Dental Bleaching and Tooth Whitening

A bright white smile may look healthy but it doesn't mean that teeth are healthy .
The aim is not making your teeth looking healthy,but being healthy.

Dental bleaching,or tooth whitening is a common procedure in general dentistry but most especially in the field of cosmetic dentistry.

A child's deciduous teeth are generally whiter than the adult teeth that follow. As a person ages the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous. 

Why our teeth become darker ? Causes of teeth stains. 

Teeth can become stained by 

• Bacterial pigments. 
• food-goods and tobacco. 
• Certain antibiotic medications (like tetracycline) can also cause teeth stains or a reduction in the brilliance of the enamel. 

Tooth bleaching is not a modern practice. Ancient Romans, for example, utilized urine as a product to make and keep their teeth whiter.

Whitening restores natural tooth color and Bleaching whitens beyond the natural color. 

There are many methods to whiten teeth, such as brushing, bleaching strips, bleaching pen, bleaching gel, laser bleaching, and natural bleaching. 

Overview
Everybody loves a bright white smile, and there are a variety of products and procedures available to help you improve the look of yours.

Many people are satisfied with the sparkle they get from brushing twice daily with a fluoride-containing toothpaste, cleaning between their teeth once a day and the regular cleanings at your dentist’s office. If you decide you would like to go beyond this to make your smile look brighter, you should investigate all of your options.

Whitening is performed by applying a high concentration of oxidizing agent to the teeth  for a short period of time, which produces quick results.

According to the American Dental Association there are different options to whiten one's teeth that include:

• In-office bleaching;
• At-home bleaching;

In-office bleaching or Chair-side Bleaching
This procedure can be done in the dental office . This procedure is called chair-side bleaching and may require more than one office visit. Each visit may take from 30 minutes to one hour.

Before undergoing any whitening method. The dentist should examine the patient thoroughly: take a health and dental history (including allergies and sensitivities), observe hard and soft tissues, placement and conditions of restorations, and sometimes x-rays to determine the nature and depth of possible irregularities.

During chair-side bleaching, the dentist will apply either a protective gel to your gums or a rubber shield to protect the oral soft tissues. A bleaching agent is then applied to the teeth, and a special light may be used to enhance the action of the agent. Lasers have been used during tooth whitening procedures to enhance the action of the whitening agent.

At-home procedures and products.
There are several types of products available for use at home, which can either be dispensed by your dentist or purchased over-the-counter. It include gels, chewing gums, rinses, toothpastes.

1 - Bleaching solutions.

These products contain peroxide(s), which actually bleach the tooth enamel. These products typically rely on percent carbamide peroxide as the bleaching agent, carbamide peroxide comes in several different concentrations (10%, 16%, 22%).

If you obtain the bleaching solution from your dentist, he or she can make a custom-fitted mouthguard for you that will fit your teeth precisely.

2 - Gel bleaching

teeth whitening gel in fitted tray

Peroxide-containing whiteners( carbamide peroxide ) typically come in a gel and are placed in a mouth-guard. Usage regimens vary. Some products are used for about twice a day for 2 weeks, and others are intended for overnight use for 1-2 weeks.

There are two main methods of gel bleaching—one performed with high-concentration gel, and another with low-concentration agents. High-concentration bleaching can be accomplished either in the dental office, or at home. 

Applying the gel to the teeth:

It is applied with thin plastic trays for a short period of time. The application trays ideally should be well-fitted to retain the bleaching gel, ensuring even and full tooth exposure to the gel.

Side effects,  that occur most often are .  

• Teeth can become sensitive during the period when you are using the bleaching solution. In many cases, this sensitivity is temporary and should lessen once the treatment is finished. 
• Mild soft tissue irritation—either from a tray that doesn't fit properly or from solution that may come in contact with the tissues.

Both of these conditions usually are temporary and disappear within 1 to 3 days of stopping or completing treatment. 

3 - Toothpastes. 

All toothpastes help remove surface stain through the action of mild abrasives. "Whitening" toothpastes have special chemical or polishing agents that provide additional stain removal effectiveness. Unlike bleaches, they do not alter the intrinsic color of teeth.

Light-accelerated bleaching

Power or light-accelerated bleaching, sometimes colloquially referred to as laser bleaching .

Dentists use light energy to accelerate the process of bleaching in a dental office. Different types of energy can be used in this procedure, with the most common being halogen, LED, or plasma, halogen light is the best source for producing optimal treatment results.

Notice that : 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 dentin layer.

Side effects, and risks of Dental Bleaching.  

Chemical burns from gel bleaching (if a high-concentration oxidizing agent contacts unprotected tissues, which may bleach or discolour mucous membranes), sensitive teeth

Over bleaching known in the profession as "bleached effect", particularly with the intensive treatments (products that provide a large change in tooth colour over a very short treatment period, e.g., 1 hour)

Pain if you have "sensitive teeth" caused by open dentinal tubules.

Risk of increased hot/cold sensitivity.

Increased risk of tongue cancer.

I hope it is useful 

Thanks

Manal Raafat [MR]