Tooth Whitening Guide

A Guide to Tooth Whitening

There are several different methods of tooth whitening available. Tooth colour is genetically determined and everyone’s teeth have a natural biologic limit as to how "white" they can become, dependent on skin tones and other factors. Once you reach this limit, no amount of bleaching will lighten them more. Some people will, therefore, experience a better result than others.

Generally we prefer to use a Custom made tray system and special bleaching pastes for external tooth bleaching although for individual teeth which have been root treated and become discoloured an internal bleaching method may also be appropriate. Your Dentist will advise you which method they feel is most suited to your needs.

Materials Used

Bleaching of the teeth is accomplished by wearing custom made bleaching trays filled with a bleaching gel. These trays are made of thin, clear vinyl and most patients find them comfortable to wear and sleep with. They are designed to be a "snug" fit and often have special gaps or reservoirs on the outer side of each tooth to be bleached. These reservoirs hold the bleaching paste.

The kit you will be given will include a custom made tray, storage case for the tray and several syringes of bleaching paste.

Tooth Whitening Theory

The active ingredient in the bleaching paste is carbamide peroxide. It gives off oxygen, which penetrates the teeth to lighten the colour.

It is the custom made trays that are the primary reason this type of bleaching works so well. They allow room for excess bleach and help provide a seal at the gum line. The trays in "Do it yourself" kits do not have these reservoirs and because they are "one size fits all" they don’t seal the bleach in place. This means that the paste is washed out of the tray very quickly by your saliva, decreasing the depth of the whitening and possibly damaging your gums with the excess bleach.

The "Do it yourself" kits also tend to be acidic in order that the bleach works faster, because they cannot achieve the amount of time or the concentration necessary. This acid will damage fillings, crowns and any exposed root surfaces. The whitening pastes supplied by the Practice have NO acid in them and will not damage your teeth or fillings in this way.

In addition to whitening, the oxygen released by our system also deep cleans the tooth, removing microscopic debris from between the crystals of tooth structure. After bleaching, these "pores" are cleansed and open. These open pores are of great significance and we will talk about them later.

Directions For Use

Bleaching needs to be done for a minimum of 2 hours per day and for ease may be done overnight. The whitening paste may cause a temporary inflammation and soreness of the teeth and gums and although there are steps which can be taken to minimise this, described later, it is possible to take mild anti-inflammatory painkillers, such as ibuprofen, if necessary.

Brush your teeth immediately before each bleaching session. This is crucial as proteins in your saliva coat your teeth very quickly after brushing and may inhibit the bleaching agent. If you normally have teeth that are sensitive to tooth brushing, cold or sweet use a sensitive tooth formulation instead of your normal toothpaste.

Squeeze a small amount of paste, as directed by your dentist onto the inner side of the outer wall of the tray (i.e. the side that will touch the fronts of the cheek and lips sides of your teeth) Once the tray is seated gently push the tray back against the teeth to establish a seal at the gum line.

Excess paste may ooze out from under the edge of the tray. This can be gently removed with a cotton bud. If you have used too little paste you will see open voids in the reservoirs not completely filled with paste. DO NOT remove the tray, there is enough paste to start the bleaching process but use slightly more paste next time.

Leave the tray in place a minimum of 2 hours or overnight.

When you remove the tray, rinse your mouth out with tepid water. Very hot or cold water may be slightly uncomfortable. Rinse your tray out gently in COOL water. You may give it a gentle scrub with your toothbrush to remove excess used paste.

Everyone is slightly different and depending on your teeth you may need to use the paste for 2-8 weeks (Occasionally longer for patients with tetracycline staining). Your dentist will advise you on this at your review appointments.

You will usually have review appointments at 2 week intervals but if you have any concerns in the interim please contact us.

What to Expect

Your teeth and gums may become sore and sensitive during and a few days after bleaching. Mild anti-inflammatory painkillers such as Ibuprofen or Paracetamol will help this. The sensitivity usually decreases after 1-3 days. Occasionally your dentist may recommend that you use a sensitive brand toothpaste or alternate with a fluoride gel if sensitivity persists.

You may notice that your teeth may develop white spots, the colour may look too opaque or chalky, or the tooth nearest the gum line may look dark. Do not worry. This will even out, usually about 2 weeks after you stop bleaching.

You may also find that your lower teeth do not lighten as quickly as the uppers. This is because the lower teeth are smaller and the reservoirs are, therefore, smaller. Thus, there is not as much surface area in contact with the paste. To compensate for this you may want to use the last syringe on your lower teeth only, for a few nights longer than the upper if you feel it is required. The lower front teeth have thinner enamel than the uppers. The underlying dentine is yellow and tends to shine through the thinner enamel more. Your lower teeth may never, therefore, lighten up quite as much as the uppers and may appear slightly darker than the other teeth. This is OK – it’s normal and looks natural.

maintaining your new white tooth colour

It is normal for all natural teeth to darken with time. Research shows that 74% of patients will stay "colour stable" for up to 18 months after bleaching and that over 60% of people maintain their colour for 3 years. The lightened teeth can be touched up periodically if required. You may wish to use your bleaching trays for one night every six months to maintain your colour. Rembrandt Age Defying Toothpaste or Rembrandt Dazzling White toothpaste may give some additional protection against darkening. They use Papaya extract and not abrasives to deep clean the teeth. Unfortunately, these toothpastes are still quite difficult and expensive to come by in the United Kingdom at present. In the interim we would suggest you use a mild, non-abrasive toothpaste i.e. not a sodium bicarbonate, current whitening or smokers toothpaste as the abrasives dull the tooth surface and also roughen it so that stain accumulates more easily.

Other Important Info

During the 2 weeks after bleaching stay away from staining foods and drinks e.g. Coffee, tea, red wines, deeply coloured foods such as Kormas and Tikkas. The open "pores" due to the deep cleaning effect of the oxygen that we mentioned earlier may fill up with these stains and decrease the success of the bleaching. If possible when drinking a staining beverage, use a straw. Keep smoking to a minimum, as this will compromise the end result too.

Store the bleaching trays safely in the container provided. Keep them away from heat, as this will distort them.

We trust that you will be delighted with the results of your tooth lightening treatment. Do not wear the trays any longer than recommended by your dentist as due to the natural biologic limitations of your own tooth shading you will not be able to achieve a "whiter" result without placing some sort of indirect restoration. Your dentist will advise as to what is best for your situation.

If there are any queries please do not hesitate to contact us.