Tooth Whitening
OK,.. Let's talk about your best shot at having the nicest smile you can have,...
WHITENING should be your second step (... after you know you don't have any cavities!)
Crooked teeth, big spaces, chipped edges, gummy smile,... Any of these defects look ten times worse if your teeth are yellow or gray. So let me fill you in on the greatest, safest thing to hit dentistry in 100 years. (Novacaine was the previous "greatest thing"! ha)
Firstly - You have to know why your teeth are not white. You can't fix this affordably or permanently unless you understand the source of the problem.
Second - You need to work with someone who has experience with repairing your particular situation. Not every dentist likes, or has vast experience in, all the options in cosmetic dentistry. (We see patients who come from VERY far away in order to have me to do their cosmetic work, and then they are free to go back to their previous dentist if they like.)
If after you read this page, you think your problem may be more than coffee or nicotine staining, take a look at our "Smile Gallery" to see some of our patients' smile transformations.
BEFORE AFTER
And to answer your first question: Is whitening safe?.. Two of the three whitening methods are completely harmless. Systems like "Crest White Strips", and the systems from your dental office that let you bleach over a couple weeks using a custom-made tray, have no damaging effects on the teeth.
The "one visit" whitening methods are a different story, so read on....
Here's some info so you can REALLY understand why your teeth are not white:
There are two types of staining:
1. External Staining- comes from things like coffee, caramel colored sodas, red wine, well water, or tobacco. It can also be from old plastic fillings that are not in good shape.
2. Internal Discoloration - is due to genetics, serious illness or exposure to medicines like tetracycline before the age of 12. Usually, this type of staining give the teeth a core gray-ish tone.
We can resolve both types of staining, but if the discoloration comes from a source deep inside the teeth (internal discoloration), it may be much more difficult to whiten. Over-the-counter products like Crest White Strips®will not work well on Internal discoloration. The would be a huge waste of money. Very often, "internal staining" is best treated with Cosmetic bonding or Porcelain Veneers. (See our website's info "cosmetic dentistry")
The good news is that "external staining" is the most common type of staining and it is very simple to resolve.
HERE IS THE INSIDE STORY ON TOOTH WHITENING...
There are four basic methods for whitening teeth:
1. Over-the-Counter Whitening Strips or Gels - These products can be purchased at any drug store. Our patients who have tried them get variable results. About half say that they noticed some improvements in the shade of their teeth. Most feel that they would like better results. Crest White strips®are an example of this type of method. We have noticed that they work best for college age people with otherwise perfect teeth: no front fillings and very few staining habits. These products treat your teeth with a concentration of 1-3% hydrogen peroxide. This is a rather low concentration that it is further diluted with your saliva. The chemistry is not strong enough to remove deep stains so you'll need to use the strips at least once each year if not more.
This can also get expensive and it is VERY labor intensive given the trouble that you have to go to for weeks and weeks, and this is often repeatedly necessary for months each year.
*** Make no mistake: I see some great results in people who are devoted to whitening with strips, but it takes far more time than I could possibly muster for myself. I'm too impatient for strips.
2. Take-Home Whitening Gels with Custom Trays - These are prescription strength (11% - 20%) hydrogen peroxide gels that you get from your dentist. Essentially, the dentists makes models of your teeth and makes you some custom made trays that fit over your teeth (and your teeth only). You put a strong gel in the tray every day, for 10 -14 days, wearing the gel filled trays for about 2 hours each day. In two weeks, for most people, there will be a wonderful improvement in the brightness of their smile.
These tray/gel systems work FAR better than the whitening strips because a higher concentration of bleach is sitting on your teeth, protected by the trays from your saliva.
And here's the good news.... If you continue with staining habits, you will want to bleach once a year, but you don't have a huge reinvestment. All you will need to do is buy some new gel. You can continue to use your old trays indefinitely! The cost for this whitening process is under $300 initially for both upper and lower teeth, but the main expense - the custom trays - is covered in that first investment. In the long-run, this is WAY more cost effective than the whitening strips which cost $35-$50 a box. As long as your custom trays fit your teeth, you can simply buy the tubes of the bleaching gel separately (at $14 per tube) and then whitening every 2 to 4 years for about $30.
(Remember, the dentist office bleach is more than ten times stronger than the bleach on strips, so you will only need to rebleach after a couple years,.. not months!)
*** If your problem includes stained old fillings, that plastic will probably not whiten, so you should still plan a visit to see us about the process of up-dating that dental work.
3. Cosmetic Bonding or Porcelain Veneers- This is the only way to whiten teeth that have the deep color stain from childhood that I call "Internal Staining". These two methods basically cover the teeth instead of trying to change the color.
You have 2 good choices if you have deep internal staining. The process can be affordable with cosmetic bonding, or the Cadillac and longest lasting option is Porcelain Veneers. (or Lumineers® ) With these options, plastic or glass coverings are permanently bonded over the front surface of each of your natural teeth. They can correct the color, shape and position of the teeth in the smile. We recommend these to patients whose teeth have any number of imperfections that can not be improved with simple bleaching. You will see endless examples of this type of change in our "smile gallery" and "smile make-overs".
4. There is a 4th method of whitening that you might want to stay away from. These are the methods that use bright lights and one long visit to the dentist, or to a "tooth whitening boutique". They will report that your whitening can be done in one visit of 3 or 4 hours and you will be charged $500 - $1000.
***But very good scientific studies show this method is not effective for longer than a few weeks. The leading dental researcher in the world - Dr. Gordon Christenson - found that you will have whiter teeth when you walk out of the office because the process has temporarily dehydrated your teeth giving them a chalky white look. By the way: The researchers got the same change in tooth color when they had test subjects drive around for one hour with their head out the car window and their teeth exposed to the sun and breeze from moving car.
Word to the wise: A permanent overnight change is unlikely to be the outcome of these "one session" bleachings. One thing that is likely is that it may make your teeth hurt excruciatingly for 3 or 4 days! (Sorry,.. just reporting what is found in the scientific literature on this "one visit" whitening.)
We have some experience with this: We bought the fancy light and tried the procedure on three volunteers. They all said that the whitening changes were temporary (lasted only a few weeks) and their teeth were exquisitely painful for three days after the procedure.
Tooth Whitening
For right or wrong, gleaming white smiles have become a sign of youth, sophistication and vigor. A healthy, bright smile has become a key to successful first impressions, in both business and social settings.
Unlike expanding waistlines, hair loss and sagging eyelids, there are simple "smile make-overs" that can be quick and affordable if done by a dentist who has a real expertise with all kinds of cosmetic dentistry.
What exactly happens as the teeth “whiten”?
Over the years, the surface of the teeth may soak up large pigmented molecules from the foods we eat or drink, or the chemicals from any other oral habits such as smoking. These molecules are simply too big to allow light to reflect off the surface of the enamel. The molecules absorb light rather than reflect it, so our eyes register this lack of reflected light as a “dark tooth color”.
Bleaching is simply a process wherein Hydrogen Peroxide breaks up these large molecules, chemically, into small molecules, which are then no longer in a light-absorbent state.
What if I have a single tooth that is very dark?
Single teeth that have darkened following trauma to that tooth may be successfully whitened with crowns or veneers, or a process called “internal bleaching". Internal bleaching requires that a root canal has been done. It is never a good idea to try to internally bleach a tooth that might have a vertical fracture through the root. It's best to come to see us for a visit if you have single tooth discoloration.
What if you have a lot of old fillings or old dental work that is staining?
The only way to know how simple it might be to correct these problems is to come in for a consultation. I see people all the time for simple "Question/Answer" visits. No scary dental setting, or lectures. We can just take a look and I can explain all your options.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
We LOVE cosmetic dentistry! We have seen lives changed by some of our smile transformations.
The only way to know which method is best for you is to visit us for a consultation. We now have patients who come from as far away as Maine, New York City, and South Carolina for our help with cosmetic dentistry. I'm sure we can help you at least answer your questions.