teeth whitening

Bleaching - Common Questions

Van der walt dental - teeth whitening

Should Teeth Be White?

Teeth in adults contain a mixture of yellow, red and grey colours with a wide variety of shades and hues. It is normal for healthy unfilled teeth to darken and yellow with age.

The portrayal of unrealistic tooth shades in the media is because they are often manipulated by digital enhancement or the person has porcelain veneers or crowns. Trying to achieve these more extreme shades of white is often an unrealistic goal with bleaching alone.

The best way to gauge your realistic outcome would be to achieve the same white as the sclera of your eyeball, also known as the whites of your eyes. Any shade whiter than this would be an unrealistic and unnatural goal.

Over bleaching has been known to cause opacity, translucency and sensitivity issues. For this reason we strongly advise close Dental Professional supervision.

What Are The Steps For Bleaching?

Firstly a thorough exam, scale and polish with x-rays is a priority. Identification of any problems is important before starting the bleaching process. This can help to eliminate any potential problems. A professional scale and polish is a preventative treatment that removes surface stains and makes teeth reflect more light and thus appear lighter. It is recommended that a polishing paste be used to maintain your teeth to keep this surfaced polished. Once this staining and calculus has been removed we can evaluate the outcome and decide if this has achieved the intended goal.

If this is not the end result you were hoping for the next option is the use of Colgate's Simply White Gel to enhance the natural colour of your teeth and remove any residual stains. This may be enough to achieve a result that is aesthetically pleasing. If not it will allow for a more successful bleaching regime.

Dental restorations, fillings, are not affected by the bleaching process as bleaching only lightens natural tooth enamel. After bleaching any existing fillings may need to be replaced to keep aesthetics uniform. Amalgam (silver) restorations that are immediatly visible may also need replacing before bleaching. Discolouration or 'greening' around the restoration may occur from the bleaching process. The other concern is that the restoration may become more visible from the resultant translucency of the tooth structure.

Side Effects

Bleaching does not appear to affect the integrity of the tooth structure. Teeth remain strong and healthy after the bleaching process. There is concern, however, that teeth gain heightened sensitivity. Please realise that any sensitivity is generally of a temporary duration. This can be managed and reduced in various ways. The use of potassium additives in the bleach or in your daily toothpaste is effective. There is a product known as 'Tooth Mousse' which is an active calcium paste. This is very successfully used as a desensitising agent. If heightened sensitivity is causing discomfort there is the option of adjusting the frequency of treatment ie. skipping days

If both arches are bleached simultaneously it can appear to have not achieved the desired result. We recommend the best way to monitor the shade changes is to bleach one arch at a time. This will also reduce the stress on your body to allow it to cope with the bleaching solution. Also only wearing one tray at a time can reduce discomfort to the jaw joint.

The bleaching solution can cause irritation to the gum tissue. We try to help minimise this irritation as much as possible by making custom fitted mouth trays and explain the correct techniques before you begin. Special attention must be made to the amount of solution that is placed in these custom trays. If too much is placed in the trays it will overflow and irritate the gums. More bleaching solution does not mean a better result will be achieved.

As bleaching is an internal oxidation process, not all teeth bleach evenly or consistently. Large white spots can become more noticeable but not normally worse. It may be recommended that an additional mechanical enamel micro-abrasion be performed on these areas clinically to even surface imperfections before recommencing with whitening.

Bleaching is a safe and easy process to undertake when used as recommended and closely supervised by a Dental Professional.

Instructions During Bleaching

  • Follow all directions of manufacturers bleach instructions
  • Avoid pigmented foods during the bleaching process, including:
    • tea / coffee
    • red wine
    • darker soy sauces
    • smoking
    • concentrated tomato pastes
  • Maintain excellent oral hygiene (avoid chlorhexadine mouthrinses ie. Savacol)
  • Sensitivity for some patients can be an issue. To avoid or minimalise this please...
    • do not overload the bleach tray
    • wipe excess bleach off if it oozes out of tray in mouth or onto gums
    • do not wear tray longer than advised
    • use 'Tooth Mousse' after brushing and chew 'Recaldent' chewing gum often during the day
    • use a sensitive toothpaste during bleaching weeks
    • drink lots of water for hydration and better saliva flow
    • only do one arch at a time ie start with upper tray first
    • if still uncomfortably sensitive only wear tray every second night. You will still achieve the end result, it will just take a little longer but effectively reduces side effects.