I am asked frequently, “Do you offer whitening?”.
First things first, I cannot stress enough—regular dental visits help to keep your smile healthy. My top priority is focusing on your oral health. While I understand that most patients want a whiter smile, tooth whitening is a treatment I am not quick to prescribe. Allow me to explain why.
There are different methods in the tooth whitening treatment universe. Dentists offer in-office whitening treatment, custom trays, and non-custom applicators. With in-office whitening, a light is usually employed to activate the whitening agent. With custom trays, a gel is usually expelled into a tray that was made specifically for the patient’s mouth. Finally, with non-custom applicators, a one-size-fits-all tray is used to deliver the whitening agent or whitening strips are used.
There are also different strengths of whitening agents. The strength of a whitening agent can range from 10% concentration all the way up to a 45% concentration. Whitening treatments usually involve hydrogen peroxide as the whitening agent. Generally speaking, the stronger the whitening agent, the faster it works. Stronger agents require less treatment time.
Whitening agents work by altering the chemical structure of the compounds that give a tooth its color. To do that, sometimes the whitening agent has to penetrate deeper into tooth layers to get the desired result. This process has been shown to have some not-so-great side effects.
First, whitening can affect the structure of the enamel on a microscopic level. To me, that is a matter of concern as the enamel protects the inner layers of the tooth and any change that softens the enamel is not a desirable change. Also, as has been shown clinically and through research, whitening can make your teeth more sensitive. Again, not something I want. Finally, in office whitening can cause more sensitivity because the whitening agent is stronger and because of the heat from the activation process. Patients report that their sensitivity is higher after the in-office treatments when compared to custom trays and non-custom applicators.
Don’t get me wrong…
There are whitening products I am comfortable using on myself and my patients. However, if you have multiple fillings, crowns, and/or exposed root structure, then I exercise caution. Studies do show that whitening agents can make existing dental work susceptible to cavities. Root structure lacks the protective enamel layer and sensitivity is more prominent in teeth that have uncovered root structure.
When it comes to choosing what method of tooth whitening to use, my recommendation is to start with the most conservative approach.
Over-the-counter whitening products can help patients achieve their goals, but my personal preference is a non-custom applicator that you can get in a dental office. It costs less for the patient and studies indicate there is not a measurable difference between the results from a non-custom applicator and an in-office whitening session. In closing, whitening does come with its own set of risks. However, when used properly, it can help patients get their smile whiter.
Contact us at Lockwood Family Dental Care to see if we can help you achieve your goals. We strive to be your favorite Webster Groves dentist! Remember, a healthy smile is a happy smile!
J Evid Based Dent Pract. 2014 Jun; 14 Suppl: 70–76.
Tooth Whitening/Bleaching Considerations for dentists and their patients. ADA Council on Scientific Affairs. September 2009 (rev. 2010).
A Randomized Clinical Trial Comparing At-Home and In-Office Tooth Whitening Techniques. JADA. Volume 141, Issue 11, Pages 1357–1364.