Should I Get my Teeth Whitened?

There are many reasons that teeth may inherently have less than optimal coloration at the time of eruption, including but not limited to:

• Using some types of medications when a tooth is developing
• Traumatic injuries during the development of the teeth
• Fevers and illness during tooth formation
• Genetics
• Elevated levels of fluoride ingestion during tooth formation

Once teeth have erupted, there are factors that can darken the appearance of teeth, including but not limited to:

• Superficial stains caused by red wine, coffee, tea, etc.
• Extrinsic stains within small cracks in the enamel caused by coffee, tea, and red wine
• Aging dental fillings and restorations
• Receding gums
• Trauma to a tooth
• Root canal treatment

Esthetic chemical tooth whitening, sometimes called “bleaching,” can often result in dramatically improved smiles.

In some cases, whitening is all that is necessary to enhance an already beautiful smile. However, whitening is often combined with other dental procedures like veneers, crowns, bonding, orthodontics, and gum surgery for receding gums to create pleasing smiles for patients that desire cosmetic enhancement.

How Whitening Works

Chemical whitening is done with various forms of hydrogen peroxide that are released from specially formulated gels that contain prescribed dosages of the active bleaching agent and release them over a controlled period of time. These gels are most commonly applied in custom-made trays at home on a daily basis for a prescribed period of time, typically for 2-6 weeks depending on the diagnosis of the tooth shade discrepancy. Alternatively, in-office applications of stronger dosages can be applied in a process called “power bleaching” for some cases. Whitening can also be done to a lesser extent with over-the-counter products like whitening toothpastes, paint-ons, and plastic strips embedded with a whitening agent.

Hydrogen peroxide essentially diffuses through the enamel and dentin of the teeth and binds with chemicals that cause stains and changes them into colorless chemical products through a chemical reaction called oxidation. When there is no more colored chemical stain for hydrogen peroxide to bind to, excess hydrogen peroxide begins to actually break down the crystalline structure of the enamel. This is why whitening of the teeth should never be done without the supervision of a licensed dental professional. Chemical whitening, when controlled, is a safe therapy—but, it is possible to cause tooth damage when not carefully controlled.

Advantages of tooth whitening include, but are not limited to:

• Whiter, brighter smiles are possible.
• Esthetic dentistry like bonding, veneers, etc., can have more pleasing outcomes.
• The long-term health of the pulp of the teeth does not appear to be compromised.

Disadvantages of tooth whitening include:

• Hypersensitivity to cold and sweets can occur due to permeation of hydrogen peroxide to the pulps of teeth.
• Enamel structure can be weakened by overuse of whitening products.
• Restorative dental materials like bonding and ceramics can be eroded.
• Existing fillings, crowns, and veneers do not whiten with natural tooth structure and may need to be replaced for a satisfactory result.
• Whitening needs to be repeated approximately every 2-3 years because surface stains continue to accumulate.