Dental Care Associates of Spokane Valley

Everyone loves clean, glistening white teeth that make a beautiful smile.  At Dental Care Associates of Spokane Valley, P.S. we can help brighten and whiten your teeth as well as help you maintain your dental health.

Dental bleaching, also known as teeth whitening, is a common procedure in general dentistry but most especially in the field of cosmetic dentistry.  A child’s deciduous teeth are generally whiter than the adult teeth that follow.  As a person ages the adult teeth often become darker due to changes in the mineral structure of the tooth, as the enamel becomes less porous.  Teeth can also become stained by bacterial pigments, foodstuffs, and tobacco.  Certain antibiotic medications (like tetracycline) can also lead to teeth stains or a reduction in the brilliance of the enamel.

There are many methods to whiten teeth: bleaching strips, bleaching pen, bleaching gel, laser bleaching, and natural bleaching.  Traditionally, at-home whitening is done with bleaching gel, which is applied to the teeth using thin guard trays.  At-home whitening can also be done by applying small strips that go over the front teeth.  Oxidizing agents such as hydrogen peroxide or carbamide peroxide are used to lighten the shade of the tooth.  The oxidizing agent penetrates the porosities in the rod-like crystal structure of enamel and oxidizes interprismatic stain deposits; over a period of time, the dentin layer, lying underneath the enamel, is also bleached.  Power bleaching uses light energy to accelerate the process of bleaching in a dental surgery.  The effects of bleaching can last for several months, but may vary depending on the lifestyle of the patient.  Factors which will decrease whitening include smoking and the ingestion of dark colored liquids like coffee, tea, and red wine.

Internal staining of dentine can discolor the teeth from inside out.  Internal bleaching can remedy this.  If heavy staining or tetracycline damage is present on a patient’s teeth, and whitening is ineffective, there are other methods of whitening teeth.  Bonding, when a thin coating of composite material is applied to the front of a person’s teeth and then cured with a blue light, can be performed to mask the staining.  A veneer can also mask tooth discoloration.

According to the American Dentist Association there are different options to whiten one’s teeth that include: in-office bleaching, which is applied by a professional dentist; at-home bleaching, which is to be used at home by the patient; over-the-counter, which is applied by patients; and options called non-dental, which are offered at mall kiosks, spas, salons, or other similar places).  Whitening products intended for home use include gels, chewing gums, rinses, toothpastes, among others.  The ADA has published a list of accepted over-the-counter whitening products in order to help people choose appropriate whitening products.

The ADA recommends having one’s teeth checked by a dentist before undergoing any whitening method.  The dentist is recommended to examine the patient thoroughly including a health and dental history, observation of hard and soft tissues, an allergy and sensitivity history, placement and conditions of restorations, and even x-rays in order to determine the nature and depth of possible irregularities.

There are two main methods of gel bleaching—one performed with high-concentration gel, and another with low-concentration agents.  High-concentration bleaching can be accomplished either in the dental office, or at home.  Performing the procedure at home is accomplished using high-concentration carbamide peroxide, which is readily available online or in dental stores and is much more cost-effective than the in-office procedure.  Whitening is performed by applying a high concentration of oxidizing agent to the teeth with thin plastic trays for a short period of time, which produces quick results.  The application trays ideally should be well fitted to retain the bleaching gel, ensuring even and full tooth exposure to the gel.  Trays will typically stay on the teeth for about 15–20 minutes.  Trays are then removed and the procedure is repeated up to two more times.  Most in-office bleaching procedures use a light-cured protective layer that is carefully painted on the gums and papilla (the tips of the gums between the teeth) in order to reduce the risk of chemical burns to the soft tissues.  The bleaching agent is either carbamide peroxide, which breaks down in the mouth to form hydrogen peroxide, or hydrogen peroxide itself.  The bleaching gel typically contains between 10% and 44% carbamide peroxide (15% is recommended) which is roughly equivalent to 3-10% hydrogen peroxide concentration.

Low-concentration whitening is far less effective, and is generally only performed at home.  Low-concentration whitening involves purchasing a thin mouth guard or strip that holds a relatively low concentration of oxidizing agent next to the teeth for as long as several hours a day for a period of 5 to 14 days.  Results can vary, depending on which application is chosen, with some people achieving whiter teeth in a few days, and others seeing very little results or no results at all.  Whitening is potentially better at a dentist because the strip or mouth-guard does not completely conform to the shape of the teeth, sometimes leaving the tips of the teeth (near the gum line) unbleached.  The bleaching agent is typically less than 10% hydrogen peroxide equivalent, so irritation to the soft tissue around teeth is minimized.  Dentists as well as some dental laboratories can fabricate custom fitted whitening trays that will greatly improve the results achieved with an over-the-counter whitening method.

A typical course of bleaching can produce dramatic improvements in the cosmetic appearance of most stained teeth; however, some stains do not respond to bleaching.  Tetracycline staining may require prolonged bleaching, as it takes longer for the bleach to reach the dentine layer.  Case studies have been performed on people with tetracycline stained teeth.  They used custom bleaching trays every night for 6 months and saw dramatic results and improvement.  White-spot decalcifications may also be highlighted and become more noticeable directly following a whiting process, but usually calm back down with the other parts of the teeth becoming whiter.  Bleaching is not recommended if teeth have decay or infected gums.  It is also least effective when the original tooth color is grayish and may require custom bleaching trays.  Bleaching is most effective with yellow discolored teeth.  However, whitener does not work where bonding has been used and neither is it effective on tooth-color filling.  Other options to deal with such cases are the porcelain veneers or dental bonding.

Although there is a wide range of whitening products and techniques available, the results after using them may vary from very positive results to almost non-existent results.  Our office is also delighted to provide Zoom whitening services.  Zoom is a revolutionary whitening procedure that is safe, effective, and very fast.  In just one hour, your teeth will be dramatically whiter.  It is a light activated gel that is a scientifically formulated, pH balanced Hydrogen Peroxide that, when activated by the Zoom light, gently penetrates the teeth to remove deep stains and discoloration.  Please ask our staff for details.