Tooth whitening has been one of those dental procedures that has literally changed people's lives. We see people who never smile change their entire personality by becoming a "smiler" rather than a frowner. We all know a smile is infectious.
There are many products in the market place that claim to whiten teeth. Most rinses and toothpastes do not. Some of these products can even be harmful. There is much advertising about the value of one step whitening using a light or laser. Every study has shown that these devices do not add value to the whitening process. (See excerpts from studies following this article.)
The procedure we find that works the best is the use of a custom tray, fabricated in our office, which fits the teeth precisely. The bleaching solution is placed in the custom tray and can be worn for as little as 30 minutes a day but the best results may be obtained by wearing overnight for a few weeks. Although results may vary, the teeth always get lighter. The photograph you see is of a 60 year old male. The upper teeth have been bleached by the above method and the lower teeth have not. Needless to say, the patient is very pleased and wants to get started on his lower teeth immediately. We believe strongly after research and experience that our method for teeth whitening is the best value and gets the best result.
Satisfaction with in-office bleaching was 48% "very satisfied" or "satisfied" (16% and 32%, respectively), and 28% "unsatisfied" or "very unsatisfied" (23% AND 5%, respectively).
This patient, who is 60, just bleached his upper teeth and is now eager to start bleaching the lower.
"Whether you use light or not, there's no question that in-office bleaching can result rapid whitening by virtue of the concentrations employed," Heymann said. Most of these materials have concentrations that range from 20% to 35%. By using higher concentrations, the treatment time required is reduced, but a greater incidence of tooth sensitivity may be expected as well. Fortunately, most of today's materials come in the form of pastes or gels, and some also include desensitizers. Because these materials can be better controlled, tissue contact and resulting irritation are minimized.
It should be made clear to patients that it typically takes more than one-in-office treatment to get the whitest smile. "I would like to dispel the notion that you can go in and get in-office bleach and in one treatment, achieve maximum or optimum whitening. That simply would be extremely rare," Dr. Heymann said, citing a research study published in 2003.
"There's no question one treatment is going to get you whiter teeth. But keep in mind that the immediately observed post-op shade change is caused as much by dehydration effects as from oxidation effects. Much of the immediate whitening effects that are perceived are transient artificial effects owing to the dehydration of the tooth."
Satisfaction with at-home bleaching was 94% "very satisfied" or "satisfied" (49% and 45% respectively), and 2% were "unsatisfied" or "very unsatisfied" (1% and 1%, respectively).
Does Light Use Enhance Results? NO LIGHT YET EVALUATED BY CRA HAS ENHANCED RESULTS
Systems tested CRA using a split arch design where contralateral teeth received the same bleach gel for the same contract time, with or without light use, showed comparable lightening results. Many think heat from lights is a catalyst in the decomposition of the bleach gel. However, CRA tests of current systems show in vivo temperatures at the tooth surface under gels illuminated according to manufacturer's directions ranged from about 320 C which is below body temperature (37 o C) to about 450 C which is slightly about body temperature. Laboratory test could not show significant affects of the light on bleach decompositions. However, CRA continues to test light/bleach systems carefully. Theoretically, a gel could contain a chemical that reacts with a specific light, but none has yet been found.