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Tooth Whitening

Tray based whitening now only £249 (8 tubes 16% Carbamide Peroxide gel)

Surveys have shown that on first meeting someone, the most observed parts of the body are the eyes and teeth (smile). Therefore, it should be no surprise that teeth whitening has grown to be a huge part of dentistry.

Why would I need my Teeth Whitened?

There are a number of reasons why you might get your teeth whitened. Everyone is different; and just as our hair and skin colour vary, so do our teeth. Very few people have brilliant-white teeth, and our teeth can also become more discoloured as we get older.

Your teeth can also be stained on the surface by food and drinks such as tea, coffee, red wine and blackcurrant. Smoking can also stain teeth.

‘Calculus' or tartar can also affect the colour of your teeth. Some people may have staining under the surface, which can be caused by certain antibiotics or tiny cracks in the teeth which take up stains.

What determines tooth colour?


WhiteB4
Tooth colour is genetically determined, like hair colour, though – unlike hair – teeth tend to darken naturally with age.


Teeth can also become stained either superficially by coffee, tea, tobacco and similar substances, or intrinsically as a result of illness or the use of certain medications while teeth are forming.

How does "Whitening" work?

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Your teeth are composed of two layers: an outer layer of hard enamel and an inner layer of soft dentin. The enamel layer is largely composed of microscopic crystal rods, and is designed to protect the rest of the tooth from the effects of chewing, acidic foods and trauma. Unfortunately, this layer is relatively porous, and over time, staining agents work their way into the pores deep within the enamel. This reduces the "whiteness" of teeth and goes deeper than we think, so regular brushing cannot remove the discolouration. 

Who can whiten teeth?

The General Dental Council considers tooth whitening to be the practice of dentistry. Therefore only dentists are legally permitted to undertake this procedure.

Bleaching vs. Whitening

The term "whitening" can be applied to any product that simply removes debris from teeth surfaces. Therefore "bleaching" can only be used for professional products that use peroxide chemicals, while even regular toothpaste can advertise itself as being a "whitening" product.

To confound things further, many dentists refer to their bleaching products as being "whiteners" because they worry that the term "bleaching" may scare potential patients. Most over-the-counter products claim to be whiteners because they lack the active ingredient that truly bleaches teeth.

What is used?

Teeth bleaching products use chemicals that get down into the tooth enamel and set off a chemical reaction (oxidation) that breaks apart the staining compound while preserving the tooth structure itself. Most products use either carbamide peroxide or hydrogen peroxide (similar to chemicals used in bleaching hair). Carbamide products tend to be three times more concentrated than comparative hydrogen peroxide products because they break down to roughly of their concentration as the release hydrogen peroxide. 

How long does it take?

The speed of the result depends on several factors such as the thickness of teeth, the time used and the degree of staining.

Usually it takes about 2 weeks, wearing the trays for at least several hours a day, many people wear these overnight for convenience.

How “white” will they go?

It is impossible to predict the final shade. Whitening can be continued until you are happy with the result or the teeth will not whiten further. Most teeth will “bleach”.

We generally recommend an initial 2 week course and then a break before whitening further if a lighter shade is desired.

Bleach Trays
Van B Haywood, ‘Nightguard vital bleaching – current concepts and research’
Journal of the American Dental Association, 1997, 128, 19S–25S.
Video from YouTube ™

What concentrations of hydrogen peroxide are used?

10 or 16% Carbamide Peroxide gel is used and this produces 3.5% and 5.6% hydrogen peroxide respectively.

The higher the concentration of hydrogen peroxide, the more chance there is of irritation to the gums.

We consider 16% (Carbamide) the highest safe concentration and is perfectly adequate for dental whitening whilst not giving too many side effects.

How successful is whitening?

There is good research evidence on the effectiveness of whitening using custom made trays. Haywood (1997) reported that tooth colour was stable for 74% of patients after 18 months without touch-up and for 62% of patients after three years. Repeat treatment is possible, the interval between treatments varying according to lifestyle whether patients drink coffee or smoke, for example.

Some people will touch up every 6 months or so with one or two applications. We give you plenty of gel!

Can all teeth be whitened?

• Only natural tooth can be whitened.

• Sensitive teeth may not be suitable, we can advise.

• Fillings or crowns will not change shade.

• If these need to be changed, this can be done at additional charge. You will have to wait at least four weeks for the shade to stabilise.

• If you have crowns, veneers or large filings that are unsightly, we can provide some fantastic new ceramic crowns or aesthetic fillings.

Is Dentist Whitening Safe and Legal?

Whitening is safe when directed by a dentist.

A dentist is able to examine your mouth and determine whether it is suitable for whitening.

More Information

Risks and side effects?

If bleaching is conducted as directed, it is a safe procedure. However, you should be aware of the following risks:

Sensitivity - By far, the greatest risk to bleaching is dental sensitivity to hot or cold foods following treatment. Mild tooth sensitivity is reported in upward of 25% of cases and if significant tooth sensitivity should occur, you should skip one or two days of bleaching as needed. Alternatively, speak to your dentist regarding using a product with a lower concentration of peroxide - this will lower the sensitivity, and your teeth can still be whitened, but the product will have to be used for a longer period of time. 

Sensitivity usually resolves on its own when the bleaching procedure has concluded. Some dentists recommend brushing with toothpaste containing potassium nitrate to alleviate the sensitivity (Sensodyne is one such product), but this is only a temporary solution.

Irritated gums - Over half of those who use peroxide whiteners experience some degree of gum irritation resulting from the bleach concentration or from contact with the whitening trays. Such irritation typically lasts up to several days, dissipating after bleaching has stopped or the peroxide concentration lowered.
Uneven whitening - Teeth fillings, even if they were the colour of your teeth to begin with, do not change colour with bleaching. The same is true for veneers, crowns, and other dental restorations. As a result, your natural teeth may lighten in colour, but these artificial teeth do not. Your dentist should be aware of these effects and you should be warned if it is relevant in your particular case. Such restorations may need replacing following bleaching.
Smile
Another common effect of teeth bleaching is uneven whitening of even natural teeth. Most often, the tips of teeth bleach first, and with continued use, the rest of the tooth follows. Some patients may even get white spots appear on their teeth during the process. With continued bleaching, these spots will blend in with the remaining portions of the tooth as the rest begin to lighten.

Summary

Whitening is carried out at home using custom made trays.

  • We use 10% or 16% Carbamide Peroxide in lab made custom trays.

  • The main side effect is sensitivity but this is usually temporary.
  • Crowns, veneers and fillings cannot be whitened.
  • The teeth will almost always lighten but the end result is impossible to predict.
  • It may be necessary to “top up” every 6 months to maintain the result.
  • It is not available to under 18’s.
  • Results may vary by individual and are not guaranteed.
  • Whitening is most effective for teeth without cavities, coatings or fillings.
  • Teeth whitening treatment is not suitable for pregnant or nursing women, people who are suffering from gum disease, open cavities or people who have had braces removed in the last 6 months

You should seek medical advice from a qualified medical practitioner for any medical condition

Our fee includes assessment, lab made custom trays and fitting and 2 weeks supply of gel. Extra gel for top ups and longer treatment can be supplied at extra charge. Replacement of fillings or crowns will incur additional charges.

Treating Fluorosis

Although optimal levels of fluoride are protective, too much can lead to:
  • White opacities in the teeth.
  • Brown spots.
  • Mottled teeth.
  • Pits.
  • Deeper Fissures.

Most of these issues are generally cosmetic in nature and are usually caused by ingestion of toothpaste at a young age, sucking it off the toothbrush, using too much or not using children's toothpaste. All of this ail have occurred before the tooth erupts. Once the tooth erupts it is no longer affected by these factors.

What can be done?

Most mottled or mildly discoloured teeth ail gradually blend in as the child grows. However in severe cases veneer (extreme) or whitening may help. This must generally be done when older, usually after 18.

The picture below shows the effects of mottling in a moderate case of fluorosis. Click on the picture to see what happens after whitening.
Fluorosis Before
Fluorosis After
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Closed for lunch 13.00 - 14.00


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0121 476 6218
0121 475 6492


www.addisondental.co.uk

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Where We Are


Addison Dental Practice
31, Redhill Road
West Heath
Birmingham
B31 3JS

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