Cosmetic dentistry

Tooth whitening

This can be done in the dental clinic with products activated by halogen or laser light. It can also be done at home by making tailor made casts for the teeth to contain the whitening agent.
A whitening tray is a horseshoe-shaped device made of transparent soft acrylic material, molded to the exact shape of your teeth so that they fit them perfectly, and are used to contain the whitening gel which will stay in contact with your teeth.

What is a teeth whitening?

External teeth whitening is currently one of the simplest and most conservative aesthetic resources. Although it is called external, what is whitened is the dentin. The crown of the tooth in its structure is made up of enamel (outermost part), dentin (intermediate layer) and dental pulp (internal structure). Enamel has no color, it is translucent like glass. The dentin is what really gives the tooth its color.

Are the teeth white?

We must know that the internal, intrinsic color of dentin is genetically determined; it is an innate characteristic of each one of us, as is the color of our skin. It can have a huge variety of colors within white (orange-yellow, gray-green, gray-pink or reddish-brown) and, within each of these groups, different gradations of intensity. The professional will determine that base color; This color is not modified with any whitening, what can be achieved is to lighten it to a greater or lesser extent.
To explain it in a simple way, we are always talking about the whitening of the base color that is located inside the tooth, since external stains, such as tobacco or other stains on the tooth surface, can be easily removed with a professional oral cleaning. Enamel stains caused by external agents should not be confused with the intrinsic coloration of the tooth, which is why a dental cleaning and a dental whitening are two different dental procedures.

To explain it in a simple way, we are always talking about bleaching the base color that is located inside the tooth, as external stains such as those from smoking or other stains on the tooth surface, can easily be removed with a regular dental cleaning. We must differentiate between stains on the tooth surface due to external agents and the intrinsic color of the tooth. This is why cleaning and whitening are two different dental procedures.

How is the teeth whitening procedure?

Before starting a treatment of this type, the case should be studied so as not to give false expectations. It must also be said that the intensity of the whitening will depend on each patient and their age (being a younger, the better response) and that in general almost all teeth respond well, even in many tetracyclinic cases (with brown or gray stripes) although in the latter the aforementioned bands do not disappear, they will only become clearer. Never with a whitening will they disappear. Whitening is not like “chalking” or painting a wall.
The external tooth whitening will be done without anesthesia to be able to perceive the sensitivities, since it is actually the tooth that is going to tell us how far we can whiten, it is useless to have a very white tooth if teeth are hypersensitive. If during the procedure the sensitivities are many, it will be necessary to stop and continue in another session, or stop the treatment permanently because the tooth does not allow us to go any further.
At the end of the treatment and the next day, the teeth can and tend to be slightly sensitive, as well as the surrounding gums, even sometimes it may require taking analgesics on the day of treatment, but we have to say that these discomforts, if any, will be temporary and low intensity if the correct protocols are followed.

When will I see the results of whitening?

Once the whitening is performed, in a few days teeth will continue whitening and the final color obtained will remain unalterably for a 2-7 years period, depending on each patient. Although color after these years can lose intensity, the color will never be like the beginning. In the event that recurs a little, a simply shorter whitening session than the original can be performed. In the mentioned cases, whitening tooth paste can be used as a reinforcement for a certain period. Always under professional control.

What materials are used to whiten teeth?

Current whitening techniques are based on the use of two products, carbamide peroxide (ambulatory treatments) and hydrogen peroxide (treatments in clinic). These products are able (through heat activation and / or special light) to detach O2 molecules that can "leak" through the tooth enamel (surface tissue) until the dentinal tubules. There are about 15,000 dentinal tubules per mm2. Thus, the tissue under the enamel (dentin) which is what gives color to teeth, is the one which is going to be whitened, giving the feeling that the enamel is whiter.

What limitations does it have?

Ambulatory whitening has certain limitations:

  • The teeth can be whitened between 2 to 4 degrees or shades of the chromatic scale, but they do it in a homogeneous way, so that the darker bands, although they are lightened, do not disappear.
  • You should know that unlimited whitening is not achieved: once a certain whitening point is reached, the gel no longer has any effect.
  • Likewise, the whitening effect is not indefinite either: some time after finishing the treatment, a slight recurrence of the old color begins to occur. This darkening, which we could estimate at 10%, can be combatted by repeating a whitening gel session when the darkening is noticed, and can be significantly prevented with a monthly whitening session, as maintenance.
  • The whitening effect takes some time: generally it takes several weeks. It is not accelerated by putting more gel in the trays or by having them in place for longer than recommended. Whitening requires sessions and sessions of a certain time, and not longer (to minimize tooth sensitivity).

What are the dangers of performing teeth whitening without the supervision of a dentist?

There are currently a multitude of products that the user can get in order to obtain whiter teeth.
It is important to make a previous diagnosis to rule out diseases in the teeth and gums, such as gingivitis or cavities, which may contraindicate teeth whitening without having previously treated these diseases.
Another problem with performing unsupervised teeth whitening is that when using abrasive products, they can create burns on the gums and mucous membranes, and even lead to the death of the tooth if the pulp is affected.

Whitening strips, activated carbon, hydrogen peroxide, LED lights… are they safe?

Elements such as sodium bicarbonate, lemon, hydrogen peroxide, activated carbon, activators by light, all these elements what they do is burn uncontrollably and scratch the enamel, the surface of our teeth, and the hardest element of the human body, in addition to being able to cause damage to gums and oral mucosa.
The use of activated carbon, for example, so fashionable on social media, is as if we were using sandpaper over our teeth, since it has a great abrasive capacity. The so-called whitening effect of activated carbon is actually also an optical effect, since staining the teeth black and then rinsing them gives the appearance that they are whiter.
On the other hand, whitening with light only works if it is combined with certain products and must be carried out in a professional center and under dental supervision, since they can damage the dental pulp due to an excess of temperature.
The whitening products and gels that can be obtained as KITS for teeth whitening have a very low concentration of whitening substances and are regulated by European regulations, allowing a concentration of no more than 0.1% for acquisition for non-professional use. Therefore, they have very little long-term effect, they can only prevent or eliminate small spots.

Do whitening toothpastes really whiten?

Whitening pastes are not really such, they have a small concentration of abrasive substances that can eliminate small superficial stains and that are usually indicated temporarily as maintenance after professional teeth whitening. These components do not enter the innermost layer, which is the dentin, but only act on the enamel, which is transparent, which means that the enamel is not whitened, what is whitened is the dentin.
In addition to maintaining proper dental hygiene, there are a number of foods that can help take care of your teeth. Here we leave you a series of foods that work in that direction:

  • Cheese: cheese not only strengthens our teeth thanks to calcium but also contains lactic acid, ideal for fighting cavities.
  • Strawberry: strawberries regulate the PH of the body which helps control bacteria on our teeth.
  • Apple: apple contains malic acid, an ingredient used in tooth whiteners.
  • Ginger: besides being a good anti-inflammatory which helps your gums, ginger is effective in killing bacteria and therefore prevents periodontal disease.
  • Pineapple: an enzyme located in pineapple participates in cleaning the teeth and breaks down bacterial plaque. In addition, pineapple stimulates the production of saliva, a great natural remedy against bacteria.
  • Carrot: like the pineapple, the carrot encourages the production of saliva with the same good results as the previous one.
  • Basil: a natural antibiotic that works to reduce bacteria in the mouth.
  • Salmon: salmon has a lot of calcium and vitamin D, something that makes your teeth stronger.
  • Sesame seed: in general, the seeds are rich in calcium, but also sesame seeds fight plaque.
  • Tea: excess tea can be harmful to teeth, but consuming it in moderation provides the body with antioxidants that fight gingivitis bacteria.
  • Quinoa: contains calcium, magnesium and phosphates, all of which make your teeth stronger.
  • Cabbage: Cabbage has an abundance of minerals that support tooth structure.
  • Lemon: they increase the body's pH, help the generation of saliva and are a natural whitener. But the lemon is a very acidic fruit and its consumption in excess can damage the enamel.

As you can see, nature can be a great ally for our teeth. Still visiting your dentist regularly is the best way to have strong white teeth.

Share it
Follow us

In our YouTube channel, world's most viewed dental channel, you will find numerous 3D videos with detailed explanations of more than 55 different treatments and subtitled in 15 different languages.

Project of Clínica Médico Dental Pardiñas where we answer FAQs about oral health matters