Teeth Whitening

Everyone wants a “wow” smile. Although this starts with a healthy smile, a little extra whitening may be desired. Teeth whitening is a bleaching process to whiten or lighten tooth color. Whitening is most commonly accomplished with chemical oxidizing agents such as hydrogen peroxide, alone or in the presence with light, acting as an activating agent.

Although considered a type of cosmetic dentistry, teeth whitening may be an important psychological boost for a person, whether an adolescent or an adult, embarrassed by off- colored or stained teeth. Focus on the whiteness of one’s teeth may be an off-shoot of media perceptions of unrealistic beauty that are imposed upon the general public. However, as noted by the American Academy of Pediatric Dentistry, a negative self image due to discolored teeth can evoke serious consequences for an adolescent.

Causes of Discoloration

Many factors interact to cause discoloration of teeth. Tooth discoloration is a function of the age of an individual and of environmental lifestyle choices. Teeth darken as we age.

Underneath the enamel (the hard, outer white covering of a tooth) is the softer region termed the dentin, with a yellowish tinge. As one ages, the enamel thins, thereby allowing the yellow dentin to be more pronounced.

Lifestyle choices that affect tooth whiteness include tobacco use and drinking colored beverages such as tea, coffee, wine, sports drinks, and cola. For a pediatric dentist, yellowing teeth due to aging is not an issue. Baby teeth are whiter than adult or permanent teeth. Thus, a pediatric dentist’s focus may be directed to adolescents, especially those who smoke or consume large amounts of colored beverages. Other factors that may cause discoloration of adolescent teeth include traumatic injury to a tooth or exposure to medications, such as tetracycline. Irregularities in coloration of a permanent tooth can be due to infection or trauma of the related primary tooth.

Effects of Whitening

The adolescent patient may have unrealistic expectations from teeth whitening. For example, the whitener will not affect the color of bonding or tooth colored fillings. If these materials were placed in the front teeth, the front teeth may not match the other newly whitened natural teeth. If tooth discoloration was due to smoking, the adolescent should be encouraged to refrain from continued smoking, especially during the whitening process.

Adverse side effects associated with teeth bleaching include irritation to the gums and increased teeth sensitivity to heat, cold, or sweets, which is a transient situation that will resolve in a short time.

Types of Whitening

Whitening methods vary. In-office bleaching often employs a light-cured protective layer that is applied to the gums to reduce sensitivity. The bleaching agent used is either hydrogen peroxide or carbamide peroxide. To accelerate the whitening process, the dentist may use light, usually within the blue light spectrum, which enhances the hydrogen peroxide bleaching reaction.

The whitening procedure is as follows: (a) the gums are covered with a protective barrier; (b) a professional hydrogen peroxide gel is applied to the teeth; and (c) the gel-covered teeth are exposed to a light source, either halogen, LED, or plasma. A typical bleaching procedure may last from 0.5 to 1 hour.

The dentist may recommend an at-home bleaching maintenance program. For your child’s safety you should follow the suggestions of the pediatric dentist and, of course, of the manufacturer of the product.

For most dental procedures, including teeth whitening, supervision by a qualified dental professional is suggested. Issues such as the overall health of the oral cavity, including gum disease, tooth restorations, existing areas of tooth decay, gum sensitivity, etc. should be evaluated, as well as the degree of whitening required to reach the desired and safe results. An adolescent with an unhealthy obsession with tooth whitening, termed “bleachorexia,” may over-bleach his/her teeth, damaging both teeth and gums. Under appropriate supervision by a qualified dentist, teeth whitening should be safe and may spark up your life.