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Simi Valley, CA 93065
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A Whiter Smile
By Dr. Ellison
March 11, 2016
Category: Health

I think most people would agree that a smile is the most memorable feature upon meeting someone. It gives you the impression of whether a person is approachable or not. Yet astoundingly, many people are unhappy with the appearance of their smiles. You might be wondering what could possibly fix that both quickly and affordably. Well, I get asked this question often by my patients. The subject came up recently with my granddaughter because she just had her braces removed and would like her teeth to be whiter. Of the various cosmetic dental procedures, teeth whitening would have to be the quickest and most reasonably affordable solution to a more enjoyable smile. It certainly isn’t the answer for all of my patients, but for many it provides just the enhancement they are looking for.

We first do a thorough oral exam to make sure the tooth discolor is not the result of a dental condition in need of treatment. Every individual is different. A patient could be a candidate for teeth whitening if there is no gum recession, enamel loss or exposed dentin. In the case of my granddaughter, I feel that she is a little too young (early teens) to have either of the procedures we offer. At her age, the tooth enamel is still porous and immature and the dentin too thin, which could make her teeth susceptible to bacterial invasion and set her up for further problems. It is best to wait two to three years.

 Bleaching has no effect on porcelain crowns and little to no effect on restorative materials. For many patients, teeth whitening is a relatively inexpensive, safe procedure with few side effects, those of which are generally mild and easily handled. There is a risk of tooth sensitivity and I discuss this with my patients prior to any procedure. As well as what they can do to both prepare and then remedy if this should occur.

There are a few options which I explain to patients. First, we offer in-office teeth whitening, a procedure whereby gums are covered with a protective barrier; a thin plastic retractor device holds your lips and cheeks away from your teeth as a professional-strength hydrogen peroxide gel is applied sequentially.  The gel is left on for a total of about an hour. When it is removed, the results are immediate and clear. There is a specific plan for at-home maintenance following the in-office bleaching. Professional whitening uses high-concentration bleaching gels that are not available over the counter. A second option is a take-home teeth whitening process. We take an impression mold of your teeth and two thin, flexible mouth trays are custom-made--one for the top teeth and one for the bottom. You will fill the trays with whitening gel and position them over the teeth. These are usually kept in for a minimum of an hour to a few hours and in some cases even overnight. The duration of use depends on the patient, but typically it is used daily until desired results are achieved and then a maintenance schedule follows.  These professional whitening procedures provide dramatic results, the effects of which can last from six months to two years.

Some patients opt for an at-home over the counter tooth whitening system which is fine. I do not promote any specific brand.  The whitening strips are easier to use than some other products on the market and generally contain a 10% carbamide peroxide gel. They look like clear band aids and are applied to the tooth surface usually twice a day for 30 minutes for up to a week. Ignoring instructions or overuse can create more sensitivity. There are “whitening” toothpastes that mostly just remove plaque and contain mild abrasives (usually silica) to clean surface stains, but they do not change tooth color as bleaching can. One more alternative option is the “whitening” mouth rinses. I know people who have used these and are pleased with the results of swishing in their mouth for 60 seconds, twice a day after brushing. There have been enough reports, though of consumers experiencing very unpleasant side effects such as severe mouth sores, burning sensations, disruption of taste buds and some other similar descriptions from these to warrant concern. Perhaps it is due to an allergic reaction, but I am hesitant to suggest the use of any “whitening” mouth rinse without further review.

Teeth whitening is an incredibly effective procedure, providing dramatic results that contribute to a person’s satisfaction with their smile.