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Transcript
Choosing a tooth whitening product
tooth sensitivity and occasional irritation of oral tissues. On rare
occasion, reversible tooth damage has been reported.
You may have seen or read about tooth whitening in a magazine or
newspaper ad. Televised “infomercials” and radio announcements.
But how do you know which product is right for you?
Whitening Toothpastes
The first thing to look for tis the American Dental Association Seal
of Acceptance on the product. This is your assurance that the
product has met the ADA’s criteria for safety and effectiveness for
intended use.
Several whitening toothpastes (dentifrices) that are available overthe-counter have received the ADA Seal of Acceptance. Whitening
toothpastes in the ADA Seal of Acceptance program contain
polishing chemical agents to improve tooth appearance by
removing surface stains through gentle polishing chemicals, or
some other non-bleaching action.
Peroxide-containing Whiteners or Bleaching Agents
These include products that are dentist dispensed for home use,
administered in the dental office, or purchased over-the-counter for
home use.
1. Home-Use Whiteners
Home-use whiteners dispersed by dentists usually contain 10
percent carbamide peroxide (the most commonly used active
ingredient in home-use bleaching products), which is equivalent to
about 3 percent hydrogen peroxide. Currently all of the homeadministered whiteners that have the ADA Seal of Acceptance
contain 10 percent carbamide peroxide, although this concentration
is not a requirement of the program.
Although bleaching agents are available over-the-counter, the
ADA Seal program considers only those dispensed by dental
offices. That’s because professional consultation by a dentist is
important to the whitening procedure’s safety and effectiveness.
Whitening toothpastes should not be expected to provide the same
level of whitening as a bleach product.
Special Considerations
It may be difficult to whiten some teeth. If your teeth are naturally
yellow or have brown stains from tetracycline use, your dentist
may recommend other options such as bonding, crowns, or veneers
to improve your smile.
If you have several fillings, crowns, and extremely dark stains, talk
to your dentist about which tooth whitening method and product is
right for you. A thorough oral examination is essential to
determine if bleaching is an appropriate course of treatment. Your
dentist then can monitor the treatment plan.
Your dentist may suggest the at-home method, where you lighten
your teeth at a time that is convenient for you.
What to Expect
Clinical data on 10 percent carbamide peroxide supports that both
it is safe and effective. Other ingredients of peroxide containing
tooth whiteners may include glycerin, carbopol, sodium hydroxide
and flavoring agents.
The most commonly observed side effects to hydrogen or
carbamide peroxide are tooth sensitivity and occasional irritant of
the soft tissues in the mouth, particularly the gums. Tooth
sensitivity often occurs during the early stages of bleaching
treatment, but usually lessens as the treatment continues. Tissue
irritation in most cases results from an ill-fitting tray rather than
the tooth-bleaching agents. Both of these conditions usually are
temporary and stop after the treatment.
2. In-office Whitening
In office (chairside) whitening is done in the dental office. There
are many professionally applied tooth whitening bleach products
available to dentists. These products contain hydrogen peroxide 10
concentrations ranging from 15 percent to 35 percent. They are
sometimes used with a light or laser. Bleach reportedly accelerates
the whitening process. Currently, all of the professionally applied
whitening that has the ADA Seal of Acceptance contain 35 percent
hydrogen peroxide. Although this concentration is not a
requirement of the program.
While home-use products often are intended for use over a two-tofour week period, the in-office procedure is usually completed in
about one hour. To help protect the mouth, the patient’s gum
tissues are isolated either with a rubber dam or a protective gel.
With the 10 percent home-use carbamide peroxide bleach
products, the most commonly observed side effect of
professionally applied hydrogen peroxide products are temporary
Dentists usually bleach teeth a shade lighter than the desired color
because they may darken with time. For a few days following
treatment, your teeth may be sensitive to temperature extremes or
the gums may experience mild irritation. If this persists, see your
dentist.
Be aware that newly whitened teeth may more readily absorb
stains. It is a good idea to avoid stain-causing beverages (such as
coffee, tea, red wine) for several days after the procedure.
Always follow the dental office’s instructions to avoid harming
your teeth and gums. Home-use bleaching is typically completed in
two to four weeks. If you experience discomfort during the
process, such as tooth hypersensitivity or sores on the gums or
other mouth tissues, discontinue using the procedure and call the
dental office.
Some patients with certain dental conditions may not be good
candidates for bleaching. Those with gum recession and exposed,
highly sensitive root surfaces, may find the whitening may further
irritate their teeth. Your dentist can advise you about which
method is right for you.
If you avoid tobacco and large quantities of stain-producing foods,
your teeth may remain lightened for several years, after which the
whitening process may need to be repeated.
Brushing twice a day, flossing, or using the interdental cleaner
once a day, and regular dental visits and cleanings will help keep
your teeth healthy and bright.
No two smiles are alike. Although we generally think of teeth as
being white, there are many natural shades of tooth enamel that
range from bright white and bluish-gray to yellow. Genetics plays
a role in the color of a person’s teeth and how quickly tooth
enamel may discolor.
Teeth may become discolored for several reasons. Discoloration
may be caused by aging or injury to the mouth. Discolored teeth
may also be the result of illness, medications (such as tetracycline),
dental restorations, excessive fluoride, tobacco, coffee, tea, soft
drinks, red wine, and other beverages and foods. Deposits of tartar
can also discolor teeth. Depending on the condition, enamel stains
may appear brown, black, pink or gray.
“Whitening” is any process that will make teeth appear whiter.
There are two ways to achieve whiter teeth.
First, there are peroxide containing bleach agents that change the
natural tooth color. These products contain peroxide(s) that help
remove deep (intrinsic) stains and surface (extrinsic) stains. They
include bleaching agents used in the dental efface or dispensed by
the dentist for home use; or they may be purchased over-thecounter for home use.
By contrast, non-bleaching whitening toothpastes contain agents
that work, by physical or chemical action, to help remove surface
stains only. These are available for purchase over-the-counter.