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Dental whitening

Definition

Teeth whitening is a technique used to lighten the natural color of teeth.

There are three types of whitening:

  • Whitening in the chair (at the dentist);
  • Whitening at home;
  • Internal whitening, on a tooth that has previously received a root canal treatment (see internal whitening).

The whitening treatment consists of applying a peroxide based product to the surface of the targeted teeth using pre-molded plastic trays, or molded closely to the shape of the patient’s teeth. The product penetrates the enamel of the teeth and an oxidation process causes the stains to burst, just like when you do the laundry. The process is safe and does not damage the teeth. The use of specialized trays offers close contact with the teeth for optimal results.

There are over-the-counter whitening products on the market. These products are often composed of abrasive agents and whitening is achieved by removing a thin layer of enamel, which is dangerous for the teeth. Other products work with peroxide, but the permitted concentrations are insufficient to achieve satisfactory results.

There are also non-specialized centres that offer dental whitening (beauty centre, flea market). These centres do not have recognized infection control devices (sterilization of instruments, disinfection of surfaces, sterile saliva management devices) and may endanger the health of patients. In addition, this type of technique often causes a spectacular whitening by dehydration of the teeth. In addition to not being effective, teeth can become very painful after treatment.

  • Lightening the natural colour of teeth;
  • Selectively brighten some of the more discoloured teeth;
  • Lighten teeth stained by medication (tetracyclines);
  • Improve self-esteem.

Disadvantages

  • The longevity of the treatment cannot be predicted, as it depends closely on the patient’s lifestyle. The longevity of the treatment can be compromised by the consumption of tobacco products, coffee, red wine, pigmented fruits, vegetables or spices (tomatoes, beets, cumin, etc.);
  • Some natural tooth shades are more receptive to whitening than others;
  • The result of the whitening is not permanent. Therefore, the process must be repeated at regular intervals;
  • The whitening product has no effect on restorations already present in the mouth such as: bridges, crowns, veneers and composite fillings. New dental restorations are to be expected if the colour of the teeth is too different after whitening;
  • Teeth may be sensitive to heat and cold temporarily during or after treatment.

Processing limits

Tooth whitening is becoming more and more popular, but the patient must be aware of the limitations of such a practice. Many factors can influence tooth colour, even after tooth whitening. Immaculate, white teeth are not the reality for natural teeth. No whitening technique can brighten the colour of the teeth beyond their original colour! Realistic expectations about tooth whitening are therefore required, and your dentist, an oral health professional, is best qualified to help you determine these expectations when evaluating your teeth.

Processing steps and times

Whitening done at home:

  • First appointment:
    • Consultation with review of the patient’s dental and medical history;
    • Impressioning of the dental arches to be whitened in the case of molded gutters (top, bottom or both);
    • Manufacturing time for plastic gutters (variable according to dental clinics).
  • Second appointment:
    • Delivery of one or more gutters with the whitening product;
    • Application instruction to the patient.
  • Third appointment:
    • Replacement of the second gutter (depending on the case);
    • Control of the processing progress.

Whitening performed in the clinic (at the chair):

  • First appointment:
    • Consultation with review of the patient’s dental and medical history;
    • Estimated costs based on the number of sessions required.
  • Second appointment:
    • Protection of gums and soft tissues of the mouth;
    • Application(s) (one or more) of the product on the teeth (with or without an activator lamp);
    • Application of desensitizing agent (if necessary);
    • Provision of post-operative instructions to the patient.
  • Third appointment:
    • Control of the processing progress.

Important notes:

  • Cleaning and descaling prior to bleaching is recommended to optimize results.
  • Whitening treatments in the clinic and at home can be combined for optimal results.

Cost

  • The cost varies according to the number of teeth to whiten (e.g. upper or lower teeth only);
  • The cost also varies depending on the method used (chair whitening or home whitening);
  • Private insurance does not usually cover this type of treatment, which is considered aesthetic in nature.

Maintenance

  • Avoid, in the hours following treatment, consuming foods rich in colouring (coffee, tea, herbal tea, red wine, etc.) It is also strongly recommended to limit smoking to a minimum;
  • For home whitening, whitening syringes for touch-ups if necessary (often once a year) are available at the dental clinic to prolong the whitening effect;
  • Maintaining good oral hygiene practices, including brushing teeth 2 to 3 times a day, flossing, using interdental brushes and mouth baths when necessary is essential to the longevity of the treatment;
  • Make an appointment twice a year for a dental exam and a complete cleaning.

Restrictions

Contra-indications:

  • Patient with active gum disease (periodontitis);
  • Patient with untreated cavities;
  • Patient who plans to change the position of his teeth by orthodontic treatment (the gutters will no longer do);
  • A person under 12 years of age or whose permanent teeth have not yet erupted;
  • Pregnant or breastfeeding woman (peroxide can cross the placental barrier and affect the fetus. It can also be found in breast milk);
  • Patient with restorations already present in the mouth that he/she does not want or cannot change (veneers, crowns, bridges, etc.);
  • Ideally, people under 18 years of age should not do a bleaching treatment, since the level of teeth in the bone can still change and the gutters do not adapt to the growth of the jaw;
  • Smokers may be exposed to a higher risk of oral cancer, since the bleach product may react with the different products contained in cigarettes. In addition, the results are not stable over time, since nicotine stains teeth very much.

It is important to seek the advice of an oral health professional before undertaking a dental clarification procedure if:

  • you have dental or gum sensitivity when you eat or drink hot or cold foods;
  • you have an unpleasant feeling of cold on your teeth when you breathe with your mouth open;
  • you suspect the presence of an oral or gum infection;
  • you notice ulcers, abscesses, redness, swelling and/or bleeding of the gums;
  • you are taking, or have taken, any medication that discolours or has discoloured your teeth.

Alternative solutions

  • Porcelain veneers;
  • Composite veneers;
  • Crowns.
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