Tooth bleaching, also known as tooth whitening, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry.
Many people consider white teeth to be an attractive feature of a smile. A child's deciduous teeth are generally whiter than the adult teeth that follow. As a person ages the adult teeth often become darker. This darkening is due to changes in the mineral structure of the tooth, as the enamel becomes less porous. Teeth can also become stained by bacterial pigments, foodstuffs and tobacco.
This has been made more apparent with the spread of American culture worldwide, where an especially white smile is coined a "Hollywood smile".
The procedure to bleach teeth uses oxidizing agents such as hydrogen peroxide or carbamide peroxide to lighten the shade of the tooth. The oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and oxidizes interprismatic stain deposits; over a period of time, the dentin layer, lying underneath the enamel, is also bleached.
Tooth bleaching lasts for a period of some months, with variations from factors such as cigarette smoking, and tea and coffee consumption.
Methods of Bleaching
There are two main methods of bleaching:
Dental Clinic Bleaching
- One performed by dentist and
- One performed by the teeth-bearer him/herself.
A dentist applies a high concentration of oxidizing agent for a short period of time, which produces quick results. In order to reduce the risk of chemical burns to the soft tissues, most in-clinic bleaching procedures use a light-cured protective layer that is carefully painted on the gums and papilla (the tips of the gums between the teeth).
The bleaching agent is either carbamide peroxide, which breaks down in the mouth to form hydrogen peroxide, or hydrogen peroxide itself. The bleaching gel typically contains up to 35% carbamide peroxide which is roughly equivalent to a 12% hydrogen peroxide concentration.
At Home Bleaching
At-home whitening involves purchasing a thin mouthguard or strip that holds a relatively low concentration of oxidizing agent next to the teeth for as long as several hours a day for a period of 5 to 14 days.
This is known as take-home or over-the-counter bleaching. Results can vary, depending on which application is chosen, with some people achieving whiter teeth in a few days, and others seeing very little results or no results at all.
Pros & Cons
Whitening is potentially better at a dentist because the strip or mouth-guard does not completely conform to the shape of the teeth, sometimes leaving the tips of the teeth (near the gumline) unbleached.
The bleaching agent is typically less than 10% hydrogen peroxide equivalent so irritation to the soft tissue around your teeth is minimized. Dentists as well as some dental laboratories can fabricate custom fitted whitening trays that will greatly improve the results you can achieve with an "at home" whitening method.
A typical course of bleaching can produce dramatic improvements in the cosmetic appearance of most stained teeth; however, some stains do not respond to bleaching. Tetracycline staining may require prolonged bleaching, as it takes longer for the bleach to reach the dentine layer. White-spot decalcifications may also be highlighted and become more noticeable.
Bleaching is least effective if teeth have white spots, decay or infected gums. It is also least effective when the original tooth color is grayish. Bleaching is most effective with yellow discolored teeth.
Recently, efforts have been made to accelerate the bleaching process by the use of light. Studies have shown varying results as to the efficacy of light-activated bleaching.
Other bleaching a more efficient method is to do veneering. This is a procedure that involves “layering” of the visible teeth surface with porcelain material made of the color shade that you choose.
This does not thin the enamel layer neither have any chemical usage.
However, veneering can be much more costly than bleaching and requires more visits for completion of treatment.
Permanent tooth need to be taken care of from the bginning to avoid early decay and loss of tooth.