Teeth Whitening FAQ

Teeth Whitening FAQ
dentist.net

Please note: Results vary and the information below is given to assist you in making an informed decision. Neither dentist.net nor the manufacturers guarantee any particular result.

1. What tooth whitening choices are there if I am interested in whitening my teeth?
There are a number of different ways to whiten teeth. There are two main choices. One is professional bleaching which requires visiting a dentist and the second is over the counter whitening i.e. buying it from a retail store or through the internet.

Different ways to bleach teeth:
* Chair-side bleaching, which involves getting your teeth bleached in usually a single dental visit at a dentist or a much publicized whitening center like Britesmile and Zoom.
* There are 2 kinds of At-home-tray whitening systems.
o From moulds of your teeth a custom-made bleaching trays is fabricated by a dental lab, which you use at home with a bleaching agent.
o A boil and bite tray is made by you in minutes and used with bleaching gel
* Tray-less Whitening using Crest Whitening Strips or a paint on gel like Colgate Simply White.

Chair-side bleaching can be done in two ways. The dentist uses a very strong bleaching agent alone or in combination with a light/laser. With both, the dentist cleans your teeth with a sandy, pumice-like material to remove plaque and cleans the surface of the tooth. Then a peroxide-based gel is applied after which a light may be applied to assist the whitening process. Most gels are self-activating and others are activated and by the use of a light. The laser does NOT whiten teeth. It merely activates the bleaching gel and initiates the chemical reaction that produces the whitening effect (the laser doesn't actually penetrate the teeth). The procedure takes about an hour and a half and offers immediate results, although it may take more than one session to achieve the desired level of bleaching.

The most publicized chair side whitening procedures:
* Britesmile Chair Side Teeth Whitening System
* Zoom Professional Teeth Whitening System

Other less well know chair side Bleaching systems include:
* Opalescence Extra Boost
* Rembrandt Sapphire System
* LumaArch
* Lasersmile

The at-home bleaching tray methods require a fitted mouth tray (bleaching tray) to hold the bleaching gel against the tooth either overnight or hourly depending on the strength of the bleach dispensed. In the past, this bleaching tray was fabricated only by a dentist. Today, these custom trays can also be ordered via the internet. You take the mold of your teeth and mail the molds to a dental lab who fabricates the trays and mails them back to you. The turn-around time is approx. 2-3 weeks. Alternatively, the boil n bite trays bypass having to wait for them to be mailed but are more bulky and donÌt fit as well. You mold the trays against your teeth yourself after placing the thermoform trays in boiling water for a few minutes to soften it. Dentist.net recommends you visit your dentist before whitening to make sure that you don't have any cavities or any other limitations that would compromise your tooth whitening results.

There are also tray-less over-the-counter options available for tooth whitening. These are the Crest Tooth Whitening Strips, Colgate Simply White, Britesmile whitening pen etc. Crest whitening strips maybe a better option for those who donÌt want to wear a tray. These strips are more difficult to keep in place especially on the lower teeth while the paint on whitening needs be kept dryish to adhere and prevent wash-out.

No matter which method you choose, how white your teeth will get depends on what color they are to begin with and the source of the discoloration. Brown or yellow teeth (often the result of superficial staining caused by smoking, coffee, and tea) will usually get whiter. Gray teeth (caused not by stains but by pigment deep inside the tooth) will lighten less, sometimes not at all. Results cannot be guaranteed. To determine the initial color of your teeth, compare them to a sheet of bright white computer paper held up to your mouth.

Chairside bleaching is the fastest but also the most expensive, anywhere from $4-$600 per session and usually requires more than one session for maximum results. Take-home bleaching kits average around $300 from the dentist, less costly online and can be used with your own schedule. Over-the-counter options, as you might expect, are the least expensive, but are thought per dentists to be less effective. Recent research has shown white strips to be as effective. The most common side effect of any of these procedures is sensitivity to hot and cold, but that lasts only while you are using the bleach and tends to persist for 1-2 days afterwards.

If there's little chance that you'll remember to pop in a mouth tray every night, or if you are impatient to see results, chair side bleaching may be a better option for you. This method also allows the dentist to treat teeth individually, which is ideal if you have veneers or teeth that vary in shade.

With proper aftercare, whitened teeth can stay bright for a few years. To keep your smile bright as long as possible, try these easy tips:
* Follow the "white teeth diet" Drink white wine instead of red wine, cappuccino instead of espresso, and grapefruit juice instead of cranberry juice.
* Use "whitening" toothpaste with a mild abrasive or peroxides (for example: Opalescence toothpaste, Supersmile , ZOOM Whitening Toothpaste and most of the over-the-counter "Whitening Toothpastes" on a daily basis.

2. Is bleaching safe or does it damage the tooth?
To our knowledge nothing detrimental has been documented and microscopic research shows no changes to the tooth surface with use of 10% bleaching solution. Most research available was initially done with a 10% concentration. There is no literature that we have come across showing any structural changes or irreversible damage to the tooth structure whatsoever.

3. What are the side effects of tooth whitening?
All bleaching gel causes some degree of tooth sensitivity. This is sensitivity to cold/hot fluids and even air can cause discomfort. This is normal and an expected side effect. Some of the brands of bleaching gel contain desensitizing agents which claim to alleviate post bleaching sensitivity. From customer feedback, this doesnÌt seem to be noticeably effective. All bleaching causes tooth sensitivity and we recommend to either discontinue use for a few days and the sensitivity will dissipate within 24-48 hrs. DonÌt be concerned as bleaching does not need to be done consecutively. You will get to the same whitening point, it will just take a little longer. A better alternative option is to use Dr. Collins Desensitizing Gel which is applied after bleaching in the same manner as the bleach. For maximum benefit use the Dr. Collins Desensitizing Gel or UltraEZ overnight. Using a desensitizing toothpaste like Sensodyne or any of the over the counter toothpastes containing potassium nitrate as the active ingredient will help.

4. I have sensitive teeth all the time. What causes this and can this be treated?
Are your teeth sensitive from using bleaching gel? - Try Dr. Collins Desensitizing Gel .

5. How long will it take for teeth to become their whitest?
Results vary. Some teeth whiten dramatically in just a few days, while others can take a few months. The majority of people whiten within 2-3 weeks. The more yellow versus gray color you have in your teeth, the better the bleaching. Grey enamel similar to that of Tetracycline (antibiotic) staining is more difficult to bleach and can take a few months to achieve a result.

6. How long the whitening will results last?
Generally, immediately after bleaching, the color will fade slightly and then remain stable for approx. 6 months to a year, sometimes longer. It is recommended for maintenance to touch up your smile every 4-6 months with 1-2 applications.

7. Why it is not recommended to bleach your teeth or use whitestrips while pregnant or nursing?

No research has been done into bleaching teeth while nursing or pregnant, so manufacturers for liability reasons recommend NOT to bleach while pregnant or nursing.

8. Will bleaching gel whiten my veneers, caps (crowns) and bonding?

All bleaching agents used to whiten teeth will only work on natural tooth structure. This means that all dental work including but not limited to bonding, veneers, crowns (caps) and bridges will NOT bleach or whiten. All dental work would need to be replaced to match the newly whitened teeth.

9. What brand of bleaching system/gel does dentist.net recommend?

There is no objective research at the present time comparing the different tooth whitening systems or the effectiveness of various bleaching gels currently available. They all work, some bleaching gels just gets you there quicker. They will all eventually get you to the same bleaching plateau (maximum whitening). Results vary, some teeth whiten very well as others show minimal changes no matter what product is used. We recommend to stay with a brand or strength that has worked for you and to maybe try another brand or strength if you are unhappy with your current bleaching results. Ultimately the choice of bleach agent is really a personal one.

10. What is the shelf life and wearing time of bleaching gel?
Generally the shelf life of most bleaching gel is approx. 2 yrs if refrigerated and 1 yr un-refrigerated. Un-refrigerated bleach should be stored in a dry cool environment. The wearing time is based on the strength of bleaching gel.

* 10% -16% can be used for minutes to overnight if no sensitivity
* 20- 22% - 1 hr / application

11. What do the different bleaching percentages mean?
The percentages (%Ìs) prefer to the concentration of bleaching agent. It is generally accepted that the higher the % of bleaching agent, the stronger the bleach and the more effective it is at bleaching. There is however, no objective research to substantiate it. One of the main advantages of the higher % is reduced wearing time. 10 - 16% can be worn for a few hours to overnight, where as a 20-22% bleach should only be used for 1 hour per application.

12. Which bleaching gel works the best i.e. faster?
The active ingredient is the same with most bleaching brands. Zoom, Nite White turbo and Day White have a slightly different active ingredient, which works a little more rapidly, but in the same manner. Some feel that these products cause more tooth sensitivity. Please keep in mind that some teeth are more difficult to bleach than others no matter what bleaching agent you use. The older you are and the more gray your teeth are, the more difficult it is to bleach. Some teeth that will achieve only minor whitening improvement no matter what product you use.

13. How many bleaching syringes do I need to buy in order to whiten my teeth?
As brands of syringes vary in the amount of bleaching gel, it is easier to quantify by using the mlÌs or ccÌs (same thing) and NOT the number of syringes. It is generally accepted that each treatment requires approx 0.5 mlÌs (ccÌs) of bleaching gel per application. The average person with yellow teeth will therefore needs about 10-15mlÌs (ccÌs). Keep in mind that you may need to do touch-up's at a later date to maintain the whitening. Grayish colored teeth are more difficult to whiten and will require additional bleaching gel. Keep in mind that only a small droplet needs to be placed on the inside surface of the outer wall of your custom made whitening tray opposite each of the front 8 teeth. It is not necessary to whiten the teeth towards the back of your mouth as these teeth are not usually visible when you smile.

14. What is the difference between carbamide peroxide and hydrogen peroxide bleaching gel?
There are 2 main bleaching ingredients. Carbamide peroxide (e.g. Opalescence, dentist.net, Nite white) and hydrogen peroxide (e.g. Day White, Zoom, and Nite White turbo). Comparatively, a 7.5% hydrogen peroxide is equivalent to a 16% carbamide peroxide while a 9.5% hydrogen peroxide is equivalent to a 26% carbamide peroxide.

Carbamide peroxide actually breaks down into hydrogen peroxide. Patients must wear Nite White for a longer period of time so that the carbamide can break down in to hydrogen peroxide, the active ingredient. The only real difference for you is the wearing time. Nite White was first developed in a 10% solution to be used overnight, allowing time for the carbamide peroxide to breakdown into hydrogen peroxide. With the demand for a more effective bleaching agent, the 16% and 22% were launched. The 16% can also be used overnight while the 22% is used for 1 hour only. Both Day White and Nite White will take you to the same bleaching end point. Theoretically it would appear then that Day White 9.5% would be more effective but there is no research to substantiate this.

15. How long I should refrain from coffee and red wine after bleaching?
It is recommended to avoid such during whitening and for 1 week after tooth bleaching. Dentist.net however recommends not changing your lifestyle. If you feel that your teeth have yellowed over time, it is okay to do touch-up bleaching 1-2 applications every 4-6 months as needed.

16. Will teeth whiten to the same degree on everyone?
No÷Results vary. Some teeth whiten dramatically in just a few days, while others may take weeks to months to show a difference, if any. The more yellow versus gray color you have in your teeth, the better the bleaching result. Grey enamel similar to that of Tetracycline (antibiotic) staining is more difficult to bleach. Some normal teeth will achieve only minor whitening improvement no matter what product you use. Results cannot be guaranteed.

17. The area of the teeth near the gums is still not as white as the rest of the tooth?
Make sure that the bleach covers the entire surface of the tooth and not just the bottom half. The average tooth will usually have a seamless whitening transition from whiter at the bottom of the tooth (biting surface) to less white towards the gum line. This is normal and an expected result. This is due to thinner enamel in this area allowing more show through of the tooth color. Very few cases have total uniform whiteness. With grayish teeth, the transition is occasionally somewhat more noticeable. One might see a demarcation area / line between the 2 areas. Keep in mind that whitening fades and the tooth will in most instances gradually blend. In some cases that are extremely resistant to bleaching, one might consider bonding or veneers as an alternative treatment.

18. I just started bleaching and it looks uneven with white spots and blotchiness. Should I continue bleaching or stop?
It is also normal that certain areas of the tooth such as areas of decalcification will respond more rapidly to bleaching resulting in blotchiness at first while the rest of the tooth catches up as one continues to bleach. The blotchiness is the first to fade after stopping resulting in a more uniform appearance.

19. How long do you recommend using the bleaching gel?
The choice when to stop bleaching is really a personal one. Stop when you are pleased with the results. Teeth will gradually get whiter and within either a few days or 2 weeks in most cases reach a plateau where they will not get any whiter. This is the maximum amount of whitening you will reach and at that point do not bleach any further. It is normal for it to fade slightly and then stabilize after you have discontinued. Dentist.net does not recommend bleaching beyond 2-4 weeks. Most teeth whiten well within the first week of use.

20. I have tetracycline (grayish) stained teeth and want to whiten my teeth!
Tetracycline is difficult to whiten. Results vary and results, if any are not guaranteed. If you have bleached your teeth with another bleaching agent, the results will most likely not show much improvement with another brand. Bleaching tetracycline teeth can sometimes cause uneven whitening, horizontal tetracycline lines to become more prominent and even blotchiness. Some cases lighten evenly and customers are pleased with the results. Accepting any bleaching product for use, is accepting all the possible risks that could arise from tooth bleaching products. With tetracycline staining you may want to consult with a dental professional for your whitening needs. Tetracycline stained teeth may need to be bleached for a few months to show results.

21. How long can I try and bleach my tetracycline-stained teeth?
It is acceptable to continue bleaching up to 6 weeks for normal teeth. Some literature suggest than one can even safely whiten for up to 6 months for those who have tetracycline-stained teeth. We feel that an 8 week regime should suffice. If you feel you reach a whitening plateau and your teeth do not get any whiter, that would be a safe termination point.

22. Is taking my own molds be a problem if I have a bridge and/or an orthodontic wire glued to the back of front teeth?
If mold material gets trapped underneath the wire or bridge, it can loosen your bonded retainer/bridge or you might have difficulty removing the mold from your mouth. You may want to rather get the molds done at your dentist if you have a bridgework. We cannot be responsible for any complications.

23. My kids have white "spotty" teeth. Will whitening be help?
White spots commonly come from too much fluoride during tooth development. This condition is known as Fluorosis. Although it might look imperfect, these teeth are extremely resistant to cavities. White spots can also occur after orthodontic treatment in the area of the orthodontic brackets. This is decalcification as a result of inadequate hygiene and in these situations, these areas are more susceptible to cavities.

There has been no research conducted on bleaching and kids. There have been a few cases reported in the literature with no adverse effects besides temporary tooth sensitivity. We recommend to wait until all the teeth have FULLY erupted otherwise the un-erupted tooth portion will not be bleached. White spots will initially get whiter quicker, but becomes less prominent as the surrounding tooth structure bleaches and becomes whiter. The white spots will usually return to their normal whitish color but will be less conspicuous as the background is now whiter. Results vary and one cannot guarantee a result.

24. Zoom has only 6% hydrogen peroxide while Day White comes in both a 7.5% and 9.5%. Surely that means that Day White is stronger?
The Zoom 6% Weekender kit is a 6% hydrogen peroxide formula but unlike Day White it is worn overnight. The hydrogen peroxide works over a longer period of time because there is a unique time release active matrix built in that controls the release of the hydrogen peroxide. Zoom also contains a surfactant, which lowers surface tension allowing more intimate contact between the bleaching agent and the tooth surface. Because of this there is an associated increase in tooth sensitivity. Zoom weekender is worn for only 3 nights. If you want something stronger then Day White & Nite White and you do NOT have tooth sensitivity or suffer from post-bleaching sensitivity or if you need to have whiter teeth for a social deadline then Zoom Weekender might be your fastest route.

25. What is the difference between Opalescence F and Opalescence?
The F stands for fluoride and the PF is fluoride and potassium nitrate. Both are incorporated into the bleach to combat tooth sensitivity. The PF is thought to be better as it has the potassium nitrate as well as the Fluoride. It will bleach the same but PF is expected to cause less tooth sensitivity.

26. It is very difficult to spread the bleach in my custom whitening trays. Do you have any suggestions for distributing the gel more evenly?
All you need to do is place a continuous line of bleach half way up on the inner side of outer wall of the whitening tray so that it forms a rope line of bleaching gel which will not run or slump. When you place the tray over the teeth, the teeth will displace the gel to cover the tooth surface (i.e. the teeth will spread the bleach).

You can see where the bleach covers the tooth and if it appears deficient in an area, you can merely touch the tray gently on the outside to move the bleach around. The gel consistency should be thick and viscous. By creating the gel with increased viscosity allows better retention of the bleach against the tooth surface and therefore more effective even whitening.

If you are refrigerating the product, allow it to sit for a few hours before using it to allow it to be more flow able.

27. How do you prevent the bleach from oozing out between applications?
Withdraw the plunger slightly after use to decrease the hydraulic pressure within the syringe. This will prevent it from oozing out.

28. Can I order an upper bleaching tray only? I have the molds.
For those of you who already have molds but need whitening tray, Dentist.net offers a service to have custom made whitening trays with no dental visit.

29. During bleaching my gums were burning, leaving several areas of my gums white. Is this due to overfilling?
Either your trays are covering the gum area or you overfilled the trays. All you need is either to place a small droplet in each tooth or a bleach line midway across the inner outer wall of the tray. The gums will return to normal in a few hrs i.e. the whiteness will disappear. Avoid any further bleaching until healed. Avoid hot and spicy foods till then. Next time use less and use for 15 minutes and then increase the time on subsequent bleaching periods.

30. Will Crest Whitestrips also cause tooth sensitivity.
Yes, all whitening products cause tooth sensitivity, but it will cease a few days after you stop using whitestrips. If your teeth are sensitive, use the strips once and repeat a few days later when the sensitivity subsides. Keep in mind that all bleaching agents cause tooth sensitivity.

31. As noted in your instruction sheet, I placed the Nite White Excel whitener in my refrigerator upon receipt. I realize this was optional, but I thought it would do no harm. However, when I started to use the whitener, I noticed that the package stated that the syringes were not to be placed in the refrigerator or freezer. Since they were in the refrigerator for several days, will this impair the effectiveness of the gel?

The bleaching instructions are generalized bleaching instructions. Bleaching gels are made from different ingredients. Nite White whitening gel does not need to be regularly refrigerated while the Opalescence brand of whitening gel does need refrigeration for long term storage due to glycerin content. Nite White does not recommend refrigeration as it could cause the gel to get cloudy/milky. It does absolutely nothing to the efficacy of the gel- it just looks cloudy.

Nite White Excel is glycol based which is more stable than glycerin and so Nite white claims a 2 year un-refrigerated shelf life. Most regular bleaching gel has a one year shelf like and 2 yrs refrigerated. In summary, its not harmful to refrigerate (but do not freeze) bleaching gel. We do recommend to allow the bleaching gel to reach room temp before use for maximum efficacy.

32. I had Zoom treatment one week ago. I have been using the bleaching trays with 22% gel since. I was instructed to use them for two applications per day, not to exceed 1 hour per application. Unfortunately, I fell asleep twice while wearing the trays and as of yesterday I feel as if my front teeth became "rough" feeling. Upon closer inspection under bright light, it seems to me I can see almost some duller areas on my teeth and then very smooth areas. Have I caused enamel damage and, if so, is there a way to correct this?

Most of the research on whitening has only been done with 10%. The manufacturers donÌt feel that the higher percentages can cause damage but just like when one drinks or eats acidic foods there is the depletion of minerals from the teeth which is put back by our saliva. This process is dynamic occurring all the time. There are some remineralization toothpaste which contain these important minerals in form that is thought to be absorbed into the tooth surface. We recommend the use of these kinds of toothpastes during tooth bleaching. It is also thought to help with tooth sensitivity. I recommend you refrain from bleaching, use one the remineralization toothpastes until such time as the tooth surface feels normal. Click here to view the new generation of remineralization toothpastes.

33. I wanted my teeth glistening white but it is costly. I have been brushing my teeth with baking soda for a few months and now I have sensitive teeth. I always have bi-annual dental check ups and my dentist told me that I have neither gum disease or receding gums. What products do you recommend?

With regards to your sensitive teeth I would recommend you review these FAQs. Its not normal to have sensitive teeth and it can be diagnosed and treated appropriately. We always recommend a second opinion when it comes to ones health. We don't usually make recommendations as we cannot be responsible for returns but here is a few suggestions to help you make an informed decision. As far as tooth sensitivity goes one can treat it symptomatically with either Sensodyne toothpaste (any toothpaste containing Potassium Nitrate). Keep in mind that these toothpastes are recommended to be used for a few weeks. What we feel are currently more beneficial are the recent launch of the remineralization toothpastes which not only address tooth sensitivity but have also been shown to remineralize the toothpaste thereby helping to reverse small cavities. I would recommend the ORAVIVE toothpaste as a choice for regular use.

Bleaching does cause and aggravate existing tooth sensitivity so we feel its important to address the teeth sensitivity first by using the Oravive or Sensodyne for a few weeks before tooth bleaching. We also recommend you by the Dr. Collins Desensitizing Gel to be used before and after the bleaching procedure. Please see this page for more info.

Please review some whitening choices here.

Some better methods to whiten ones teeth are Dentist.net Bleaching Kits and Boil and Bite Bleaching Kits.

Once your teeth are whitening we recommend the regular use of a whitening toothpaste. We recommend SuperSmile and BriteSmile

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