Are you considering teeth whitening to help reinvigorate a smile tainted by discoloration? Professional, in-office teeth whitening is the most popular cosmetic dental procedure in the world today. Unlike home-use systems that incorporate low-dose bleaching agents, in-office whitening takes place under carefully monitored conditions which allow for the safe, controlled, pain-free use of a relatively high concentration of bleaching gel – yielding results that are visible immediately.

1/- Stains That are Best Removed by a Pro

Chairside whitening removes organic stains or discolorations primarily caused by:

• Aging. Over time, the teeth darken with a yellow, brown, green or grey cast (which may be due to heredity and/or eating habits). Yellowed teeth tend to whiten most readily.
• Consumption of certain foods (notably coffee, red wine, sodas and dark-colored vegetables and fruits).
• Tobacco use.

2/- Stains Resistant to In-Office Whitening

• Teeth with certain stains – typically those that are inorganic – do not respond well to in-office treatment. In fact, these teeth may look even darker after the surrounding teeth have been whitened.
• Trauma, which causes the dentin to darken.
• Tetracycline antibiotics ingested during tooth-formation. These drugs chemically bind with the crystalline structure of both the tooth’s enamel and underlying dentin.
• Overexposure to fluoride, which can cause fluorosis, resulting in tooth discoloration.

3/- Are you a Candidate?

This procedure is not suitable for those with the following conditions:

• Tooth and gum hypersensitivity. To avoid a hypersensitive reaction, your dentist is likely to recommend take-home bleaching trays with a low concentration of carbamide peroxide – which is not as potent as hydrogen peroxide.
• Deep and intractable staining. Some stains are resistant to high-concentration in-office bleaches. In such cases, dentists may recommend a supervised regimen of intensive take-home bleaching or alternatives to peroxide bleaching such as bonding, crowns or veneers.
• Teeth that have become transparent with age. This is particularly true of the front teeth, which are thin to begin with.

4/- Prepping the teeth

• Your teeth will likely be given a prophylactic cleaning to clear away plaque and debris that have collected on the surface and between the teeth.
• A dental exam will be performed (often in tandem with the prophylactic cleaning) to check for potential problems such as severe tooth decay, cracks and gum disease. Bleaches can cause varying degrees of irritation if these conditions are present. Your dentist will likely delay the procedure until such problems have been corrected.
• Photos may be taken of your teeth, and their color measured on a shade guide. This provides a benchmark for assessing your progress.

5/- The In-Office Whitening Procedure

• While details may vary, a fairly standard routine is followed. Typically, the steps involved are not painful or uncomfortable; in fact, many patients doze or watch a DVD or TV during the procedure.
• A cheek retractor is inserted into the mouth, exposing all the “esthetic zone” teeth (teeth that are visible when you smile).
• A liquid rubber dam or hardening resin is painted onto the gum tissue to protect against any irritation caused by the bleaching gel.
• A bleaching gel containing hydrogen peroxide is applied to the esthetic zone teeth and kept on for approximately 15 to 30 minutes.
• The bleaching gel is suctioned or washed off, and fresh gel is applied for one or more additional periods of 15 to 30 minutes.
• Some whitening treatments incorporate an intense light that is focused on the teeth and is said to activate or enhance the bleaching process. Opinions vary as to whether this light improves the bleaching outcome.
• Between gel applications, the teeth are checked to see how well they have whitened, and whether more bleach needs to be applied.
• After the final gel application, the cheek retractors are removed, the patient rinses and the immediate post-treatment shade change is measured. The teeth may whiten by as few as two to three shades or as many as eight (out of a total of 16). Part of the whitening effect is due to dehydration during the bleaching process, which makes the teeth look whiter than their true new color. That color will emerge after a couple of days.

If a satisfactory level of whitening hasn’t been achieved, your dentist may recommend follow-up in-office bleaching at a future date, and/or a regimen of take-home bleaching trays.

6/- What are Your Options?

A number of brand-name whitening systems are in use at dental offices today. Here are are the two best systems available in our dental offices:

• Opalescence Boost
  Praised for the viscosity of its bleaching gel – a sticky quality that is considered a major plus in tooth-bleaching – Opalescence Boost relies on chemistry for achieving its effects, and does not include the use of a special light activator. Its 38 percent solution of hydrogen peroxide gel contains a unique patented component called PF, a mix of potassium nitrate (reducing the risk of sensitivity) and fluoride (the enamel-strengthener which reduces the risk of cavities).
  Total chair time: One to two hours.
• Zoom! Chairside
  Widely used throughout the country and the world, the Zoom! system features a 25 percent hydrogen peroxide gel and the Zoom! Advanced Power Chairside Lamp, said to accelerate the bleaching process. Generally, the hydrogen peroxide gel is applied three times, each interval lasting 15 minutes. Immediately afterwards, a sensitivity-reducing fluoride paste-gel is applied to the teeth.
  To help maintain your whitened teeth, you are given a Zoom! home-use touch-up kit, including custom-fitted whitening trays.
  Total chair time: Approximately one hour.