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Chirstopher Basiago DDS | Teeth Whitening in Long Beach

Basiago Family Dentistry

Christopher Basiago, DDS

Jonathan Basiago, DDS

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(562) 429-5965

Teeth Whitening

Teeth Whitening/Bleaching Systems Review

Teeth whitening is the most popular dental procedure in the world. It is a relatively safe, simple, non-invasive procedure, but please note this first:

First Consideration

The most important thing to consider before starting any tooth whitening procedure is to realize that only natural tooth structure will predictably lighten to some extent. Older white fillings will not lighten at all. Newer white fillings may appear slightly lighter if they are thin and translucent because the background tooth structure is lightening. Porcelain crowns will not lighten at all but please consider that most older crowns are lighter than the natural tooth structure because the natural teeth have darkened over the years. This can work to our advantage if we want to lighten the natural tooth structure to match the lighter shade of the older porcelain crowns.

Teeth that have thin porcelain veneers can sometimes be made to appear lighter by placing the gel on the back side of the tooth so that it can be absorbed through the natural tooth structure. As the underlying tooth lightens, it will appear that the veneers are lighter. If you don't know what type of restorations you have on your front teeth, please see your Dentist first. In some cases, the restorations will have to be replaced after the tooth whitening is completed.

Care should be taken to wait 2 weeks from the time the teeth bleaching is finished before replacing any bonded restorations. The peroxide gel severely inhibits the effectiveness of the adhesives used in modern cosmetic bonded restorations! These additional procedures increase the complexity and cost of the case.


Effectiveness of Teeth Whitening

The effectiveness of the tooth whitening process depends on the concentration of the gel (Carbamide Peroxide) and the length of time that it is held in contact with the tooth surface. The higher the concentration of the gel and the longer it is held on the tooth, the whiter the teeth will get. Unfortunately, this also increases the tooth sensitivity and the gum tissue irritation.

People with teeth that have darkened because of age, coffee, tea or smoking should experience some success whitening their teeth. If you feel that your teeth were whiter 10 years ago, you should experience favorable results. If you were born with darker teeth, it will be more difficult but not impossible to successfully lighten them.

Shades of yellow, brown, or orange respond to teeth bleaching. Gray stains from fluorosis (too much fluoride while the teeth were developing) or tetracycline (antibiotic taken by pregnant mother or as youngster) will not respond as favorably. It will take much longer to attain satisfactory results. People with extremely sensitive teeth may not be able to bleach long enough to experience good results.

Teeth that are dark due to previous trauma or root canal therapy will not lighten as easily. If you have gum tissue recession and a lot of root surface exposure, you will not be able to lighten the root surface as much as the top crown of the tooth which is covered by enamel.


Methods of Tooth Whitening

Professional In-Office Teeth Bleaching

A strong teeth bleaching gel is applied while the gum tissue is protected. A special light is often used to enhance the action of the teeth bleaching gel. This method gives the quickest start of all tooth whitening methods. It tends to be the most expensive and causes the greatest sensitivity. Britesmile, Zoom, and Laser bleaching are examples of this method.

Custom trays are usually made to continue the process at home. Studies have shown that after 2 weeks of tray use, the light activated cases are no whiter then the strictly home custom tray method.

Home Custom Fit Tooth Whitening Tray Method

This method involves taking impressions of the upper and lower arches and making custom fit trays that fit over the teeth. The trays will hold a slightly weaker gel uniformly on the teeth for one to three hours during the day or all night while sleeping. With this method, the upper and lower arches can be bleached at the same time or separately.

The process usually takes 4 to 6 weeks but can take longer. The teeth will usually whiten easily the first week and then take much longer for more improvement as the process continues. The most difficult cases can require 6 months or more of daily tray use.

The teeth will appear splotchy or cloudy when you initially remove the trays because the teeth are dehydrated. They will have a uniform color once the teeth are rehydrated by your saliva. The final color of your teeth will stabilize after 2 weeks (they get slightly darker).

Touch ups can be done every 6 to 12 months for brief periods of tray wear. This method tooth whitening has been used the longest (since 1990) and I find it to be the best and most effective.

Over The Counter Products (non-custom fit tooth whitening trays)

This method is less expensive because the non custom bleaching trays come in one size fits all. The effectiveness of the method depends on how well the tray holds the gel on the tooth surface. Care should be taken to use brand name gels for safety. Some people can do well with these products. TheraBreath's TheraBrite Whitening Kit is a popular example of this method.

Brush on Gel System For Teeth Whitening

This method involves gel that is brushed on to the teeth. No trays are used. The gels can be more difficult to apply and I find that my lips are more irritated because there are not trays to cover the gel. Some people do well with this method of teeth whitening and it does tend to be the best for spot bleaching one or two teeth and doing touch-ups in general.

GoSmile and CelebritySexyTeeth are the most popular examples of this method. These products are especially helpful if a person is unable to wear a traditional tooth bleaching tray for any reason... for example, sensitive gag reflex.

Teeth Whitening Strips

Strips containing the gel are placed on the teeth like scotch tape. No trays are used. If all the teeth are covered uniformly and the strips will stay on, this method will work. The concentration of the gel is lower so it may take longer.Crest Whitestrips have been a very successful product. Some people preferRembrandt Whitening Strips because they feel that the strips stay on better.

Whitening Tooth Paste

This technique for teeth whitening is generally not very effective because the active ingredient is not on the tooth long enough. It may remove superficial surface stain. Please avoid abrasive tooth paste that can remove heavy stain, but scratch the surface of the tooth causing it to stain again more quickly.

I feel that Rembrandt Whitening Toothpaste  has shown the best results.


Dangers and Side Effects of Tooth Whitening

Most people will experience minor to moderate tooth and gum tissue sensitivity. A sore throat can also occur. When starting with a tray system, keep them in place for a short time and gauge your level of sensitivity. Increase the time in the mouth as sensitivity allows. Take a day or two off when your teeth are too sensitive and they will go back to normal. Any sensitivity should only last during the tooth bleaching process. There are no long term residual effects.

The gels do not damage any restorative materials or tooth structure. Soft tissue irritation disappears after completion of the process.

A desensitizing tooth paste can be used before, during, and after the process to combat the sensitivity. In the most sensitive patients, a fluoride gel can be alternated in the tray every other day and this will help to control sensitivity.

Please realize that the teeth bleaching gels are not FDA regulated.

Using well known brand name gels, like Nite White, are the safest. Avoid anything that says "acid pre-rinse." There were a couple of these products years ago that caused problems. Use the gels as directed!

Final Thoughts about Tooth Whitening

We all have different teeth and levels of staining. Tooth whitening is not 100% predictable. Most people get satisfactory results but some better than others. Not everyone follows through with the process to get satisfactory results. Some people over do it and seem to become addicted to the process and never seem to feel that their teeth are white enough. We have all seen some of these people and the teeth can take on a strange abnormal glow.

Use any of the products as directed and you should get satisfactory results with a minimum of side effects. 


Long Beach Dentist | Teeth Whitening. Christopher Basiago is a Long Beach Dentist.