There are an amazing number of over-the-counter products that claim to whiten your teeth. There are toothpastes, rinses, gels, even foods. The best that can be said of most of these products is they probably won’t hurt anything. It is, however, unlikely to make much change in the actual whiteness of your teeth. One negative result that we have seen in our office is a dramatic increase in patients with sensitive teeth, many times as a result of regular use of the whitening toothpastes. When looking for a tooth paste, whitening types are usually fine as long as they are ADA-approved and have fluoride in them. If you find that your teeth have become sensitive to temperature or sweets, try a de-sensityzing toothpaste for a few weeks (Crest sensitive, Sensodyne, Colgate Pro Relief).
Over the counter teeth whitening strips (Crest White Strips, etc.)
These products do seem to have some ability to whiten your teeth. They are not a huge cost (usually $40 – $60) and you can decide how much to use them. It is typical to see a few shades of whitening. Some patients find them a nuisance to use and you are unlikely to get the results they show in their marketing material.
These are trays, usually custom-made trays, that are made by the dentist. You then place whitening gel in the trays and place in your mouth. The cost is around $350. They are better than the strips because you are using a tray to get the tooth whitening material against the teeth for extended periods of time. There is a choice of concentrations of gel that can be selected. We now offer a great product that can be used in short 20 min increments in comparison to the typical couple of hours or over night. Historically, the main disadvantage of the trays is that it is difficult for many patients to wear them enough to get the most effect from it, most patients do not wear them enough to get the best results. It can be an ideal solution for the patient already sensitive teeth as the rate of the process can be controlled. There is also a big difference in how the trays are made. If the dentist goes to the trouble of creating an effect reservoir for the gel material and a good seal around the teeth they will be more comfortable and more effective.
We have been using BriteSmile in our office for 10 years, in fact we were the first office to offer BriteSmile in Utah. I still believe it is the gold standard for teeth whitening. There have been over 1 million procedures done so far with BriteSmile. It is the system that has the best and longest studies on the effectiveness and safety of their teeth whitening system. The cost for BriteSmile is $500.
With the BriteSmile system, a protective barrier is placed over the gums. The gel is then placed on the teeth and is light activated. The gel is replaced and the whitening is done in three 20 minute sessions, all in one appointment. The entire procedure takes about an hour and a half, or just about long enough to watch a movie.
There is some sensitivity (about 25% of our patients) that lasts approximately 24 hours.
There are a lot of teeth whitening systems and they all make great claims. Britesmile has a way of getting the most from their whitening gel. Some systems use 35 – 50% Hydrogen Peroxide solutions. Britesmile uses a 15% solution but are able to get exceptional results in spite of (or possibly because of) it. With a lower concentration of solution, no heat from the light, we see much less tooth sensitivity. The main competitor to BriteSmile has been Zoom! which is also an in-office whitening system. They now are the same company and the newer Zoom system is comparable to BriteSmile.
For those patients that want to get the absolute whitest teeth they can get without going to porcelain veneers there is Deep Bleaching. It is a combination of in-office whitening and take home trays. The trays are custom-made by a special laboratory to give the most precise fit we can get. There are other advances in the system, such as refrigerating the material from point of manufacture until it is given to the patient. This maximizes the effectiveness of the material. The extra time, effort and attention to detail makes the cost of this system higher. It also makes the results far more significant than any other system. The cost is $1200 and involves several weeks of wearing trays at night and one office visit. This will whiten even the toughest cases and also has the added benefit of the patient having trays to use to whiten the teeth from time to time if they start to darken.
Single Tooth Whitening
In some instances, such as when a tooth has had a root canal and turned dark, a single tooth can be whitened. This is done using a process of internal bleaching and can be very effective under the right circumstances.