Tooth whitening or bleaching is a treatment where stains are removed from the dental hard tissue thereby making them appear more “white”. Yellowish teeth may result from beverages such as tea or coffee whereas dark stains may result from smoking tobacco. In today’s world when appearance and aesthetics have become a fad, the desire to have sparkling white teeth has become an obsession. Tooth bleaching as a method to get a brighter smile has become one of the most frequently asked for cosmetic dental procedure. A variety of products and treatment options are available ranging from professional bleaching to home use of products such as strips and jells. What makes this so attractive is that it is one of the most economical and relatively safe treatment options to get a brighter smile.
What is Tooth Bleaching?
The colour of our teeth is determined by the enamel which is the outer layer, and inner layer of hard tissue known as dentine. The shade and thickness of these two dental hard tissues will primarily determine the colour of our teeth. A variety of external and internal factors can modify this natural colour of teeth resulting in staining or darker looking teeth. The extrinsic causes of tooth discolouration are generally due to beverages such as tea or coffee or due to tobacco. On the other hand, birth defects due to some genetic disorders or trauma to teeth may cause discolouration of your teeth from the inside.
Most whiteners use peroxide compounds to whiten teeth. The peroxide compounds break down into hydroxyl free radicals, penetrate into the enamel and dentine where they react with the stain and thus lighten the tooth by a process of oxidation.
The market today is flooded with products and options for tooth whitening from which a patient can choose. The treatment options include professional bleaching that is done by the dentist in his/her clinic or supervised by the dentist or home bleaching where the procedure may be performed at home using products that are available over the counter.
The advantage of all these procedures is that they are relatively easy to use with noticeable results achievable in a few sittings.
As is the case with any treatment, tooth whitening is also associated with a variety of side effects such as sensitivity, pain and inflammation of gums. It is important that the cause of tooth discolouration and the probable result be determined before any treatment option is chosen.
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.
Latest Publications and Research on Tooth WhiteningTooth whitening for the under-18-year-old patient. - Published by PubMed
Tooth whitening efficacy of pigmented rice gels containing carbamide peroxide. - Published by PubMed
ERRATUM: Neurosensory analysis of tooth sensitivity during at-home dental bleaching: a randomized clinical trial. - Published by PubMed
A Whiter Shade of Grey: Comparisons of the Legal and Professional Status of Tooth Whitening in Three Jurisdictions. - Published by PubMed
Remediation of adult black dental stains by phototherapy. - Published by PubMed