What Works Best When It Comes To Teeth Whitening?

If you’re like most people, you’ve probably considered teeth whitening at some point. But with so many options available now, you’re probably wondering what really works the best. It’s important to remember that not everyone is a good candidate for teeth whitening and that any option that you select should be discussed with your dentist. 

There are generally three categories of teeth whitening: Pinterest Savoy D.I.Y Treatments, Over The Counter Treatments and Treatments applied or dispensed by your Dentist. And of course each of these major categories have their own little sub-categories. By the end of the day all of these different options can leave you extremely confused as to what to try first, what will give you the best bang for your buck, what works the fastest, and what will give you the best results.

To truly understand teeth whitening, and why certain things work better than others, it best to understand the reason your teeth appear yellow. There are three main types of teeth stains:

• Extrinsic Staining: Meaning that the outer layer of the tooth, the enamel, is stained. This can be caused by dental plaque, coffee, wine, soda, food and smoking.
• Intrinsic Staining: When the inner structure of the tooth, the dentin, is stained. This can be caused by many different things, most common is Tetracycline Antibiotics, trauma to the baby teeth while the permanent teeth were developing, trauma to the permanent tooth, or a rare condition called dentinogenesis imperfecta.
• Age-related Staining: This is a combination of both extrinsic and intrinsic staining. The dentin of our teeth naturally yellows over time, and the enamel of our teeth starts to thin, making the dentin more visible. This combined with staining from coffee, wine, soda, foods and smoking makes our teeth appear yellow.

It’s also important to understand the different types of whitening agents contained in these products and why one is more effective than the other. Both Carbamide peroxide and Hydrogen peroxide are effective in whitening teeth, they just work differently.

Carbamide Peroxide: Works slower and has a longer oxygen release time. It releases about 50% of it’s whitening agent in the first 1-2 hours and then continues to remain active for up to six hours. It’s typically considered to be more stable and sometimes has better long-term whitening effects. It is also estimated to be 1/3 less potent than hydrogen peroxide. Meaning a 30% carbamide peroxide would be equal to a 10% hydrogen peroxide.

Hydrogen Peroxide: Achieves results much quicker results, releasing most of it’s whitening agent in 30-60 minutes. Because it is more concentrated, tooth sensitivity is experienced more frequently with this type of whitening system.
Treatments provided by your dentist have been proven to have the best whitening results. The most effective being the in office whitening. However, your dentist can also create custom fitted whitening trays, and dispense home use whitening gels that are also proven more effective than over the counter whitening. Either method utilized is not only treating extrinsic staining, but also intrinsic staining.

In Office Whitening: These systems use a very concentrated high dose of hydrogen peroxide. When these procedures are performed, your dentist or their assistants will isolate all of your teeth and place barriers between your soft tissues (which can be burned by the peroxide), and the areas being treated. Once everything has been isolated and a strong barrier has been established between your teeth and your gums, the whitening agent is applied directly to the teeth. There are many different in office whitening systems available, some require lights and some require constant agitation of the peroxide. Certain systems have even been proven effective in lightening teeth effected by tetracycline staining. The advantages of this type of treatment is the immediate results. You will leave your dentist’s office with a whiter smile that day. And because it is under the supervision of a dental professional, if sensitivity is experienced it is easy to stop treatment and apply relief gel. The disadvantages are: a bounce back period is expected after these procedures because of tooth dehydration. Meaning your teeth will appear whiter and possibly even chalky the day of the procedure. This is because while being isolated to apply the whitening products, your teeth have been removed from their normal wet environment and dehydrated. As the teeth re-hydrate, it is normal for them to appear slightly darker. Most dentists will also include custom formed whitening trays and a take home carbamide peroxide gel for touching up the whitening achieved. Patients are also more likely to experience tooth sensitivity using this method because of the high dosage of hydrogen peroxide being used. While this sensitivity is temporary, it is uncomfortable.

Custom Whitening Trays: These are made by taking impressions of your teeth. The dental assistant will take the impressions and create stone models of your teeth, then using a heating/vacuum appliance and a special tray material plastic, will create vacuum formed trays. The assistant will then trim the trays to make them comfortable to wear. Once your trays have been completed you will have a short visit with the dental assistant to ensure the proper fit of the trays and review instructions on how to use the take home whitening gel provided. Depending upon your dentists preference you will either be given a carbamide peroxide solution or a hydrogen peroxide solution. The advantage of this system is that while you are not achieving “Hollywood White” over night as you may be able to with an in office treatment, over time you can achieve the same results. Also, because the trays are custom fitted, as long as the appropriate amount of gel is being used, the gel remains only on the teeth during treatment and there is little risk of burning soft tissues such as your gums. The disadvantage is that it is not an overnight solution to yellow teeth and does require dedication to completing the process daily for 2 weeks.

The Pinterest Savoy D.I.Y Treatments are most commonly slightly effective, but not entirely and some are down right terrible ideas. A good thing to keep in mind when viewing D.I.Y. treatments is that they do not treat intrinsic staining. Although it advertises a bright white smile, most likely that is not what you will achieve. Below are the two most common D.I.Y. treatments found on Pinterest.

Combining baking soda, whitening tooth paste and hydrogen peroxide and brushing time per week. – While this may be slightly effective after time, this approach is not the best for your teeth. Whitening toothpaste is already very abrasive, adding another abrasive to the paste makes it overly abrasive and can actually damage the enamel on your teeth. This approach also only addresses extrinsic staining, it does not address any intrinsic staining.

Activated Charcoal Scrub. – This approach will also address the extrinsic stains on your teeth. However, similar to the baking soda approach, it is extremely abrasive and not good for the enamel of your teeth. It also is not addressing the intrinsic staining. Further, there is research suggesting that this trend may not be as good for your health as advertised. Visit http://www.womenshealthmag.com/health/drinking-charcoal for more information about possible health risks with using Activated Charcoal.

Over The Counter Whitening products seem to multiply each year! Between the strips, the trays, mouth rinse, pens, and the tooth pastes; it’s easy to get confused.

Whitening Strips: Typically the strips sold at the grocery store range from 6%-10% hydrogen peroxide applied on one surface of the strip. The advantage of this type of over the counter whitening product is that it is fairly priced, decently effective over time and easily available at your local grocery. The disadvantages are that the strips are one size fits all and do not typically reach all of the teeth that whitening is desired on. Another disadvantage is that because it is a strip there is more chance for contact on the soft tissues of your mouth such as you gums which can be burned by the whitening agents. Also, because it is using hydrogen peroxide, patients are more likely to experience sensitivity using these products.

Whitening Trays: Whether pre-formed with gel already placed inside, or trays that you place in boiling water and add gel to yourself; typically these products contain carbamide peroxide. The advantages of this type of system is that it is much safer for at home use. Because the whitening agent is not as concentrated you are less likely to experience tooth sensitivity and soft tissue burning is less severe if it comes in contact with those areas. With the non-preformed trays is that you are able to include all of the teeth you are wanting to see results on, and it is available over the counter. Disadvantages are that the trays while somewhat “custom formed to your teeth” are not completely tight to the teeth and therefore don’t keep the material as well. That type of custom tray is only achieved by a dentist by taking models and using a heat/vacuum system. Also, because the product is using a carbamide peroxide, it takes much longer to achieve the results of a “Hollywood White Smile”.

Whitening Toothpaste: Tooth pastes that claim whitening results do so by using an abrasive additive that helps to remove extrinsic staining from your teeth. These products do not help with intrinsic staining and are known to cause tooth sensitivity as you are scrubbing your enamel of the tooth.

Now that you are a little more educated on what products are available, and how they work, hopefully you can make an educated decision with your dentist on what type of whitening is best for you. For more information on the effectiveness and safety of teeth whitening, you can visit http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/tooth-whitening-safety-and-effectiveness.