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What should you ask the dentist?

You may want to start by speaking with the dentist.  He or she can tell you whether whitening procedures would be effective for you.  Whiteners may not correct all types of discoloration.  For example, yellow-ish hued teeth will probably bleach well, brownish-colored teeth may bleach less well, and grayish-hued teeth may not bleach well at all.  Likewise, bleaching may not enhance your smile if you have had bonding or tooth-colored fillings placed in your front teeth.  The whitener will not affect the color of these materials, and they will stand out in your newly whitened smile.  In these cases, you may want to investigate other options, like porcelain veneers or dental bonding.

What is in-office bleaching?

If you are a candidate for bleaching, the dentist may suggest a procedure that can be done in the office.  This procedure is called chair-side bleaching and may require more than one office visit.  Each visit may take from 30 minutes to one hour.

During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues.  A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent.  Lasers have been used during tooth whitening procedures to enhance the action of the whitening agent.

What are at-home procedures and products?

There are several types of products available for use at home, which can either be dispensed by the dentist or purchased over-the-counter.

Bleaching solutions.  These products contain peroxide(s), which actually bleach the tooth enamel.  These products typically rely on percent carbamide peroxide as the bleaching agent; carbamide peroxide comes in several different concentrations (10%, 16%, 22%).

Peroxide-containing whiteners typically come in a gel and are placed in a mouthguard.  Usage regimens vary.  Some products are used for about twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks.  If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouthguard for you that will fit your teeth precisely.  Currently, only dentist-dispensed home-use 10% carbamide peroxide tray-applied gels carry the ADA Seal.

You also may want to speak with the dentist should any side effects become bothersome.  For example, teeth can become sensitive during the period when you are using the bleaching solution.  In many cases, this sensitivity is temporary and should lessen once the treatment is finished.  Some people also experience soft tissue irritation – either from a tray that doesn’t fit properly or from solution that may come in contact with the tissues.  If you have concerns about such side effects, you should discuss them with the dentist.

Toothpastes.  All toothpastes help remove surface stain through the action of mild abrasives.  “Whitening” toothpastes in the ADA Seal of Acceptance program have special chemical or polishing agents that provide additional stain removal effectiveness.  Unlike bleaches, these ADA Accepted products do not alter the intrinsic color of teeth.