The two main products used for teeth whitening are hydrogen peroxide and carbamide peroxide. Unlike a whitening toothpaste that uses an abrasive ingredient to mechanically remove surface-level stains, the oxygen molecules within these whitening agents weaken your tooth stains on a molecular level.
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Many over-the-counter (OTC) whitening strips, kits and pens also use a form of peroxide. The difference between these and professional teeth whitening is the chemical concentration.
&#;In the office, we use a very high percentage of hydrogen peroxide because we have the capability to isolate the teeth,&#; says Joseph Michael Brofsky, head of pediatric dentistry at Cohen Children&#;s Medical Center of New York. &#;We use a special rubber dam to protect the patient&#;s gums because if peroxide gets onto the gums, it would burn them.&#;
Like at-home whitening products, there are a variety of professional teeth whitening methods. In-office professional whitening is a quicker, albeit more costly way to lighten up your pearly whites. Meanwhile, custom take-home trays fall somewhere between in-office professional whitening and an OTC whitener in terms of treatment time and cost.
In-office professional whitening treatments are typically completed in several short appointments but will depend on your unique needs. A whitening agent is left on for 15- to 30-minute increments, and the entire appointment should take no longer than an hour and a half.
There are a few types of in-office whitening treatments:
Halogen light and laser light increased teeth lightness more than hydrogen peroxide alone, according to a study in the Journal of Conservative Dentistry. After three weeks, study participants in the halogen and laser light groups still had the white teeth color achieved during treatment while the non-light group had &#;shade rebound&#; after just two weeks&#;initially brightened teeth became darker.
However, some studies show no benefit from using a light tool such as a laser or lamp over a whitening gel alone.
Aside from effectiveness, is light exposure safe for your smile? A study in Materials found that tooth cells recovered well after LED light-accelerated technology, concluding that most side effects are &#;temporary and transient.&#;
In-office whitening typically involves several steps:
Even if you stick to your dentist&#;s recommended regimen of resisting bright foods, coffee and wine, your teeth may appear a bit darker a few days after whitening. But don&#;t be discouraged. The dehydration caused by teeth-whitening makes them look immediately bright right after your procedure. After a week, if your teeth are not at your preferred shade, speak with your dentist about whether or not there&#;s potential for them to become lighter with at-home products or more in-office visits.
While in-office whitening is fast, custom take-home trays require some diligence on the part of the patient. They may be your only treatment or a follow-up treatment to in-office whitening if your dentist believes your smile is prone to getting new stains again soon.
With a professional take-home-tray, your dentist will make an impression of your teeth for a custom-fabricated tray. Because this tray will fit perfectly to the shape of your mouth, it will typically give you more comprehensive whitening results than OTC trays. Instead of a hydrogen peroxide-based gel, you&#;ll most likely get a carbamide peroxide-based gel to place in the tray and use at home. Even though it doesn&#;t whiten as quickly as a hydrogen peroxide-based gel, you&#;re less likely to experience sensitivity if you accidentally get it on your gums, cheek or tongue.
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The concentration of the gel your dentist gives you for your custom-fit trays ranges from 10% to 38% carbamide peroxide, according to the American Dental Association. Your duration of treatment will also vary, from wearing your tray from two to 10 hours a day, and for up to 28 days. Over-the-counter trays come with a similar percentage of carbamide. The difference in quality is in regards to fit. A custom tray will fit directly around your teeth, giving little room for the gel to slip up to your gums or miss whitening hard-to-reach crevices.
&#;These toothpastes are good to remove stains, but they leave the surface of the tooth rougher than they found it, which means the stain comes back faster than it did before,&#; says Luke Bauserman, a dentist at Family Tree Dental in Parkersburg, Ohio&#;.
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Tooth&#; whitening strips are small pieces of flexible plastic coated with a thin layer of gel that contains peroxide. Each strip is pressed against the surface of the teeth, allowing the bleach to seep into the enamel to lighten the color and lift stains. Though whitening strips don&#;t &#;use as high a concentration of peroxide as other whitening methods you&#;d get in your dentist&#;s office, they can deliver decent results (figure on a shade or two lighter) for people whose teeth aren&#;t too badly stained for a fraction of the cost of in-office treatments. They&#;re also no fuss, no muss &#; since you just press the strips on&#;to your &#;teeth and go &#; and convenient: You wear them daily, for about 30 minutes to an hour, over a period of two to three weeks. Results last for up to four months.&#; These strips are safe and effective, notes Wolff. But he recommends that you check in with your dentist beforehand, since cavities or broken teeth will be extremely sensitive to bleach.
There are some cons, however&#;. &#;Unless your teeth are perfectly straight, it can be difficult to get the strip to lie close enough to make contact with the entire tooth surface &#; particularly in between the teeth &#; which can lead to uneven results,&#; says Kimberly Wright, a dentist at Advance Dental Arts Center in West Linn, Ore&#;gon. An&#;other thing to keep in mind: Whitening products will work only on &#;natural&#; teeth; they won&#;t change the color of crowns, bridges or veneers. What&#;s more, whitening can&#;t work miracles. If you&#;ve lost a significant amount of surface enamel, veneers may be a better choice. Other types of discoloration that are difficult to tackle with whitening alone: grayish teeth, caused by the antibiotic tetracycline (sometimes given to children whose teeth are still developing) and some antihistamines, or &#;discoloration from high levels of fluoride in drinking water.
If you are thinking about using an &#;OTC bleaching kit, discuss options with your dentist and look for one with the ADA Seal of Acceptance. That means it has been tested &#;for safe&#;ty and effective&#;ness for teeth whitening. Expect a kit to cost between $25 and $65 and know that the best time to use one, Wright says, is right after you&#;ve had a professional cleaning. &#;The less residue on the surface of your teeth applying the whitening strip, the better the results.&#;
Whitening (or bleaching) trays are made of flexible material that fits around your teeth to whiten the surface and in between your teeth. They&#;re usually prefilled with a peroxide-based whitening gel, or come with syringes of whitening gel that can be dispensed as needed. You can purchase dispensable trays over the counter or be fit with a customized take-home tray at your dentist&#;s office. &#;Your dentist can also supply &#;bleach refills&#; to take home; when you come in for a cleaning, you can get a few more tubes for touch-ups.
Either type of tray will do the job. But a customized &#;tray and gel&#; treatment from your dentist will probably contain &#;a higher percentage of bleach than over-the-counter kits&#; do, delivering faster results. As with strips, it&#;s all about getting good contact with the teeth, says Wright: &#;Custom-made trays fit snugly, so the gel seeps into every nook and cranny, for the most even results possible.&#; A close fit also minimizes the amount of bleach that can dribble onto (and potentially irritate) your gums, while preventing saliva from coming into contact with the bleaching agent, which can dilute its strength. Basically, though, &#;it all comes down to what fits into your lifestyle,&#; notes Betsy Bakeman, a Grand Rapids, Mich&#;igan&#;-based dentist and &#;former president of the American Academy of Cosmetic Dentistry, who&#;s a fan of prefilled disposable OTC trays for traveling. She suggests Opalescence Go, which has whitening gel in prefilled trays, worn for about 15 to 20 minutes a day for &#;five to 10 days. It contains potassium nitrate to reduce sensitivity, plus fluoride to help strengthen enamel. (Ten trays cost about $63.)
Store-bought trays come with a few caveats. There&#;s a limit to the percentage of peroxide &#;in kits sold over the counter, so you&#;ll probably need to bleach longer than you would if you had a professionally made tray with a higher percentage of bleach. (Figure on about an hour or two a day, for &#;five to 10 days, depending on the degree of whiteness you&#;re aiming for.) What&#;s more, with a one-size-fits-all tray&#;, there&#;s a &#;better chance that gel will get on your gums and possibly irritate the tissue, though it typically heals &#;in a few days. &#;A dentist can trim the trays that she or he dispenses,&#; says Wright, &#;so there&#;s less of a chance the bleach will come in contact with the gums.&#;
OTC kits &#;can cost $100 and up, while in-office kits are pricier&#; &#; from about $200&#; to $600. Tip: If you prefer to wear a tray overnight, as you &#;sleep, try a product that contains lower-strength carbamide peroxide (10 percent to 16 percent). &#;Carbamide peroxide, which gradually breaks down into hydrogen peroxide, releases about half of its whitening power in the first two hours, then remains active for up to six additional hours,&#; says Wright. &#;Some people experience less sensitivity, because it&#;s a slower process.&#;
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