Written by Dr. Smriti Bhanot, BDS, MDS (Prosthodontics) | 
Medically Reviewed by dr. simi paknikar, MD on May 14, 2014

Tooth Whitening Options

Based on the cause and severity of discolouration, tooth whitening options are selected. These may range from the professionally performed procedures to the use of home whitening options.

The methods of tooth whitening have been classified into 3 broad categories. The first is the in-office type that is performed by the dentist in his clinic, second being the dentist-prescribed products where the dentist may prescribe certain bleaching products to the patient and shall monitor the patient at regular time intervals and finally the over-the-counter products, these may be chosen by the patient based on his preference.

In-Office Power Bleaching

The in-office bleaching procedure where the dentist applies a gel or a liquid on to your teeth to achieve bleaching is also known as power bleaching. Power bleaching uses concentrated bleaching agents and therefore is performed under the supervision of the dentist. The advantage of this procedure is that the procedure is performed under dentist supervision and the concentrated bleaching agent used ensures faster results. However, on the flip side, due to the concentrated bleaching agents used, there are more chances of hypersensitivity and tissue irritation.

Tooth Whitening Power Bleaching

During in-office bleaching, the dentist will apply a mask on your gums to protect them from the caustic effects of the bleaching agent. This is followed by application of the bleaching agent which are supplied in the form of gels. After application, the dentist will activate the gel using lasers or LED devices for a fixed time duration. Once the desired shade of teeth has been achieved the dentist will remove the gel. Subsequently, a fluoride gel is applied and the teeth polished. In certain cases, multiple appointments may be required to get the desired results.

Dentist-prescribed Bleaching

The dentist-prescribed home bleaching procedure is generally prescribed for patients with only mild stains. Here, the dentist used milder concentration of the bleaching agent. The disadvantage of this procedure lies in the fact that as it is not performed under direct dental supervision, there are greater chances of adverse reactions and unreliable results such as blotchy appearance of teeth and irritation to the gums.

During this procedure the dentist will fabricate a tray to hold a bleaching agent. The bleaching agent must then be dispensed in these trays and placed onto the teeth for a prescribed time duration followed by rinsing with water and a fluoride mouth wash.

Tooth Whitening Tray

In-Store / Over-The-Counter

There are a variety of over-the-counter bleaching options available. These include strips, trays and brushes and tooth pastes.

Strips

Whitening strips are one of the most common over-the-counter products available for tooth whitening. These are clear strips with a gel in between; the cover is peeled off and the strip with the gel is placed on the teeth. The strip should be kept in contact with the teeth for the time prescribed by the manufacturer.

Tooth Whitening Strips

The disadvantage of the strip system is that the strips can slide easily and have the potential to produce uneven whitening. There are also chances of irritation to the gums and are messy to work with.

Trays

The tray system contains a prefabricated tray which adapts well onto the teeth. They may or may not contain a gel in between. The tray can be worn for the time prescribed by the manufacturer and gives the best results among all the over-the-counter products.

The disadvantage with this system is that the tray may not adapt well to the teeth causing the gel to leak out resulting in soft tissue irritation.

Tooth Pastes

These pastes contain mild enzymes and only remove very mild stains. They should be used like normal tooth pastes twice daily.

Tooth Whitening Tooth Pastes

References:

  1. Tooth Whitening/Bleaching: Treatment Considerations for Dentists and Their Patients ADA Council on Scientific Affairs September 2009.
  2. J.E. Dhal; Tooth Bleaching-a Critical Review of the Biological Aspects;Critical Reviews in Oral Biology & Medicine, July 2003; vol. 14, 4: pp. 292-304.
  3. Howard E. Strassler, Vital Tooth Bleaching: An Update ;University of Maryland Dental School
  4. A Watts & M Addy Tooth discolouration and staining: Tooth discolouration and staining: a review of the literature; British Dental Journal 190, 309 - 316 (2001).
  5. C J Tredwin, S Naik, N J Lewis & C Scully: Hydrogen peroxide tooth-whitening (bleaching) products: Review of adverse effects and safety issues: British Dental Journal 200, 371 - 376 (2006).
  6. Baratieri, Luiz Narciso; Ritter, André Vicente; Monteiro Jr., Sylvio; Caldeira de Andrada, Mauro Amaral; Cardoso Vieira, Luiz Clóvis: Nonvital tooth bleaching: Guidelines for the clinician: Quintessence International. Sep1995, Vol. 26 Issue 9, p597-608. 12p.

Comments

Imayavaramban Tuesday, May 27, 2014

Do using lemon for tooth whitening cause any problem.....??

rrrajaa Tuesday, May 27, 2014

Hi imaya, using lemon cannot be supported as it can cause erosion of the Dental enamel as it contains citric acid, which even can cause gastritis in person who are having acidity.

vaishali9524 Thursday, May 15, 2014

What is the average cost of in-office tooth whitening??

drraja Saturday, May 17, 2014

The basic fee is around 10,000 INR and more over it varies,

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