As a dentist performimg cosmetic therapy in Charlotte, NC, Dr. Plascyk performs cosmetic teeth whitening. Also called bleaching, teeth whitening is an easy and inexpensive way to brighten your smile. Although whitening or bleaching can have a positive effect on a smile, it does not in and of itself constitute a smile makeover. Teeth whitening works best for teeth that are already fairly attractive and just need a color change. Teeth whitening will have less of a positive effect for teeth with excessive wear or misalignment (crowding, rotations, and angulation issues). Teeth with these conditions will need cosmetic porcelain veneers, cosmetic porcelain crowns, Invisalign or a combination of these treatments to get the best cosmetic look to the smile. Teeth whitening does not work on tooth decay, old fillings, existing porcelain veneers or crowns. Teeth whitening often will cause sensitivity and even pain in the teeth and gums. So it is important do whitening under the supervision of a dentist. The results of tooth whitening vary greatly. Some patients will get a great result and some patients will get poor a result. Also, whitening is temporary. You will need to re-whiten periodically to maintain the color.
Take-home whitening: The patient is given custom-made trays for the upper and lower teeth, along with a professional teeth-whitening solution kit. Trays should be worn from 40 minutes to over night.
In-office whitening (“laser whitening”): This procedure usually takes about an hour in the dental chair. The teeth are isolated from the rest of the mouth, then a strong whitening solution is applied to the teeth. A bright white light (“laser”) is placed in front of the teeth to activate the teeth whitening solution. In-office teeth whitening still requires a take-home teeth whitening kit and custom trays. As a matter of fact, most of the whitening is actually completed by the take home trays. At best, the in-office system will give the whitening a jumpstart. In-office teeth whitening is more expensive than take-home teeth whitening and the result is no better. For this reason Dr. Plascyk only offers less expensive take home whitening which will give the same result.
Basic components of whitening solutions: Most whitening solutions are carbamide peroxide, which is urea + hydrogen peroxide (CH6N203). Carbamide peroxide breaks down into urea and hydrogen peroxide when it contacts water. The hydrogen peroxide molecule actually does the whitening. Hydrogen peroxide releases oxygen, which combines with the material causing the stain. The oxygen changes the optical properties of the staining material (actually the chromophores within the staining material), which makes them colorless. So the staining material is still in the tooth, but it can no longer be seen.
Other ingredients that may be in whitening solutions are fluoride and potassium sulfate. These ingredients decrease temporary tooth sensitivity. Whitening solutions remove stains both on the surface of the tooth and in the microscopic tubules in the enamel. These tubules extend deeper into the tooth. Whitening solutions vary according to concentration of carbamide peroxide, pH and other ingredients that decrease sensitivity of the teeth. A solution of 10% carbamide peroxide breaks down to approximately 3% hydrogen peroxide. A 22% solution of carbamide peroxide breaks down to 7.5% hydrogen peroxide. The pH of whitening solutions varies. Some are acidic. Enamel will begin to decalcify in a pH of 5.2, so unsupervised prolonged exposure to whitening solutions can harm teeth and dental work (veneers, crowns, fillings).
Since whitening solution is an oxidant and can cause harm to the body if not used correctly, Dr. Plascyk only recommends whitening under the supervision of a dentist. Some people become “bleach-aholics” and overuse the whitening solution to an extreme. This can be harmful to their health.
Teeth whitening toothpastes: Unlike whitening solutions, teeth whitening toothpastes only work on the surface of the tooth to chemically and mechanically to remove stains. Dr. Plascyk has found that patients generally experience increased sensitivity in their teeth when they use whitening toothpastes. Part of the problem is that whitening toothpastes are highly abrasive, which wear down teeth. Dr. Plascyk generally does not recommend whitening toothpastes to his patients.