The least damaging and most conservative way of making your teeth lighter is with the use of a whitening solution. Contrary to what you might think, brushing your teeth harder with an abrasive toothpaste will not make your teeth whiter, but rather may darken them faster. The tooth-whitening concept has been around for many years, and the techniques have become easier and less expensive to accomplish. Tooth whitening was noted in the dental literature in the 1920s. The technique has become easier and the cost has decreased. Today, there are two convenient methods to whiten dark teeth: At-Home Whitening and In-Office Whitening.

Why Do Teeth Get Yellow?
The intrinsic (normal) color of your teeth is related to the color and thickness of the enamel and dentin, as well as the types of foods and liquids you ingest. The thinner the enamel, the darker the underlying dentin; the more coffee, tea, cola beverages, and red wine you drink, the darker your teeth will be. Cracks that are commonly found in the enamel of your teeth may provide a pathway for discoloring fluids to reach the underlying dentin.

If you have a yellow, brown, or orange shade to your teeth, in most cases it can be made lighter by the whitening procedure. Whitening works very well in removing age-related darkening of your teeth. This age-related darkening is most likely due to years of drinking the darkening beverages, or other environmental factors, rather than genetics. No drilling or anesthesia is required for whitening. Your teeth will not become weaker. Because the mineralization of teeth varies so much from person to person, there is no way to determine how many office visits it will take to effect the color change or how white the teeth will get. The darker your teeth are, the more time required for the change and the more distinctive the color change will be.

The whitening procedure will also work to a lesser degree on teeth with tetracycline discoloration. We have seen several fair to good results from both in-office and at-home whitening. It does take more time to achieve good results on this type of stain, and unfortunately, sometimes the change is minor.

TWO AVAILABLE TECHNIQUES
There are two types of whitening available. One is done by the patient at home, and the other is done by us during an office visit. They can be done separately or in conjunction with each other.

IN-OFFICE POWER WHITENING
Front teeth, the 6 to 10 teeth most easily seen when you talk or smile, are the teeth that can benefit most from an in-office “power” tooth whitening. Just as with back teeth, if there are medium- to large-sized fillings in the teeth, it is probably better if these teeth were protected with crowns. The in-office power whitening procedure is one of the most conservative and least expensive methods to attempt to lighten tooth color back to a more acceptable appearance. The procedure involves isolating the teeth to be whitened and protecting the gum tissues and lips. A whitening solution is then mixed and applied to the teeth. The type of application and number of appointments depends on the type of whitening system we believe will be best in your situation.

Most patients show great improvement after only one treatment. Since the protective biofilm that normally covers the tooth enamel is removed during the whitening procedure, you should avoid smoking and drinking pigmented liquids (coffee, tea, red wine) for about 24 hours after the whitening is completed. After 24 hours, the biofilm is usually back in place. The final color will usually regress one shade in the first 1 to 3 months, with most of the change coming in the first week. Some teeth may need a second appointment (or a combination of in-office and at-home tray system whitening) to achieve the desired result. The degree of whitening for any tooth is variable and impossible to predict. However, recent studies show that 97% of all patients who whiten their teeth are happy with the result. The color change should be satisfactory for 3 to 7 years.

If you have dental restorations (crowns, bonding), the plastics and porcelain will not change color. You may need to have some of those fillings redone once your teeth are lightened. We will let you know whether you can expect to have some fillings replaced due to the color change. If you are going to have fillings replaced, you should wait at least 2 weeks after the whitening is completed for the tooth color to stabilize before new restorations are placed. Some postoperative sensitivity is possible, but it usually disappears quickly. The tooth enamel or dentin is not damaged by the whitening process.

AT HOME WHITENING involves using a soft, thin, comfortable mouthguard-like tray. An impression is made of your teeth, and custom whitening trays are fabricated. Then at home, you place the whitening solution in the trays and wear them for an hour or two each day or sleep with them in place all night. With in-office whitening, you come to the office for 1 or 2 hours, and a stronger whitening solution is applied by us and activated for that time. Usually only one visit is required.

The color change should last for 3 to 7 years in most people. The color change you see immediately after the whitening is completed will regress one shade over the course of 1 to 3 months, with most of the change taking place in the first week. If you drink a lot of coffee, tea, cola beverages, red wine, or if you smoke, the teeth may begin to turn darker again. When this happens, the whitening process can be repeated.

The possible side effects include temporary white discoloration of the gum tissue if the office whitening solution comes into contact with the gum. This goes away quickly. The teeth may become slightly sensitive to temperature changes for a short time. This also goes away quickly. There is no damage to the tooth enamel, dentin, or pulp from the whitening process. Fillings and crowns do not whiten. When your teeth change to a lighter color, you may need to have those fillings and/or crowns redone. We will let you know whether this is a possibility before we whiten your teeth. There are no other adverse effects known.

The teeth that show when you talk, smile, or eat are the teeth that would benefit your appearance most if whitened. Usually the top teeth are whitened because they are much more visible than the bottom teeth, but both arches can be successfully whitened. The lower teeth take about three times as long to reach the color change of the top teeth.

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