Whitening: What Are Your Options

By Dr. Jarrod Jones

A large majority of our patients mark on their dental history form that they would like their teeth to look whiter.  When I see this, there are several questions that pop into my head:

  1. What have you tried so far to whiten your teeth?
  2. How did that work for you?
  3. Are you looking for treatment that will temporarily whiten the teeth or are you looking for a permanent whitening solution?

There are several solutions to whiten one’s teeth, it just depends on what your expectations are.

If you smoke or drink large amounts of staining beverages (coffee, tea, etc.) and feel your teeth are yellowed from stains that are on the surface of the teeth (extrinsic staining), then you can try a whitening tooth paste to see if that will remove the stains from the surface of the teeth and make them look whiter.  Toothpaste ingredients typically consist of mild abrasives to remove debris and residual surface stains. Examples of abrasives include calcium carbonate, dehydrated silica gels, hydrated aluminum oxides, magnesium carbonate, phosphate salts and silicates.  You must be careful when using these toothpastes long term as they can remove enamel from the teeth due to their abrasiveness.  Whitening toothpastes will only remove the stains from the surface of the teeth (extrinsic stains), not stains that are within the teeth (intrinsic staining).  You must employ other tactics to remove the intrinsic staining.

Intrinsic staining can be removed by using bleaching gel such as carbamide peroxide or hydrogen peroxide.  Any of the bleaching gels can cause your tooth sensitivity.  This sensitivity is transient and usually subsides if you discontinue using the product for a few days.  You can then resume using the product again until your teeth become sensitive again.  This bleaching gel can be delivered using several different methods.

Over the counter bleaching trays such as Crest Whitestrips is one option.  The Crest Whitestrips have evolved over time and have become very effective at tooth whitening.  One of the drawbacks with the whitening strips is that if you have crooked teeth, it is very hard to get the strips to apply to ALL the teeth evenly.  If this is the situation, we can fabricate custom bleaching trays for you.

Custom bleaching trays are fabricated by taking an impression of your teeth and then pouring them up in dental lab stone.  Using the dental lab stone models, we make a custom bleaching tray that is specifically made to hug your teeth and keep the bleaching gel in contact with your teeth.  You will then come back in to deliver the bleaching trays and we will give you instructions regarding how to use them.  It can take 7-14 days so if you have a wedding or a big event coming up and need to whiten quickly, we can perform in-office bleaching to jumpstart the bleaching process.

In-office bleaching involves the placement of a barrier on the gums to protect them from the bleaching gel.  The bleaching gel used in the in-office setting is of a higher concentration and can irritate and harm the gum tissue if it exposed to it.  Once the barrier is placed, the in-office bleaching gel is applied to the teeth and allowed to sit for a specified amount of time.  Once the gel has set for the allotted time, it is removed from the teeth and the whitening is evaluated.  2-3 applications may be required to obtain desired results.  Usually in-office bleaching is followed up with the use of custom trays after the in-office bleaching to help maintain the desired whitening.  What if your teeth just won’t bleach or you are looking for a permanent whitening solution because you don’t want to mess with bleaching?

Porcelain veneers or porcelain crowns may be an option in this situation.  Porcelain veneers will be your most conservative option.  No, or minimal prep, porcelain veneers may be an option in a few situations.  These are great for cases where we are closing spaces or building the smile out further. Traditional porcelain veneers are used in cases where you need to have the veneer be thicker to hide the darkness of the tooth.  If you have several restorations or the tooth is dark, we may have to crown the tooth to protect it and get the appropriate shade match.

It is important to remember that any restorations that are present will not be altered by the bleaching process, therefore the teeth may lighten around the restorations and make the restorations much more noticeable.  If you are wanting to whiten your teeth and change the existing restorations to match, it is important to bleach prior to replacing those restorations.  You should discontinue bleaching for at least 2 weeks prior to selecting the shade or replacing the restoration.  The teeth can darken slightly after bleaching is stopped due to the rehydration of the tooth structure.

If you have any questions or would like a free consultation to see how we can help you improve your smile, call us at (785) 625-7369.  We love making you feel and look your best!!

Cedar Lodge Dental

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Whether you need a Hays dentist to provide your children with routine dental exams and professional cleanings or are interested in implant dentistry to fill the gaps in your own smile, you can rest assured that we have the dental services you need to achieve and maintain your best possible smile! To schedule an appointment with us, please give our office a call at (785) 625-7369 or complete the Appointment Request form. We look forward to meeting you soon and welcoming you to our practice where we give our patients plenty of reasons to smile!