Authored By: Linda Dyett
Reviewed By: Larry Addleson, DDS, FAACD
Professional in-office teeth whitening is the most popular cosmetic dental procedure in the world today. Unlike home-use whitening systems that incorporate low-dose bleaching agents, in-office whitening (also known as power bleaching, power whitening, professional whitening or chairside 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.
Advantages of In-Office Whitening
- No other teeth whitening procedure produces faster results.
- This is the safest form of tooth bleaching.
- Gum and tooth sensitivity (formerly drawbacks to in-office bleaching) are more controllable today due to thicker peroxide gels (that don't soak into the teeth as much as previous gels) and the use of desensitizers such as potassium nitrate and fluoride.
Disadvantages of In-Office Whitening
- In-office bleaching is more expensive than take-home alternatives. Its cost, on average, is $650, compared to $400 for take-home trays and under $100 for over-the-counter bleaching trays or whitening strips.
- Results can be unpredictable, depending on factors such as age, heredity and the type of staining that is present.
- In-office bleaching is not a permanent solution. Shortly after treatment is completed, the teeth resume accumulating stains. Many dentists therefore recommend home maintenance follow-up with a lower-percentage bleach that can be kept on the teeth for longer periods of time.
Stains That are Best Removed with In-Office Whitening
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.
Stains Resistant to In-Office Whitening
- Teeth with certain stains typically those that are inorganic do not respond well to in-office whitening. 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.
Whitening and veneers are two popular smile makeover treatment options. Weigh their pros and cons with your needs.
Are you a Candidate for In-Office Whitening?
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 porcelain veneers.
- Teeth that have become transparent with age. This is particularly true of the front teeth, which are thin to begin with.
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 whitening 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 whitening progress.
The In-Office Teeth 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.