sore throat or white patches on the gum line. These symptoms are usually temporary and should disappear within a few days of the treatment finishing. If any of these side effects persist you should consult your dentist.
Whitening treatments are not available on the NHS; charges will vary from practice to practice and region to region. We recommend you get a written estimate of the cost before you start any treatment. Whitening treatments can start at £99 and go up to about £800 depending on what technique or system is being offered.
The effects can last for up to three years, but once your teeth have been whitened it is important that you look after them properly to stop them becoming discoloured or stained again: avoid staining foods and drinks and maintain good oral hygiene. Stopping smoking is one of the most important things you can do if you want your teeth to stay white.
