Teeth whitening in questions and answers.

One of the most popular services in cosmetic dentistry today is teeth whitening. In no way related to medicine, nevertheless, it is in great demand, because... in the minds of many of us, it is white (light) teeth that are an indicator of their health, as well as the high social status of their owner.

As I wrote earlier, such ideas were not always dogma, and how long such a fashion will last is unknown, but today it is so. I myself am neither a supporter nor an opponent of this procedure, and therefore I will try to talk about whitening as objectively and unbiasedly as possible. Moreover, I will do this in the form of questions and answers (i.e., a kind of FAQ on teeth whitening).

What is whitening and how does it differ from professional cleaning?

Very often patients say: “I want to whiten my teeth because... they have stains from coffee and cigarettes.” At the same time, they confuse 2 different procedures - teeth cleaning and teeth whitening. If brown plaque has accumulated on your teeth or stones have formed, then you need professional teeth cleaning, which is carried out with ultrasound, sandblasting (air-flow) or simply with a brush and a special professional abrasive paste. In this case, the dentist simply removes plaque from the surface of the teeth without changing their natural color. Although they become lighter, this is not bleaching. The whitening procedure involves the use of a strong oxidizing agent to lighten the actual tooth tissue. Hydrogen peroxide or carbamide peroxide, familiar to any unnatural blonde, is used as an oxidizing agent (it is approximately 2 times weaker than hydrogen peroxide). Penetrating into the internal structures of the tooth, the released active oxygen destroys the molecules of natural pigments, which leads to the fact that the tooth becomes lighter.

This is what plaque on teeth looks like, resulting from the abuse of cigarettes, coffee, and strong tea. It can be removed by professional cleaning, which has nothing to do with bleaching.

Nutrition after tooth restoration

In the first few hours after restoration, the dentist does not recommend eating solid food and avoid chewing with the restored tooth in the first days. Subsequently, loading the tooth is also not recommended, since the extended tooth does not have the same strength as a natural one.

It is also recommended to follow the following rules:

Do not eat food that may change the color of the restored area. These are products such as coffee, berries and fruits with bright colors, some sauces and seasonings.
Hard vegetables and fruits must be cut into small pieces. You should especially avoid biting off pieces when restoring anterior teeth.
Avoid cracking nuts and seeds with your teeth.
Do not eat food that is too hot or cold.

Only the dentist who performed the procedure can answer the exact question of how much you should not eat after restoration. The period depends on the complexity of the restoration operation. For example, when using pins you will have to stop eating for a day.

In addition, restrictions on food intake are imposed when using painkillers until their effect completely subsides.

What types of whitening are there? Which whitening method is more effective?

If we talk about really effective whitening, then there are only two types. Office and home. I repeat once again that the essence is the same everywhere. What's the difference then? Office work, as you might guess, is carried out in the dentist’s office. It is produced by gels with a high concentration of bleaching agent (usually 35-38% hydrogen peroxide). You cannot do procedures with such concentrations yourself, because contact of the gel of such concentrations with the mucous membrane causes severe burns. The doctor uses numerous means of protection so that only the teeth are whitened, and not the tongue or lips. Some whitening systems (Zoom, LumaCool, etc.) involve activating the gel with a special lamp for a faster and more effective procedure. Some are simply applied to the teeth and work without any additional activation by light (Opalescence, Bleach n' Smile , etc.) In any case, the procedure takes about 1-1.5 hours and the result can be seen almost immediately. Especially in systems with light activation of the gel.

This photo shows the process of in-office whitening with the Opalescence XtraBoost system, which I prefer to use in my practice. The green arrows indicate the actual whitening gel (38% hydrogen peroxide), the blue arrows indicate the protective coating of the gums (the so-called “liquid dam”), the black arrows indicate a temporary plastic crown, which does not whiten and will be replaced with a permanent one after completing the whitening course.

Home whitening involves the patient performing the procedure independently at home. BUT! Under the supervision of a doctor exclusively! Ideally, you come to the doctor, in 1-2 days they make a special plastic individual mouthguard for your teeth, give you instructions on what gel, what concentration and according to what scheme is best to use in your case. And then at home you do everything exactly as the doctor ordered. Results can usually be seen within a couple of weeks. Exactly the same result as with the cabinet version.

The custom tray is filled with whitening gel and placed over the teeth. Mouthguard wearing patterns vary and must be selected individually by the dentist.

Let's summarize the pros and cons of teeth whitening options . In-office treatment is faster, but it is usually more expensive and is often associated with the appearance of unpleasant sensitivity, both during the procedure and for some time after it. Home whitening will give a similar result over a longer period, but it is cheaper and, as a rule, does not cause discomfort in the form of increased tooth sensitivity. In cases where the result is not required right now (unexpected wedding, urgent important date, etc.), it is better to choose home whitening. But if you are not confident in your accuracy, you don’t want to spend a long and tedious time remembering all the rules and following all the recommendations, prefer a less complicated office option.

If you suddenly have an important event in your life that you need to approach with a dazzling smile, then in-office whitening is your choice.

How are teeth whitened in dentistry?

To whiten teeth in the dentist’s office, only the most modern, effective and safe techniques are used.

Almost all technologies are based on the brightening effect of reactive oxygen species released during the activation of gels based on high concentrations of hydrogen peroxide. The entire whitening process takes place under the radiation of special lamps: halogen (Beyond Polus), LED (Luma Cool) or ultraviolet (Zoom 3).

The main advantages of office methods:

Speed of the procedure. Whitening takes no more than an hour.
High degree of efficiency. In one session it is possible to lighten enamel up to 12 shades.
A snow-white smile lasts up to 5-7 years with proper dental care.
The safety of the procedure, the progress of which is constantly monitored by a doctor.

Possible inconveniences that the patient may encounter during and after whitening:

You need to stay in the dentist's chair in one position for about an hour.
The risk of developing increased sensitivity of tooth enamel.
You should not drink coffee, strong tea or red wine for several days. If the patient smokes, then it is necessary to minimize the number of cigarettes or completely abandon this bad habit.
Dentures and fillings are not subject to bleaching, so it may be necessary to replace them with others that are more consistent with the new shade.

A new word in professional whitening is laser technology. It causes minimal discomfort to the patient, since during the procedure there is no heating of dental tissues and there is no risk of burns to the mucous membranes and skin. In addition, laser radiation noticeably compacts the enamel, thereby preventing its destruction by peroxide compounds. The only drawback of the method is its high cost.

Will my teeth have sensitivity after the whitening procedure?

I began to partially answer this question in the previous paragraph. In each case, the manifestation of hypersensitivity during and after the procedure cannot be predicted; everything is quite individual. Generally speaking, the appearance of increased sensitivity of bleached teeth to one degree or another manifests itself after any whitening method. The faster the procedure occurs, the higher the concentration of the whitening gel, the stronger and longer the discomfort. Therefore, according to the degree of severity of unpleasant sensations, we can rank the procedure options as follows: in-office with the use of activating lamps gives complications more often and the intensity of unpleasant sensations is higher, in-office without activating the gel with light - less, home - least often, up to complete absence. One way or another, there is no need to be afraid of this. Usually, however, the sensitivity is not very intense and lasts a maximum of a few days. In addition, there are special products to reduce tooth sensitivity that you can use during this period. In some whitening systems, they come complete with all consumables for the procedure, and are given to you by the doctor.

Is it worth doing home whitening?

The use of folk remedies is definitely not recommended. The mild effect achieved with their help does not justify the damage caused to the teeth. Everyone makes their own decision about the use of professional drugs.

In modern dentistry, you can go through all stages of preparation and purchase special products for safe teeth whitening at home. They can be used to enhance the effect of professional whitening in the clinic or separately.

If you want to become the owner of a snow-white smile and keep your teeth healthy, you should not resort to experiments, it is better to trust the professionals. Teeth whitening in dentistry is a guarantee of safety and impeccable results.

Is teeth whitening a harmful procedure?

As one medieval doctor said, “All poison is just a matter of dose.” The same can be said here. It is no secret that there is absolutely no benefit from bleaching in the medical sense. But there will be no harm from a competently carried out procedure. Suffice it to say that in the USA the bleaching procedure is very popular, and is generally equated to hair lightening, because... they even carry it out in shopping centers, not seeing any sedition in it. Therefore, if you really want to, bleach it. Only under the supervision of a doctor. In addition, the teeth on which the gel will be applied must be healthy, they should not have leaky fillings or caries. The dentist should check all this before you go into all serious troubles. He should also choose the best whitening method specifically for you and your teeth . Suggest the correct scheme for using products for home use, explain the features of dental care, etc. and so on. In general, conduct a full briefing and control. Only in this case the procedure will be as safe as possible and will bring nothing but a refreshed, white-toothed smile (if you are dreaming of it).

Teeth whitening looks so unpretentious and mundane in many shopping centers in the United States. While your wife is replenishing her wardrobe, and her beloved mother-in-law is replenishing her refrigerator, you can lie down and benefit your appearance.

You cannot whiten your teeth with activated carbon, soda and hydrogen peroxide -

Can cheap products like baking soda, activated charcoal or hydrogen peroxide help whiten teeth? Indeed, they may have a small effect, but the possible negative effects on the enamel of teeth and gums will significantly exceed the potential benefits. Let's figure out why this is so.

1) Teeth whitening with activated carbon: reviews

If you decide to try whitening your teeth with activated carbon, you should know that activated carbon is an abrasive (like tooth powder). Unlike abrasives that are included in toothpastes, activated carbon crystals are not spherical, and therefore its use will lead to the appearance of small scratches on tooth enamel.

At the initial stage, you may notice that there is a little less pigment plaque, because... the abrasive will scrape off the plaque. However, microscratches will make the surface of the teeth rough, and pigment and microbial plaque tend to stick to rough surfaces even faster. Conclusion: charcoal has a mechanical/abrasive effect on pigment plaque, scratches and damages tooth enamel, so it should not be used.

2) Teeth whitening with soda (consequences) –

Reviews of teeth whitening with soda are not very positive. Baking soda can indeed slightly lighten surface stains on tooth enamel (pigment deposits), but like activated carbon, regular baking soda also has a fairly high degree of abrasiveness. Therefore, adding a large amount of soda to your toothpaste can also lead to micro-scratches on the enamel of your teeth. Still, it is much safer to use professional whitening toothpastes, which contain high-quality spherical-cut abrasives. The latter are guaranteed not to scratch the enamel of your teeth.

3) Teeth whitening with hydrogen peroxide: reviews

Teeth whitening at home with hydrogen peroxide is theoretically possible, but in practice it is very difficult to do, and because of this, it has a large number of side effects (complications). Hydrogen peroxide in whitening products for home and professional use is used in the form of a gel, which is in close contact only with the surface of the teeth (and at the same time must be isolated from the gums and excessive contact with saliva).

At the pharmacy you can buy hydrogen peroxide with a concentration of 3% or 6%. The only thing you can do is soak cotton balls or a gauze pad with peroxide and apply it to your teeth. Why is this ineffective... If gauze and cotton swabs come into contact with saliva, the procedure can be immediately called ineffective. Upon contact with the organic components of saliva, the peroxide will immediately begin to disintegrate (although the minimum time required to achieve the effect when using 6% peroxide is 1 hour).

But the rapid decomposition of peroxide occurs not only from contact with saliva, but also on its own. This is where the main advantages of professional home systems lie: they contain carbamide peroxide gel in a fairly high concentration, but from which hydrogen peroxide is released gradually. The latter allows you to maintain an effective concentration of hydrogen peroxide for a long time.

Well, one more thing: if hydrogen peroxide comes into contact with the gum, you will get a chemical burn (the gums will turn white), which can then even lead to gum recession. In addition, if you do all this without gloves, your fingers will turn white, also due to a chemical burn to the skin. Therefore, there are only negative reviews for home teeth whitening with hydrogen peroxide.

4) Why you can’t whiten your teeth with lemon (or other acids) –

Citric acid, as well as any other acids, cause the leaching of calcium from the surface layer of enamel. Due to a sharp decrease in enamel mineralization, this process really looks like teeth whitening. The color of the teeth becomes dull (chalky), the surface of the enamel becomes rough, and in addition, the teeth will lose their shine.

Those. There will be not just a deterioration in the appearance of the teeth, but also a decrease in the resistance of the enamel to mechanical stress, as well as to the effects of cariogenic bacteria. As a result, rapid wear of the enamel and multiple dental caries.

How effective and harmful are whitening toothpastes?

Here it must be said that the vast majority of so-called whitening pastes are actually not capable of whitening anything, because... they simply lack an oxidizing agent. So this is a kind of advertising ploy by the manufacturers. But what they do have is a higher content of abrasive substances for more effective plaque removal. You should not use such toothpastes regularly; it can cause serious harm to your teeth. At a minimum, this may threaten the appearance of increased sensitivity of teeth , and at a maximum, the appearance of non-carious lesions (mainly wedge-shaped defects). They can be used only temporarily (no more than one medium tube is used up) and it is advisable to alternate it with regular toothpaste. It is needed primarily by heavy smokers and coffee lovers. If you are not one of them, then you should not turn your attention to “whitening” toothpastes. In some rare cases, whitening toothpastes do contain small amounts of a bleaching agent. And such a paste really has the right to be called “whitening.” They are sold more often in pharmacies and are much more expensive than regular pastes. But even with regular use, you should not count on a noticeable effect from their isolated use. Concentrations are too low. As a rule, they are used for the period while the home whitening process is in progress to enhance and maintain the effect.

Here you can also talk about other “pharmacy” products for teeth whitening – various varnishes, strips, etc. All of these are very ineffective drugs for the same reason - a low concentration of the bleaching agent. To feel the results from them, you need to have a very high power of self-hypnosis. So it's just wasted money.

Whitening toothpastes

Whitening toothpastes contain abrasive microparticles. It is under their influence that coloring substances are removed from the surface of the enamel. At the same time, these particles cannot cause mechanical damage to the enamel itself, since the enamel is many times stronger than these particles. However, such pastes can only be used if there are no fixed dentures in the oral cavity.

Rough particles can create micro-scratches on the surface of dentures. Over time, bacteria accumulate in these scratches invisible to the eye, and then tartar forms. As a result, instead of whitening the dentures, the reverse process occurs.

We strongly recommend that people with fixed dentures use only regular toothpaste, not whitening toothpaste.

What effective folk whitening remedies exist? How to whiten teeth at home?

This question could be answered briefly: there are no effective traditional methods of teeth whitening . And I would like to warn against the thoughtless use of improvised means in order to save money. Very often this backfires. It is strictly forbidden to use soda, tooth powders, lemon, activated carbon, etc. to brighten your smile. in different combinations. I personally once had a patient who spent a considerable amount of time brushing her teeth with a mixture of baking soda and lemon juice. When she came to me, I learned for the first time what enamel erosion looks like. At that time I had not yet photographed clinical cases, but it looked something like this.

How do you like this “whitening”? Instead of beautiful teeth, they were irreparably damaged and their restoration cost her a lot of money. As usually happens, thoughtless savings turned into even greater expenses.

I also heard a story from colleagues about how one of the patients whitened his teeth with “Toilet Duck”, because the bottle said “safe for enamel.” Well, what else can you say?

to whiten your teeth on your own online . Most of them are just a waste of time. And some are simply harmful. So, in pursuit of beauty, do not lose your sanity, otherwise you risk losing your teeth. Ultimately, if you need to post your photo on a social network or forum, you can whiten your teeth using Photoshop (as they do in glossy magazines for unnaturally white-toothed models). Or if you need white teeth for some important occasion, you can visit the solarium several times, use a foundation of a darker shade... against the background of dark skin, the teeth will appear lighter even without any bleaching (just look at the “tanned” Africans, whose teeth are always appear dazzlingly white just because of the color of their skin).

What contributes to the darkening of crowns and dentures

It is not only the appearance of artistic restorations and fillings made using composite materials that causes dissatisfaction among patients in dental clinics. Some complain that they are not satisfied with the color of prosthetic structures made from metal-ceramics or plastic. Why is this happening?

Plastic products are similar in aesthetic and quality characteristics to those made from composites. The material is very “delicate”, it is porous, and quickly loses its aesthetics under the influence of food and drinks with dyes, from smoking, and due to lack of oral hygiene.

Metal-ceramic prostheses are a different story. And if you are going to install them in the smile area, which professional doctors strongly do not recommend doing, then you must have a clear understanding of their shortcomings:

the metal shines through the ceramics: if the restoration is single, then this will be noticeable, especially in bright lighting,
the metal oxidizes, so a bluish rim may appear at the border with the gum over time, which will further spoil the overall impression of your smile.

Important! In order not to think about the question of how to whiten artificial crowns and dentures installed in the smile area, initially choose the right materials from which they will be made. Ceramics and zirconium dioxide are ideal for the smile area: they do not change shade throughout their entire service life and have high aesthetics.

Is it possible to whiten a dead, darkened tooth?

Yes, and this procedure is called endobleaching . Those. internal tooth whitening. It may be needed when, after removing a nerve in a tooth, for various reasons it becomes dark, turns yellow and begins to stand out from its healthy neighbors. In this case, access to the canal is made in the tooth, it is reliably isolated, and the same hydrogen peroxide/urea whitening gel remains in the cavity for 2-3 days. As a result, the darkening of the dead tooth can be eliminated. Often this procedure must be performed before prosthetics of the front teeth with metal-free crowns or veneers. Due to their fairly high transparency (which is very necessary from an aesthetic point of view), any change in the color of the tooth underneath will be unpleasant to show through. This may prevent you from making restorations of the same color.

Upper central incisor darkened after depulpation

The same after the internal bleaching procedure

What is the best way to save a pulpless “dead” tooth?

There is a special intracanal technology for whitening pulpless teeth. During internal whitening, a peroxide solution is injected into the tooth cavity, after which a temporary filling is applied. When you visit the dentist again, it is determined how well the new shade matches the color of the remaining teeth. If the result is satisfactory, the remaining solution is washed away and a permanent filling is placed.

Another possible method is external whitening by applying the gel to only one single tooth. In this case, you can also use home remedies.

What is restorative bleaching? Is it possible to whiten teeth with veneers?

Restorative bleaching is, in most cases, a great stupidity that some doctors suggest that their patients do to themselves. This procedure involves covering the front surface of the teeth with a thin layer of white opaque composite material (it was popular in the past), or the same white opaque ceramic veneers/lumineers. In both cases, an irreversible change in the surface of a healthy tooth is assumed. In the case of a composite, you get a very dubious option from the point of view of aesthetics and service life. Well, about all kinds of “ veneers without grinding teeth/lumineers/ultraneers , etc.” you can read it here. In what cases can this option be used? There is only one good indication here – serious generalized (i.e. on all teeth at once) changes in their color. Such problems may be associated with impaired development of tooth buds in childhood or even in the womb. The most common of these pathologies are the so-called. tetracycline teeth.

This is what one of the unpleasant lesions of teeth looks like during their development, the so-called. "tetracycline teeth"

You can also resort to total restoration of all visible teeth if you desperately need teeth the color of plumbing fixtures - absolutely white. It will never be possible to whiten healthy, normal teeth to such a state using any method, and attempts to do so can still end disastrously for the teeth. So if you are a movie and TV star, and your mouth is periodically shown in close-up on the entire screen throughout the country, and the size of your future fees depends on the degree of whiteness of your teeth, then restorative bleaching is quite an option for you... After all, against the background of circular braces , liposuction, enlargement/reduction of everything that can be enlarged/reduced, total teeth veneering looks like a completely innocent and absolutely safe children’s prank.

What is the best way to whiten tetracycline teeth?

When taking some antibiotics from the tetracycline group, a person may change the color of tooth enamel. It becomes dirty yellow, brown or dark gray. This is especially noticeable when treated with such drugs in childhood during the formation of teeth.

Tetracycline teeth are extremely difficult to whiten because the pigmentation is deep. In this case, folk remedies and home methods will not be effective. Only professional whitening techniques in a dental office can help. Often several procedures are required in succession.

How to care for whitened teeth?

Immediately after the whitening procedure, for 2-3 days it is better to refrain from coloring products - wine, berry jam, strong tea (especially cheap... from bags in which nothing but paint is poured, not even tea leaves), coffee, smoking (if possible ) and so on. If increased sensitivity occurs after the procedure, you can use a special paste for sensitive teeth (Lacalute Sensitive, Sensodyne) or ask your dentist for a special gel to reduce sensitivity, which often comes in the same set with a whitening gel. In the future, no specific care for whitened teeth is required. Over time, their natural color will be restored. In this case, you can conduct a short maintenance course of home whitening, after consulting with your dentist. Typically, such a need arises no more often than every 6 months to 1 year.

How to make white teeth yourself

There are many products available in pharmacies that guarantee complete whitening at home without the participation of dentists. In their composition, an obligatory component is hydrogen or urea peroxide, from which a large number of oxygen ions are formed, which have a whitening effect.

Whitening gels, strips, and pencils are very popular among buyers. Such products do not require special skills for application. They are practical and act quickly. They are convenient to take on trips, to work, or you can do household chores and whiten your teeth at the same time. The effect of gel products is noticeable after just a few uses. The maximum you can achieve is 3-4 tones of lightening, which will last up to a year. The most famous brands:

Plus White
ROCS
Crest

Semi-professional systems for teeth whitening at home, which consist not only of peroxide gel, but also a dental tray and an activating lamp, stand somewhat separately. They are as close as possible to office methods. When used correctly, the effect is equal to 4-5 tones on the VITA scale, which lasts for one and a half years. The most used systems are Zoom and Opalescence.

What is laser whitening? Is it true that it is the most effective?

Laser whitening/photo whitening (I came across other names) - all of this is essentially the same thing. In order to stand out from the crowd and offer patients something “unique... and only here,” clinic advertisers come up with a bunch of names for the same procedure. All this is standard whitening with gels, which are activated by the light of special lamps. Indeed, such systems (Zoom, LumaCool, LumaArch and many others) give the fastest and most noticeable results. But at the same time they also give the greatest number of cases of the development of very intense hypersensitivity. Plus, due to the rather high cost of consumables required for each procedure, the high cost of the lamp itself, which must be “beaten”, the price for such a service turns out to be the highest of all possible options for whitening procedures. But the choice is ultimately yours. Do you want instant results visible to the naked eye? Pay with money and discomfort from pain. Do you want it cheaper and with a minimum of discomfort? Then be patient and forget about “laser” whitening.

The generation of advertisers who grew up watching Star Wars apparently imagines the dentists of the future in this way, luring patients to clinics for “laser treatment of caries,” “laser whitening,” and “laser implantation.”

In fact, this is what the Zoom lamp for “laser” (i.e., actually conventional, light-activated) whitening looks like these days.

How do stars whiten their teeth?

Celebrities spend many tens of thousands of dollars on their snow-white smiles. After all, the overall appearance and potential success depend on them. Therefore, such people do not skimp on the dentist and do not use questionable techniques. To achieve radiant whiteness, stars trust only modern professional techniques: Zoom 3, Luma Cool, laser whitening. But they are not limited to the lightening procedure. To maintain the achieved shade, periodic professional cleaning of the enamel is carried out, and special proven toothpastes are used for everyday care.

In order for your smile to be as radiant as that of the stars, you should not experiment with whitening agents. It is better to contact a good specialist who will assess the condition of the oral cavity and give a personal recommendation as to which remedy will be optimal for your particular situation. When carrying out the procedure at home, you must strictly follow the instructions and not violate the whitening technology. Only in this case can you count on success without negative health consequences.

Are artificial crowns and fillings bleached?

No. No crowns or fillings can be whitened using any method. Therefore, after lightening your teeth, you will have to replace any restorations with those that are visible when you smile and talk. If your teeth have caries or leaky fillings, then before whitening a temporary restoration is made, which, after all lightening procedures are completed, is changed to a permanent one, taking into account the resulting shade of the teeth.

This photo shows that the plastic temporary crown, originally made to match the color of the neighboring teeth, after the whitening procedure stands out strongly against the background of its lighter neighbors

These are the main questions about teeth whitening that I have encountered. This article will be updated as new ones appear. If you are thinking about this fashionable procedure, remember that beautiful teeth are, first of all, healthy teeth. And in attempts to improve their appearance, you should not harm them with dubious methods or independent exercises using improvised means.

Teeth Whitening Pencil –

A teeth whitening pencil is the most ineffective and pointless way to spend your free time waiting for your teeth to lighten. Such pencils not only make teeth lighter, but also temporarily recolor their white color due to the white dye they contain. A teeth whitening pencil of the “Crestal” type (Fig. 20) costs more than 900 rubles at retail, with a purchase price of 100-150 rubles. This already says a lot...