The advertising promises are everywhere -- a whiter smile can bring you that perfect partner, land you the perfect job, make your life better than you ever dreamed. Okay, maybe teeth whitening can't do all that. Nevertheless, these days it's easier and less expensive than ever to make your pearly whites shine. "White teeth are the biggest thing in dentistry," says Dr. William Ebbs, a dentist with the Washington Dental Studio.
Teeth become stained for many reasons: drinking coffee and tea; smoking or chewing tobacco; taking certain antibiotics, such as tetracycline; ingesting excessive amounts of fluoride while teeth are still developing; and injuring a tooth's root pulp. Aging is also a factor -- as you grow older, the enamel on your teeth starts to wear away, exposing the darker portion surrounding the root.
Many options are available to start whitening your teeth. Whitening toothpastes are by far the least expensive, simply adding chemicals that work to remove the stains alongside the abrasive ingredients that clean your teeth. The American Dental Association has given its Seal of Acceptance to some whitening toothpastes, indicating that those particular products meet standards of safety and effectiveness. However, whitening toothpastes will only help to reduce staining on the teeth and will not change the tooth color.
Actually changing the coloration of your teeth means using bleaching products, which contain chemical agents such as a form of carbamide or hydrogen peroxide that removes stains and whitens the tooth enamel. Bleaching products range from over-the-counter strips and gels to prescription-only kits. Choosing among these products is often based on cost and convenience. Over-the-counter products such as Crest White Strips, Colgate Simply White Night or Rembrandt 2-Hour White can be found at grocery stores and pharmacies and cost from $15 to $35.
While these products are easy to find and do have success, they will only lighten your teeth a few shades and the results may vary if not used correctly. The products are generally recommended for nighttime use since saliva mixing with the gel can reduce the amount of bleaching. Moreover, you will need to limit talking and eating during use. For a whiter and possibly longer lasting change, you need a stronger bleaching product than these brands provide. (The ADA has not given its Seal of Approval to any of these over-the-counter products.)
The stronger products are more heavily regulated and must be provided by a dental professional either by prescription or in the dental office. At-home bleaching products are the less expensive of the two options, consisting of a custom-fitted tray (mouth guard), a liquid or gel peroxide solution, and applicator. Users must wear the trays for 1 to 2 hours daily or overnight for about two weeks. You'll need to visit your dentist for a custom fitting for the trays.
A major benefit of this option is having the solution tailored to your particular needs. A dentist will take into account the cause of the staining of your teeth, as well as any factors that may limit the effectiveness of the bleaching procedure. The treatment course can cost from $300 to $500.
The third option is chairside bleaching. One popular procedure available in the D.C. area is the Zoom! In-Office Whitening System. The procedure combines use of higher concentration peroxide gel with intense light, which activates the gel and speeds the bleaching process. The gel is applied for 20 minutes, rinsed off and reapplied once or twice more, depending on the results. This process takes only 60-90 minutes and can whiten teeth 6-10 shades.
Edward Henley, dental assistant at D.C. Smiles, says the major benefit of this procedure is the swiftness of the results, since the "strength of the product is much higher," in comparison to the at-home methods. This option provides the quickest change, but is the costliest. Zoom! and other similar chairside procedures run from $500 to $1,000 for a session.
The main side effect that patients may experience from bleaching is irritation of the gums. Irritation is a result of the bleaching gel being absorbed by gum tissue or from ill-fitting mouth trays. Additionally, the peroxide may cause hypersensitivity in the teeth in some individuals. Side effects are generally considered mild, however, and short term in duration.
In some cases, tooth whitening is not recommended. If you are a very heavy smoker, bleaching won't last long. Although you may find initial whitening, heavy smokers may notice their teeth darkening again within just a few weeks of treatment. The cost may not be worth the short-term results. For people with advanced periodontal disease, irritation to the gums can be strong and of longer duration. If you have advanced disease, you should definitely discuss the pros and cons with a dental professional.
Crowns and bonding on your teeth will retain their original color and will be noticeable next to your newly bleached teeth. If you plan to bleach your teeth and need a crown or bonding, Dr. Ebbs recommends having the crown/bonding created a shade lighter than your teeth so that the color difference won't be as strong once you do whiten your teeth.
Finally, take into account the natural color of your teeth. While bleaching may produce a dramatic change in your teeth, your results may seem a bit less bright next to someone else's. Bleaching can't make all teeth pearly white, but nearly everyone can bring a little more sparkle to their smile.