What whitening product should you use when you only have two months to whiten? Two weeks? Two days?
From teenagers to baby boomers, everyone wants to have whiter smile. Your smile is one of the first things people notice about you, and a flawlessly bright smile indicates health, vigor, and of course, beauty.
With each decade that we age, our teeth can get up to one to two shades darker. The color pigments inside teeth become more prominent as the dentin structure below the enamel grows. Consider the enamel to be like translucent glass, with the dentin structure shining through underneath, giving us our tooth color. Genetics play a large role in the darkening of our teeth extrinsically and intrinsically, but environmental factors, oral hygiene, and nutrition also contribute to the shade of our teeth.
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The whitening craze started over a decade ago, when strips and professional whitening lights were introduced to the market, creating a new industry overnight. Since then, over 100 million Americans have whitened their teeth using whitening toothpastes and whitening products.
The standard for whitening has steadily increased over the past decades. What we called a light shade 15 years ago is considered yellow today. To help patients visualize their results, aesthetic dentists like myself have created special bleached porcelains to parallel the heightened whitening expectations that Americans have today.
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In the last 12 years, we’ve gained a significant amount of knowledge regarding important factors that affect whitening and what choices people have today.
So, what do we do if we want to look younger and whiten our teeth, but we don’t want to cause any harm to our precious pearlies?
The most effective whitening method and regimen will vary from person to person, and it’s up to the individual to determine what’s best for him or her. As a rule of thumb, if you experience pain from teeth whitening procedures, whether in the professional office or at home, stop and reevaluate. Your body is alerting you to course correct.
Perhaps the intensity of the heat in the professional whitening lights is the culprit? Or maybe your sensitivity and irritation is caused by the caustic breakdown of the carbamide peroxide formula used in tray and gel whitening methods? No matter what the source of the discomfort is, here are some facts to help guide you in making the right choice when it comes to your preferred method of whitening:
- The higher the concentration of the peroxide gel, the more whitening oxygens are released, and the greater the overall efficacy.
- The success of whitening depends primarily on the following factors: contact time, which is the amount of time the whitening gel is on the tooth, and consistency, which refers to the number of consecutive days you stick to your whitening regimen.
- Hydrogen peroxide, the bleaching agent in whitening gel formulas, breaks down to water and whitening oxygens. In its purest form, there are no breakdown byproducts that cause irritation.
- Hydrogen peroxide is unstable and will degenerate over time. To ensure freshness, use whitening gels that are completely encapsulated in a hermetically sealed vial or package.
- Carbamide peroxide breaks down to hydrogen peroxide and ammonia, which can cause soft tissue irritation.
- Heat accelerates the reaction rate of the hydrogen peroxide: for every 10-degree Celsius increase, the reaction rate doubles.
- Light also accelerates the reaction rate, but the level of lumens necessary to see results will require protective eyewear.
- The closed system of the tray and gels keeps the whitening oxygens from escaping, increasing contact time of the whitening gel on the teeth, also targeting the gel towards the teeth, away from the gums.
Now that you are armed with these facts, let’s take a look at the various whitening options available in the market today. Professional whitening procedures provide the most efficacious results, especially when followed up by an at-home regimen to stabilize the whitening (think, high frequency, low intensity). For those who don’t have the extra money to spend on professional treatments, let’s take a look at the four categories currently available in over-the-counter today and which one to use based on how much time you have to commit to a whitening regimen.
The four categories are:
1. Over-the-Counter Tray and Gels
Over-the-counter tray and gels have been around the longest. Known as a “boil and bite” system, they require you to heat a tray, fill it with gel, and place the formed tray in your mouth. This whitening method takes weeks to deliver results, and 80 percent of users report sensitivity due to the breakdown of the carbamide peroxide gel. While the tray helps prevent oxygen from escaping, there are other options that can lead to efficacious whitening without the soft tissue irritation and pain.
2. Whitening Strips
Whitening strips revolutionized the industry 10 years ago, as researchers figured out how to impregnate hydrogen peroxide on a polyethylene strip that the user places directly on the teeth. This product has existed in several iterations over the years. The various types of strips have differed in terms of the level of hydrogen peroxide in the gel to modifications in the shape and thicknesses of the strip. The efficacy is excellent for an OTC product, but you must be cautious not to burn your fingers or rest the strip on the gums, as this will cause irritation over time. If you are patient and compliant, you’ll see results in a few weeks. This method is best if you have two weeks to whiten.
Paint-ons appeared on the scene around the same time as whitening pens and brushes, with success rates varying by formulation. Both user-friendly and convenient, a sealed delivery system is required to avoid harmful byproducts of carbamide peroxide breakdowns. The good news is paint-ons can be targeted to the teeth, thereby avoiding contact with the soft tissue which often results in sensitivity and irritation. It’s best to look for a gel that does not migrate from the tooth. However, because this method does not involve a closed system, there’s no way to prevent whitening oxygens from escaping, which means you can expect to see results in a couple of months. This whitening method also requires patience and the commitment to use for consecutive days. It’s a good option if you have two months to whiten.
4. Whitening Devices
(Disclosure: Dr. Levine is the inventor of the GLO Brilliant Whitening device.)
Whitening devices appeared on store shelves approximately two years ago, bringing elements of professional lightening to the user at home. Heat works to accelerate the breakdown of hydrogen peroxide, creating more whitening oxygens. High-intensity lights are required to accelerate the reaction rate of the hydrogen peroxide, meaning users and those in the immediate vicinity must wear protective eyewear. By combining the professional elements of light and heat in a closed system mouthpiece, along with a non-migrating gel, the device calls upon the professional whitening experience. If you are short on time, this device may whiten your teeth in two days.