Tooth Lightening / Bleaching

Lynne Heckert, DDS, JD

Q: How does bleaching work?
A: The procedure uses oxidizing agents such as carbamine peroxide. The bleach agent penetrates the porosities in the crystalline structure of enamel, the outside covering of the teeth.  The bleaching gel used in the dental office can be as high as 35% to 45% (hydrogen peroxide equivalent).  Home try bleaching uses around 10% to 16% bleach (you will need to buy the higher percentages of tray bleach from your dentist), but longer periods in contact with the teeth are required. Both methods work,  perhaps equally well.  The in-office procedure is faster but can burn soft tissues.  In home trays, 16% may be too strong for some patients.  Bleaching strips range from 7% to 14%

Q: How much will my teeth lighten?
A: Every patient is different.  Teeth are different and some lighten easily and others seem to change very little.  If the layer underneath the enamel, the dentin, is dark or yellow,  this will make bleaching much more difficult and the process will take longer. See the hype for what it is,  expect less than refrigerator white teeth and you will probably be very pleased.  No teeth are refrigerator white; it just doesn't happen in the animal kingdom and that includes us.

Q: Once my teeth are bleached will they darken again?
A: Some of the lightening will be lost over time.  If you are using at home systems,  you can easily do short "touch up" treatments.

Q: Will I get a better result with a system that is done in a dental office advertising a special light?
A: Probably not.  The light activation method will be more costly, but independent research does not support use of the light.  Light activation of the bleach is not harmful.  I, and many other dentists and researchers, just don't feel that it adds much, if anything,  to the process.

Q: Will bleaching hurt my teeth?
A: It is doubtful that bleaching hurts teeth as long as it is not overdone in an attempt to have unnaturally white teeth.  There may be some transient sensitivity.  With in-office bleaching, the strong peroxide can burn gum tissue even though, for the most part, they will be protected and covered during the procedure.  Harm to gums is not lasting or serious but can be a bit uncomfortable for a day or so.

Q: I would like to have lighter teeth but can't afford the $250 to $1000 charged by my dentist.  Is there anything I can do?
A: Yes. The best bet is the higher strength strips. They are easy to use and they work!

Q: What about bleaching kiosks at the mall?
A: These are not real dental offices.  The bleach used is not a high percentage and you will be better off with whitening strips.

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