Bleaching by definition actually changes natural tooth color. Nearly all bleaching products contain carbamide peroxide or its breakdown product hydrogen peroxide, which helps remove both deep (intrinsic) and surface (extrinsic) stains. Deep staining is seen commonly as a result of changes to the tooth due to natural aging, old root canal treatments, large fillings, tetracycline antibiotic or excess fluoride intake during development. Surface stains are caused by substances such as coffee, tea, red wine and tobacco.
Over-the-counter, (OTC) products for home use have a lower concentration of the active ingredient which helps remove both types of stains. The American Dental Association reports that the accumulated data on neutral pH 10% carbamide peroxide supports both the safety and effectiveness of these home use products.
The same carbamide or hydrogen peroxide bleaching agents are applied by your dentist. They are stronger, however, varying in concentrations from about 15% – 35%, and sometimes used together with a specialized light or laser. This reportedly accelerates the process, down to a visit or two instead of two or three weeks for the home use OTC products. In all instances, look for the ADA Seal of Acceptance on the products used and consult with your dentist for advice before proceeding.
Studies indicate that bleaching can successfully achieve noticeable increases in whitening of stained teeth.
Bleaching attempts to whiten your natural teeth as opposed to improving whiteness with restorative materials like veneers and crowns which require removal of some of the tooth structure. Bleaching has proven to be a very effective method that involves less time and expense than restorative dental treatment.
While bleaching can dramatically improve your smile, there are some potential side effects such as tooth sensitivity and irritation of the gums or other oral tissues. These conditions are generally temporary with very rare reports of irreversible damage. Tooth sensitivity tends to appear earlier in treatment. When using the stronger professionally applied agents the dentist will sometimes isolate the gums and soft tissues with a “rubber dam” and/or protective gel.
When considering this technique, be aware of the following:
- Bleaching is not a permanent solution: the effects will diminish over time. Optimally, this period lasts six months to a year — referred to by dentists as the “fade rate.”
- Although fading is inevitable, it is possible to slow down the process by avoiding foods and habits that cause staining. Some patients may need a tooth-whitening “touch-up” with the home bleaching technique for 1-2 days, once or twice a year.
- Acceptable color matching can be difficult to achieve due to the mix of natural teeth with pre-existing crowns, bridgework or fillings. Dentists can sometimes improve the color match by adjusting the concentration of the bleaching gel, as well as the actual contact time on the teeth.
While many over-the-counter whitening products produce successful results, patients should still seek a professional consultation before bleaching. Your dentist can discuss your cosmetic needs and review with you all the risks, benefits and alternatives to bleaching.
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