What’s the first thing you notice about another person? Is it their eyes? Is it their physique? Or, as science seems to support, is it their smile?
Appearance plays an overwhelmingly decisive role in informing how we see others and how others see us, at least initially. Moreover, one of the most significant components of this initial visual impression is your smile. Small wonder then that improving, enhancing, or even completely remaking one’s smile is not only highly desirable, but it’s also extremely commonplace. In the US alone, about $1 billion per year is spent on cosmetic dental procedures.
Millions of people put their children through the misery of orthodontic treatment regimens in their teen years, typically with braces, so that their children can have perfect smiles as adults. They understand the immense value of investing in cosmetic dentistry can have. A beautiful, attractive smile will help their children’s self-confidence, improve their social lives, enhance the likelihood of landing a great job, and even help them attract a lifelong partner and mate.
"Modern whitening treatments can be divided mainly into two broad categories - treatments that focus on removing extrinsic staining and treatments aimed at affecting the dentin itself."
--- DR. REZA KHAZAIE, DDS. PROSTHODONTIST
Of course, in pursuit of a perfect smile, braces (Clear Braces) and other straightening treatments are but one component. Dazzling white teeth are the hallmark of a beautiful smile.
Everyone wants to have whiter teeth. With readily available over-the-counter pastes, gels, lights, trays, and other equipment, attaining whiter teeth has never been easier. In fact, clinical dental whitening is probably the easiest, least invasive, and the most effective way to professionally improve and enhance your smile. However, a wide range of options also breeds consumer confusion.
Which teeth whitening treatment will work best for me?
How much will it cost? Do they even work?
How exactly does the teeth whitening process work?
These are but a handful of the questions most consumers have. While brilliant white teeth are desirable, getting the best results is much more difficult.
In a world rife with misleading marketing, overhyped products, and overblown claims, it’s easy to feel overwhelmed. That’s where patient education comes in. Since you're reading this article, you’re already off to a great start.
It’s our goal here at Willow Pass Dental Care to educate you by taking you through the ins-and-outs of the dental whitening process, including not only how professional whitening treatments work, but also relevant and useful information about at-home treatments, over-the-counter products, holistic therapies, and alternative treatments.
The Science of White Teeth and Attraction
People find perfect, white teeth to be attractive. They simply do. Explaining the science behind why human beings are so enamored of this one particular dental quality is much more difficult. The working theory goes something like this: dental quality (i.e., white teeth) acts as a psychological signal to potential mates about the age, health, and vitality of a particular individual. Crooked, yellow teeth are associated with poor health and poor hygiene. Likewise, discolored teeth may also indicate someone who is older, weaker, and less potent. Of course, teeth are so much more than just a mere visual cue for potential mates. They also act as ornaments. You can literally “wear” your smile like a beautiful, dazzling, and brilliant piece of jewelry.
How Does Whitening Work?
To understand the underlying process behind dental whitening, it is essential to know about the structure of your teeth. The outer layer of a tooth is known as the enamel. While it is visible and exposed for all to see, it is only partially responsible for dental coloration.
Right underneath the enamel is the dentin. Dentin is naturally yellowish. The coloration of natural teeth is mostly the dentin showing through the translucent enamel. That’s what gives healthy teeth a slightly off-white hue. Therefore, dental coloration is not only determined by the color of the enamel but also the dentin beneath the enamel.
Because dental enamel is exposed, it is vulnerable to extrinsic staining. What that means is that the enamel itself can be physically discolored by staining agents such as the tannins found in colored beverages such as coffee or wine, or the gradual infiltration of staining agents into the enamel matrix thanks to biofilm, bacteria, and enamel erosion. It is important to note that the gradual wearing away of enamel can also result in visible discoloration as yellower dentin is revealed beneath the enamel.
Discoloration due to the condition of the dentin is known as intrinsic staining. Intrinsic staining beneath the enamel is often not the result of exposure but rather the consequence of factors that are systemic in nature and difficult to control such as genetics, medications, fluoride exposure, and environmental circumstances.
Modern Teeth Whitening Treatments
Modern whitening treatments can be divided mainly into two broad categories - treatments that focus on removing extrinsic staining and treatments aimed at affecting the dentin itself.
In the former falls general dental hygiene and cleaning services and products aimed at removing and reducing enamel-destroying bacteria and extrinsically staining substances.
In the latter falls peroxide-based treatments that rely on chemicals such as hydrogen peroxide to chemically alter the underlying dentin. To achieve a long lasting and natural looking result, both approaches are recommended. Both extrinsic and intrinsic staining must be addressed to get a brilliant white smile.
Extrinsic whitening methods are widely understood. Physically removing staining pigments, such as darkening tannins, will lead to whiter brighter teeth. Likewise, eliminating bacterial biofilm, also known as plaque, tartar, and calculus, will reduce and reverse enamel erosion. Remember, enamel is translucent which means decreasing its natural thickness will expose the yellower dentin underneath leading to visible discoloration. To avoid thinning the enamel and exposing the dentin, you should avoid exposing your teeth to eroding acids or physical trauma.
Intrinsic whitening is a little more abstract, and it typically is what patients and dentists are generally referring to when they talk about “dental whitening.”
Dentin contains color molecules known as chromophores which reflect light in a way that makes the dentin look darker than the enamel. These chromophores also tend to bond together resulting in a gradual darkening of the dentin which gives teeth a yellow hue. To combat this, dentists and some off-the-shelf products utilize peroxide-based treatments to break up bonded chromophores chemically. This results in noticeably whiter looking teeth.
Off-The-Shelf & At-Home Dental Whitening Products
Toothpaste products claiming to whiten teeth are everywhere and easy to find. In fact, it may be harder for consumers to find a toothpaste that does not claim to provide some whitening action. Buying a whitening toothpaste is by far the easiest, most accessible, and most affordable form of dental whitening treatment available to consumers.
Mostly, whitening toothpaste products rely on surface action to remove extrinsic surface stains. Many toothpaste products formulated explicitly to whiten teeth contain harsh ingredients, such as silica, that mechanically scrub away staining agents. As a result, whitening toothpaste products generally have little effect on the natural coloration of a person’s teeth. Many consumers find that the claims found on the toothpaste packaging, while technically correct, tend to underwhelm.
Results from using specially formulated whitening toothpaste products generally take months to manifest and must be accompanied by good dental habits such as avoiding coffee, wine, and other staining agents.
Whitening strips are the second most popular option for at-home dental whitening after whitening toothpaste products. Dental whitening strips can be found at your local grocery store or pharmacy. While more expensive than whitening pastes, they are also far more effective with patients seeing a noticeable lightening of their teeth within three to seven days with results lasting as long as six months with adequate dental care.
Dental strips consist of two flexible plastic strips that are applied to the teeth for a period of time. The strips are often coated with hydrogen peroxide or a peroxide derivative that can remove intrinsic dental staining.
Whitening gels, which are typically utilized in conjunction with a tray, are the next logical step up from dental whitening strips.
Gels should be used with caution. Unlike most off-the-shelf dental strips, gels often contain a higher percentage of hydrogen peroxide or carbamide peroxide and are often in contact with teeth for a more extended period of time. When used with ill-fitting trays, hydrogen peroxide can irritate gums. When using gels with an at-home tray application, be sure to follow the manufacturer, or supervising dentist recommended application time to avoid unnecessarily damaging your gums and soft tissues.
Due to the stronger nature of gels and the longer contact time with teeth, results are often noticeable within days. Like other peroxide-based treatments, gels remove intrinsic staining which makes teeth shine brighter for more extended periods of time.
Whitening pens are simply portable and pocketable implements containing peroxide-based gels (typically 10% carbamide). They are designed to be applied to each tooth quickly and discreetly and are great for removing stains on the go.
While trayless, whitening pens do not provide the whitening power of dental whitening strips or tray-applied gels because the peroxide film applied by the dental whitening pen usually does not last long on the surface of the teeth. It is easily rubbed off or dislodged by consuming food and drink or by the natural rubbing of the inner mouth on dental surfaces. In other words, dental whitening pens are a nice, portable, quick fix but they are not a long-term whitening solution.
Whitening kits with LED lights is a recent craze in the at-home dental whitening market. However, before you jump on the bandwagon, it is vital to understand what you are paying for. LED lights do not in and of themselves whiten teeth. Instead, they are intended to accelerate the bleaching properties of peroxide gels.
Do whitening kits with LED lights work?
The answer seems, at least based on the science as it stands today, to lean towards “no.” There have been studies that have shown marked whitening improvement with LED light-based treatments. However, there have been far more studies that show LED lights either made little difference or no difference whatsoever. The consensus is that whitening kits with LED lights may help accelerate the bleaching process but may not be worth the costs.
Professional Dental Whitening Treatments
Clinical whitening sessions are typically much more involved than at-home, self-directed therapy. The process usually takes a few sessions or visits to your dental clinic, although it is possible to complete an entire whitening regimen in a single visit.
A professional process often begins with a touch-up cleaning.
Analysis of the Shade and Coloration
This is followed by a comparative analysis of the shade and coloration of your existing teeth and a target shade that looks best for you.
Teeth Are Prepared
Once a shade is determined, the patient’s teeth are prepared for the whitening procedure.
Dental Dams Are Applied
Dental dams are applied to prevent any gum irritation. These protective applications prevent any bleaching peroxide from touching your soft tissues.
Professional-Grade Hydrogen Peroxide Whitener is Applied
Once the dam is put in place and hardened using a unique light, the dentist applies a professional-grade hydrogen peroxide whitener. These super strong peroxides can range in concentration from 15 percent to as much as 50 percent. In comparison, at-home bleaching gel concentrations are typically 10 percent and sometimes less.
After the bleaching agent is applied, it is given time to work. Sometimes a bleaching light will be used to accelerate the bleaching time, although the jury is still out as to the efficacy and effectiveness of such measures.
Teeth Are Washed & Dental Dams Removed
After the peroxide gel is done curing, it is removed, and the teeth are washed. Dental dams and other protective gear are removed, and the treatment process is completed.
Finishing Application of Fluoride
Some dentists will also recommend a finishing application of fluoride to help reduce dental sensitivity and help protect their patient’s newly whitened teeth.
Professional Whitening vs. At-Home Whitening
Both professional whitening in a dentist’s chair and self-guided whitening at home are both great options for patients seeking to brighten up their smiles. Ultimately, both approaches have advantages and disadvantages that should be taken into account when making a decision.
Which Whitening System Works Best For You?
In general, patients with a larger budget and less time should seek professional whitening. Patients with a tight budget and who are willing to wait weeks to months to see results could find at-home dental whitening treatments. Patients should also take into account their own ability to self-direct treatment and stick to a prescribed treatment plan. To see results from an at-home treatment, users must be diligent, follow instructions carefully, and perform each treatment session on time. Patients who receive whitening procedures from a dental facility such as Willow Pass Dental Care often see marked improvement immediately and rest easy knowing their treatment planning and execution is being handled by dental professionals.
Lifestyle & Holistic Dental Whitening Strategies
While effective, direct chemical whitening treatments aren’t your only option for maintaining or even gradually whitening your teeth naturally. Most dentists would recommend a balanced combination of extrinsic, intrinsic, and holistic strategies to help support, preserve, and actively brighten up your smile.
Lifestyle changes can be one of the easiest, most cost-effective ways to whiten your teeth or protect your whitening investment. Simply avoiding staining beverages such as coffee and wine can go a long way towards preserving your white teeth. When drinking beverages, especially acidic beverages such as fruit juices and sodas, using a straw does wonders for your teeth. Other lifestyle changes that can play a role in your whitening include eating a healthy diet, getting enough sleep, and exercising daily. A healthy body means healthy teeth. Our teeth are intimately connected to and affected by the rest of our body. Maintaining good health means that our teeth will have the nutrients they need to build enamel, fight off bacterial infections, and keep healthy bone density.
Watching what you eat and maintaining good health is, by far, the most economical, most effective, holistic, and the best way to improve your smile and your teeth.