Table of Contents > Alternative Modalities > Tooth whitening procedures and products Print

Tooth whitening procedures and products

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Related terms
Background
Theory/evidence
Safety
Author information
Bibliography
Technique

Related Terms
  • Bleach whiteners, carbamide peroxide, extrinsic stains, hydrogen peroxide, hydrogen peroxide tooth whitening, intrinsic stains, lasers, peroxide tooth whiteners, tooth bleaching, tooth pastes, tooth whitening, whitening gels, whitening products, whitening strips, whitening trays.

Background
  • Tooth whitening refers to procedures or products that make teeth look brighter. Tooth whitening has been gaining popularity since the 1990s.
  • Teeth can be whitened with or without bleach. Bleach products contain a peroxide agent (usually carbamide peroxide, which comes in concentrations of 10%, 16%, and 22%) to take away surface stains and underlying stains. This changes the color of the tooth. Bleaching can be done at home or professionally at a dentist's office. Some dentists use lasers or lights along with bleaching chemicals, which some claim makes bleaching faster and/or more effective.
  • Non-bleach products use chemicals or abrasive agents to clean stains off the tooth's surface.
  • Extrinsic stains refer to those on the surface of the teeth. People with extrinsic stains are good candidates for over-the-counter and home-use products. Intrinsic stains, which are beyond the tooth's enamel of the tooth, are more difficult to remove. Removing intrinsic stains is generally more effective when treated in a dentist's office.
  • Whitening toothpastes and other whitening products can be bought at dental offices or over-the-counter, and then used at home. There are also home remedies or natural remedies for teeth whitening. Some of these at-home products are pastes that are brushed on the teeth. Some are hydrogen peroxide strips with backings that are peeled off. Strips are placed on the teeth for about 30 minutes, often twice daily, for 10 days to roughly three weeks. Other products may include a mouth guard or tray. The whitening gel or solution is applied to the tray, which is then placed on the teeth and typically worn overnight.
  • Whitening at a dentist's office, sometimes called "chairside bleaching," takes 30-60 minutes, and may involve more than one office visit. First a rubber shield or special gel is applied to protect the gums and tissues in the mouth. Then a bleaching agent is put on the teeth. The whitening agents used by dentists are often more powerful than those sold over-the-counter.
  • Some dentists offer a relatively new process called "deep bleaching," developed by dentist Rod Kurthy, who also tests products for dental product manufacturers. Deep bleaching may cost up to $1,500 and takes two in-office bleachings with a combination of chemical whiteners, plus an at-home application of whiteners in between.
  • Because results from studies have varied, there is disagreement among dentists on whether laser beams or other types of lighting improve the effectiveness of tooth bleaching. Some believe that the lights activate the peroxide whiteners more quickly and to a greater extent.
  • There has been criticism of bias regarding some studies of tooth whitening products that are funded or implemented by companies that sell these products.
  • The most extreme methods of tooth whitening are cosmetic procedures, such as bonding, veneers, and crowns.

Theory / Evidence
  • Teeth can be stained by beverages (such as tea, coffee, colas, red wine), foods (such as berries, tomatoes, soy sauce, and balsamic vinegar), tobacco products, certain medicines, and genetic factors.
  • Whitening toothpastes remove stains on the tooth's surface (extrinsic stains) with abrasives and chemicals that buff away stains, but unlike a bleaching agent, they will not alter the color of teeth.
  • Bleaching with a peroxide agent (typically carbamide peroxide) attacks stains that are under the tooth's surface (intrinsic stains) when applied. The agents break down and sink into the tooth, where they attach to stain particles and break them up.
  • Lasers and lights are said by some to activate or speed up the whitening process, although evidence of effectiveness is mixed.
  • Natural methods include avoiding agents that cause stains, such as abstaining from or limiting smoking, drinking coffee, etc. Some also suggest that by eating foods that are high in fiber and that trigger a lot of salivation, the bacteria that contribute to staining may be eliminated.

Safety




Author information
  • This information has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

Bibliography
  1. American Dental Association.
  2. Browning WD, Chan DC, Myers ML, et al. Comparison of traditional and low sensitivity whiteners. Oper Dent. 2008 Jul-Aug;33(4):379-85.
  3. Deliperi S, Bardwell DN, Papathanasiou A. Clinical evaluation of a combined in-office and take-home bleaching system. J Am Dent Assoc. 2004 May;135(5):628-34.
  4. Gerlach RW, Barker ML. Randomized clinical trial comparing overnight use of two self-directed peroxide tooth whiteners. Am J Dent. 2003 Nov;16 Spec No:17B-21B.
  5. Hasson H, Ismail AI, Neiva G. Home-based chemically-induced whitening of teeth in adults. Cochrane Database Syst Rev. 2006 Oct 18;(4):CD006202.
  6. Lee SS, Zhang W, Lee DH. Tooth whitening in children and adolescents: a literature review. Pediatr Dent. 2005 Sep-Oct;27(5):362-8. Review.
  7. Moore M, Hasler-Nguyen N, Saroea G. In vitro tooth whitening effect of two medicated chewing gums compared to a whitening gum and saliva. BMC Oral Health. 2008; 8: 23.
  8. Natural Standard: The Authority on Integrative Medicine.
  9. White DJ, Duschner H, Götz H. Effects of hydrogen peroxide bleaching strips on root surfaces in vitro. J Clin Dent. 2007;18(3):87-90.

Technique
  • Many experts and organizations, including the American Dental Association (ADA), recommend consulting a dentist before making any decisions about whitening or using whitening products. This consultation is intended to deliver information that suits the client's particular situation, as well as to learn about potential side effects, cost, etc.
  • Products that can be bought over-the-counter or from a dentist include whitening toothpastes, brush-on whiteners, strips, and various kits that contain strips, bite-shaped trays, and gels. These products are typically intended to be used for 2-4 weeks.
  • Procedures at a dentist's office include bleaching or laser/light-assisted bleaching. These procedures take about 60 minutes.
  • Tooth whitening bleaches that are approved by the ADA for home use contain 10% carbamide peroxide. Dentists usually use products with concentrations as high as 35%.
  • Natural methods for teeth whitening include applying lemon juice, wood ash, strawberries, aloe vera gel, baking soda, hydrogen peroxide, salt, vodka, bay leaves, orange peel, or others on the teeth. Note: Some sources warn about potential decay and damage to the tooth's enamel with some these methods. Therefore, patients should consult their healthcare providers before trying any of these methods.
  • The effects of whitening depend on how teeth looked before treatment, how often foods and beverages that stain are consumed, and whether or not the person smokes. According to product reviews, professional whitening may last five to seven years.

Copyright © 2011 Natural Standard (www.naturalstandard.com)


The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.

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