Professional Teeth Whitening

The Complete Guide to Professional Teeth Whitening

Discover the ins and outs of professional teeth whitening, from its effectiveness to personalized treatment options, in this comprehensive guide.  

When it comes to enhancing your smile, professional teeth whitening is frequently a reliable, secure, and successful option. However, there are several factors to take into account. These include the cost, your lifestyle habits, and determining whether an extensive in-office treatment or a personalized take-home tray would be more suitable for you.

How does professional teeth whitening work?

There are two primary substances used in professional teeth whitening: hydrogen peroxide and carbamide peroxide. Unlike whitening toothpaste that relies on abrasive ingredients to mechanically remove surface stains, these whitening agents work at a molecular level by weakening tooth stains with oxygen molecules.

Over-the-counter (OTC) whitening strips, kits, and pens also utilize some form of peroxide, but the key distinction from professional teeth whitening lies in the chemical concentration.

During in-office professional whitening, a high percentage of hydrogen peroxide is used because dentists have the ability to isolate the teeth. Special rubber dams are employed to protect the patient's gums, as peroxide can cause burns if it comes into contact with them.

Similar to at-home whitening products, professional teeth whitening offers various methods. In-office professional whitening is a faster but more expensive option for brightening your teeth. On the other hand, custom take-home trays provide a middle ground in terms of treatment duration and cost, falling between in-office professional whitening and over-the-counter whiteners.

How does In-office teeth whitening work?

In-office professional whitening procedures are typically conducted over several short appointments, tailored to meet your specific needs. A whitening agent is applied and left on for intervals of 15 to 30 minutes, with the entire appointment lasting no more than an hour and a half.

There are different types of in-office whitening treatments available:

  1. High-concentration hydrogen peroxide gel, applied using a syringe.
  2. Hydrogen peroxide combined with a high-intensity light, such as LED, UV, or halogen. The light is administered through a lamp or laser device positioned outside your mouth.
  3. According to a 2016 study in the Journal of Conservative Dentistry, halogen light and laser light were found to enhance tooth lightness more effectively than hydrogen peroxide alone. Participants in the halogen and laser light groups maintained their white teeth color achieved during treatment even after three weeks, whereas the non-light group experienced "shade rebound" after just two weeks, resulting in a darkening of initially brightened teeth.

However, some studies indicate that using a light tool, such as a laser or lamp, may not provide any additional benefits over using a whitening gel alone.

Apart from assessing effectiveness, it's important to consider the safety of light exposure for your smile. A 2020 study published in Materials revealed that tooth cells recovered well after LED light-accelerated technology, suggesting that most side effects are temporary and transient.

During an in-office teeth whitening appointment, you can expect the following steps:

  1. Assessment: Your dentist will use a tooth shade chart to determine the current color of your teeth and discuss the potential shade improvement achievable through whitening.
  2. Polishing: A pumice tool will be used to polish your teeth, removing any remaining plaque.
  3. Protection: To prevent the whitening agent from coming into contact with sensitive areas like your gums, cheeks, or tongue, your dentist will use tools to keep your mouth open and place a protective barrier along the gum line.
  4. Whitening application: The dentist will apply the whitening agent to your teeth and leave it on for up to an hour. If light activation is part of your treatment, it may be used at this stage.
  5. Additional coats (if needed): If the whitening agent requires additional applications, your dentist will reapply it accordingly.
  6. Rinsing and fluoride application: Once the whitening process is complete, your mouth will be rinsed. Your dentist may also apply fluoride to help reduce potential sensitivity.
  7. Discussion and post-treatment care: You and your dentist will discuss the achieved tooth shade and the lifestyle habits you should practice in the following day or so. These may include avoiding brightly colored foods, coffee, and red wine, as your teeth are dehydrated immediately after whitening, making them more susceptible to staining. It's important to note that your teeth may appear slightly darker a few days after the procedure due to this dehydration effect. However, after a week, if your teeth haven't reached your desired shade, you can consult your dentist regarding the possibility of further improvement with at-home products or additional in-office visits.

Custom Take-Home Trays: Personalized Whitening with Enhanced Results and Comfort

Take-home trays offer an alternative approach to teeth whitening, requiring the patient's dedication. They can serve as a standalone treatment or as a follow-up to in-office whitening, particularly if your dentist anticipates the likelihood of new stains forming soon.

With professional take-home trays, your dentist will create a customized tray by taking an impression of your teeth. This personalized tray, designed to fit your mouth perfectly, generally yields more comprehensive whitening outcomes compared to over-the-counter (OTC) trays. Instead of a hydrogen peroxide-based gel, you will likely receive a carbamide peroxide-based gel to be applied in the tray for home use. Although it may not whiten teeth as rapidly as a hydrogen peroxide-based gel, you are less likely to experience sensitivity if the gel accidentally touches your gums, cheek, or tongue.

The concentration of the gel provided by your dentist for the custom-fit trays typically ranges from 10% to 38% carbamide peroxide, as outlined by the American Dental Association. The duration of treatment varies, with instructions to wear the tray for two to 10 hours a day, over a period of up to 28 days. Over-the-counter trays generally contain a similar percentage of carbamide peroxide. The key difference lies in the quality of fit. A custom tray conforms precisely to your teeth, minimizing the chances of the gel reaching your gums or missing difficult-to-access crevices during the whitening process.

Comparing In-Office Teeth Whitening to Custom Take-Home Trays

While both in-office teeth whitening and custom take-home trays are effective when supervised by a dentist, there are several key distinctions between the two methods.

Cost Custom take-home trays are more affordable than in-office whitening but still pricier than over-the-counter trays and other at-home whitening products. Typically ranging from $300 to $600, custom trays provide a middle-ground option. On the other hand, in-office whitening costs between $800 and $1,000, according to Brofsky.

Dental insurance generally does not cover teeth whitening since it is considered a cosmetic treatment.

Time In-office whitening treatments can usually be completed in one or two appointments, depending on the severity of stains and your dentist's assessment of how many shades whiter your teeth can become. Each session typically lasts 60 to 90 minutes at most. In contrast, custom take-home trays require wearing them for several hours a day over the course of up to a month. For optimal results, your dentist may recommend using a custom-fit tray for touch-ups even after in-office whitening.

Longevity While no tooth whitening treatment is permanent, it's important to take steps to maintain the brightness of your teeth for months and years to come. Experts advise maintaining a rigorous oral care routine, avoiding highly pigmented foods, coffee, red wine, and soda, and utilizing over-the-counter touch-up products.

As for the longevity of the results, there is no definitive answer. However, with custom trays, frequency is key. You can regularly use at-home trays for up to three to five years, whereas an in-office visit may provide immediate results in one or two sittings. Consequently, the bright shade of your teeth while using trays may last longer since you can obtain a professional whitening agent from your dentist to be used at home with your reusable dental tray for touch-ups.

Determining If Professional Teeth Whitening Is Right for You

If you're contemplating whether professional teeth whitening is suitable for you, there are a few factors to consider. According to Brofsky, if you desire a whitening treatment that can lighten your teeth by at least two shades and prefer not to experiment with over-the-counter remedies or have previously tried them without much success, then a professional treatment might be the ideal choice.

Important Topics to Discuss with Your Dentist Before Whitening

Several aspects can influence the success of your whitening results and help you achieve the radiant smile you envision. Firstly, it's crucial to address any issues related to plaque buildup, as whitening substances cannot effectively penetrate through plaque. Additionally, subjecting a tooth with a cavity or exposed roots to a whitening procedure may result in discomfort and sensitivity. Therefore, it is essential to undergo a comprehensive checkup and professional cleaning prior to undergoing in-office whitening.

Furthermore, your dentist can evaluate specific areas of your teeth that may be resistant to the whitening agent, including:

  1. Areas that have been overexposed to fluoride.
  2. Previous dental work, such as porcelain teeth or bonded areas.
  3. Darkened dentin, the inner layer of the tooth, due to trauma.
  4. Exposure to tetracycline antibiotics during tooth formation.

By discussing these factors with your dentist, you can ensure that your professional teeth whitening treatment yields the best possible results, tailored to your specific needs.