Helpful Hygiene Tips: Whitening

First off, i'm sorry for the hiatus! We've been on vacation and dealing with illness around the house. But I'll try hard (even with the holidays!) to do my best to give at least a quick tip each Sat!

Whitening... I get oh so many questions about this. Constantly.

Its interesting, the idea of whitening. 30 years ago, people were quite content with the color of their teeth, it seemed. The idea of preventative dentistry was not "new" to everyone, but in more remote areas (even like the one i grew up in) it was still something to work towards and the dental profession was making attempts to educate children in schools by offering fluoride treatments, exams, etc. Healthy mouths was the goal.

Fast forward 15 years to the mid 90's. Preventative dentistry was widely accepted and no longer was it true that people only went to the dentist when a tooth hurt. But at this point while most people were enjoying healthy smiles, their focus shifted to the appearance of their smile. Cosmetic dentistry was born. The days of whiter, brighter smiles had begun.

And to be quite honest with you, I think its gone too far. When i first started my career as a dental assistant in 1999, the average shade of peoples teeth was called "A2". On a shade guide, there were only 2 colors lighter so A2 was quite light.

Today, most people who have whitened no longer are able to be identified as a shade on a "normal" shade guide. We now have "Bleach" shade guides! So interesting.

So when people ask me "do you think my teeth are yellow", my response is always this: "unless you have whitened your teeth, i guarantee you that your teeth are yellow, as are mine, because thats the way God made them". Remember that diagram from a few weeks back? The second layer of the tooth is called "Dentin" and its yellow (or brownish or grayish). The color of the dentin shows through the enamel. How much of it shows through is dependent on the opacity of the enamel. And yes, people do have different color hue's as well. Some people have grayish teeth, or brownish, or yellowish. But we all have a color.

Ok, so onto the "how" of whitening and products to choose from. History lesson over :-)

First off, yellowish colored teeth lighten the easiest. Grayish take the longest and are the most stubborn. Often times, a grayish color is caused by taking an antibiotic called tetracycline as a child, when the teeth are forming. This was a common antibiotic offered in the 50's and 60's but is no longer given to children or pregnant women. Brownish coloration is not as common, but is more in the middle in terms of difficulty in lightening.

Products:
1. Over the Counter

• Advantages: price, ease of accessability
• Disadvantages: strength of whitening product is limited by FDA/ADA so efficiency is limited, comfort of product varies as it is not a custom product
• Example: Crest white strips
• Works best for: people who only want to lighten a little, people with very straight teeth (particularly people who have recently undergone orthodontia [braces]).

I've only tried a few otc products and Crest White Strips are by far my favorite. Having said that, i still dont like them much. Keep in mind that I'm a hygienist so i'm a bit of a "snob" when it comes to products. Anyone who has ever used custom trays are not going to like the otc products nearly as much. But that doesnt mean they arent good. You just have to have realistic expectations of the results you will get. Any otc product is going to be the same whitening ingredient as a professional whitening kit (carbomide peroxide) but at a lower concentration. Hence, it will take longer to see results, but you will see them. Eventually.

2. Professional Whitening Systems

• Advantages: very effective, comfortable
• Disadvantages: cost, ease of accessability
• Examples: Custom Trays, 1 hour systems such as "Zoom"
• Works best for: Adults (no teens), people with malalignments (crooked teeth), any color teeth

Professionally made custom trays are what I use. I prefer them, even over the "zoom" because of one thing: sensitivity. ALL whitening agents cause sensitivity, but the more intense the treatment, the more sensitivity you will experience. My teeth are already generally sensitive so there's no way i could ever do zoom. I would not make a good candidate. It is, however, very effective. Keep in mind, however, that even with the one hour whitening systems you will need to "touch up" from time to time, therefore you will still need custom trays (unless you plan to pay for and repeat the process every so often). With the custom trays, you will still experience sensitivity, but the advantage to them (as well as the otc strips) is that YOU control how sensitive they get because you can take a break. For example, in our office we recommend that you wear the custom trays nightly for 3-4 hours for approximately 2 weeks. (Of course, if your teeth are still darker than you prefer you can quit early or if they are as light as you'd like after a week, you can stop!). But if your teeth are sensitive you may want to choose to skip nights or not do tops and bottoms at the same time, etc. Its up to you. You can control how sensitive your teeth get. On the contrary, with the one hour whitening systems, your teeth will be as light as they will get when you leave the office. Unfortunately, they will probably be as sensitive as they can get, also.
I dont mean to say that zoom is bad. Not at all. Its just not for everyone. But if your teeth are not normally sensitive, or if they are pretty dark, then zoom (or another 1 hour system) may be the perfect product for you!

The best thing to do if you have questions about your specific situation is to seek a professional's opinion.

Ok, folks... feel free to ask ?'s, as always!