The gel used in bleaching is usually composed primarily of carbamide or hydrogen peroxides which break down to form oxygen molecules. There are tiny pores in the enamel and dentin of your teeth which these molecules go into and break up the light blocking stains. More and more light is able to pass through the teeth, making them look lighter, as the staining particles are broken into smaller and smaller particles. Stains that have built up over long periods of time which appear light brown or yellow are the stains which respond best to this treatment. Stains on teeth which are blue-gray to dark brown are the most resistant to bleaching peroxides due to the fact these stains are usually the most deeply embedded in the tooth structure. Stains of this darker type are usually formed due to the patient having medications such as tetracycline in their bloodstream while their teeth were developing, and can take 3 three weeks to six months to be bleached out properly.

Depending on how long the gel in is contact with the teeth and what strength of gel is used, typical results can be expected to appear within the first few hours to a day or two. It can take several weeks to several months for complete results to be attained depending on what the stain’s source was and whether or not the patient’s teeth are naturally resistant to bleaching procedures. Depending on personal habits of the patient, the bleaching procedure can have effects lasting up to 3 years. Once your teeth have reached your desired color you can usually maintain that color for as long as you like by periodically using your trays once or twice.

What will the initial consultation with my dentist be like?

When you first visit your dentist, you should discuss what your expectations are for the whitening procedure. The different options currently available to you should be explained by your dentist, as well as how the procedures are performed and what are the limitations.
Your dental appointment will begin with a complete medical history as well as an exam. Your dentist may also take pictures to record your progress and make available to you before and after pictures so you can evaluate your results if you choose to proceed with treatment. The presence of poor oral hygiene or large cavities, which may require x-rays to be diagnosed, need to be dealt with before any cosmetic procedures such as whitening can be performed. You should use your consultation as an opportunity to ask questions that you may have about treatments that you are considering.

How is teeth whitening performed?

You have essentially three options to choose from. You can use the self-administered treatment which involves a take-home kit, or two in-office options.

In-Office options:

The first option we will discuss is in-office power or laser bleaching. This process is started by the dental staff applying a protective layer of material which only covers your gums to prevent the bleach from injuring them. Then a special hydrogen peroxide containing bleaching solution is applied to the teeth and a laser or high intensity light is aimed at the gel on the teeth to begin activation. This causes the release of oxygen molecules from the gel. Laser and power bleaching both take around one hour to complete.

Teeth whitening at home:

Bleaching at home is performed under indirect observation of dentist. At your initial appointment, your dentist takes impressions of your teeth and from these he or she has bleach trays fabricated which should almost perfectly fit your teeth. These trays allow the patient to apply the bleaching gel to their teeth while avoiding it spreading to the soft tissues in the mouth such as the gums, cheeks, tongue and inner lips as they are very sensitive to the bleaching solution.

How much discomfort the patient experiences can vary from individual to individual and also relates to the method used. The majority of patients experience slight if any discomfort which usually goes away within 24 hours. If the discomfort is too much for the patient, they may use anti-inflammatory drugs. In the instance that the discomfort lasts for more than 2 days the patients should call his or her dentist for advice. Another remedy for tooth sensitivity due to bleaching is fluoride applications on your teeth. You may ask your dentist for fluoride gels which you either apply to your teeth or put inside your trays and wear for about an hour. Check with your dental office for the best options depending on your particular needs.

You should talk with your dentist about your pain tolerance, budget and expectations in order to assist him or her in deciding what bleaching method or combination of methods would be best for you.

What should be expected after the teeth whitening treatment?

Although the results of teeth whitening can vary from person to person, most patients are very satisfied with their results. Foods such as red wine and tobacco which can stain teeth rapidly should be avoided for about a week. Maintaining good oral hygiene through flossing and brushing can help stop the loss of the results you have achieved through whitening. On average, tooth bleaching last about 1-2 years. However, if you don’t use tobacco on a regular basis and don’t eat too many of the foods proven to stain teeth, your bleaching results may last longer.

The best candidates for tooth bleaching are in general:

• Patients old enough to understand how the procedure works
• Patients with marked and stained teeth
• Those who are knowledgeable about the therapy
• Those who desire to improve their appearance
• People with expectations that are realistic

This is only part of the criteria that your dentist will use when determining if this treatment is proper for you. Patients interested in tooth bleaching should have a consultation with a dentist before proceeding with treatment

This article was written by Dr. Shawn M Keller of Smiles By Design. Dr. Keller is an experienced cosmetic dentist who provides free consultations for any patients with questions or concerns about any type of aesthetic dental procedure. If you would like a free consultation with Dr. Keller please call Smiles By Design at 425-558-1515

Veneers are frequently used to create smiles that are beautiful while avoiding removing too much of the patient’s tooth structure. Types of staining that can be hidden with veneers include tetracycline and erythromycin staining. The base of veneers can be opaquely designed to hide cases of severely stained teeth underneath. A wonderful appearance can usually be attained with these restorations when proper surface texture and coloring are used. They can lengthen, whiten and even straighten teeth to give patients a functional and beautiful smile. One major advantage of veneers is that patients don’t have to wait years to see results as they do with treatments such as braces or invisalign. Even fairly significantly misalignment of teeth can be covered with only two appointments only two weeks apart.

These restorations remove less tooth structure that other conventional dental restorations such as crowns. Also, unlike using composite bonding techniques to build up and whiten teeth, these restorations don’t stain or wear with time and can have a much more natural appearance. Your cosmetic dentist will use the best method for each patient to create a beautiful smile. Veneers are just one method dentists employ, frequently other procedures such as teeth whitening gel, cosmetic tooth reshaping, full ceramic crowns and various other techniques are used in conjunction to create wonderful smiles.

A smile makeover can overcome cosmetic deficiencies such as cracked or worn teeth, yellow or stained teeth, crooked or poorly aligned teeth, spaces in teeth and smiles which reveal too much of the patient’s gums. Another cosmetic alteration which smile makeovers can achieve that many people aren’t even aware of is the tightening of the skin around a patient’s mouth to remove wrinkles in that area or sagging of the skin below the jaw. The way that this is achieved is through opening of the bite which may have become overly closed through wear during the patient’s life. When the bite is more open, the jaw is positioned farther down like it was when the patient was younger, before the teeth were worn down, and the skin is stretched to cover the increased vertical height of the lower face. This results in a much more youthful appearance to the lower face of a patient and doesn’t require any invasive surgery to the skin of the face. This is why smile makeovers are considered conservative surgeries which are capable of dramatic results.

If you are interested in potentially receiving a smile makeover but would like to know more, please give Smiles By Design of Seattle a call at 425-558-1515 for a free consultation with Dr. Keller. Dr. Keller is an LVI trained dentist and provides complementary consultation sessions with all patients interested in receiving or simply learning about aesthetic treatment.