Dentist says teeth whitening best done at home
A dentist's office might not be the best place to get your teeth whitened.
That's according to ... a dentist.
Not that there aren't advantages to the in-office procedure, said Dr. Joseph C. Bender of Panther Hollow Dental Lodge in Port Charlotte. It's just that they don't outweigh the one large negative.
He separates teeth whitening systems into two major categories: in-office and at-home.
For do-it-yourselfers, there's certainly no shortage of teeth whitening products on the market.
"Many teeth whitening systems and products are available," reports WebMD, "including whitening toothpastes, over-the-counter gels, rinses, strips, trays and whitening products obtained from a dentist."
Which one is the best? It depends upon the patient. There are even over-the-counter bleaching products, although Bender doesn't recommend them.
"Some use the same type of bleaching agent we use in the office, but it's a much weaker concentration," he said. "So you don't quite get the results as you do with what's prescribed by a dentist."
The systems Bender does recommend both start in a dentist's office -- but there are critical differences.
The process in an office offers "a little more instant gratification," Bender said. "You get a more dramatic change over a quicker period of time than you do with the at-home method."
With the office method, a patient can expect to spend an hour being treated. The teeth are isolated with what's known as a "rubber dam" -- a small rubber sheet that goes over the teeth to protect the gums. The bleaching product -- a type of peroxide -- is then painted onto the teeth, and a light/heat source is applied to help promote, or catalyze, the bleaching process.
The type of peroxide used in-office is slightly stronger than the one use at home.
"By the end of the hour, there's usually a pretty dramatic change in the teeth from what we started with," Bender said.
Despite the intensity of the in-office treatment, it's usually followed up with the at-home procedure anyway.
"The office procedure just jump-starts the bleaching process," Bender said. "We still follow up with bleach trays that patients wear at night time, just to continue the process for a few nights."
Making an impression
The at-home procedure still requires a dentist's visit. Impressions are taken of the patient's teeth in order to make trays -- similar to mouth guards – that hold the bleaching agent against the teeth.
"These trays are very thin and flexible," Bender explained, "so when patients wear them, they're not very cumbersome. It doesn't really bother them at all."
The patient is then given a bleaching agent -- Bender describes it as being like a gel -- that is placed into the trays with a syringe. The patient then applies the custom-fitted trays over his or her teeth.
Depending on the concentration of the agent, the application lasts from two hours to overnight. Patients continue the procedure for a week to 10 days.
"After that, we'll follow up and see if they require any additional bleaching," Bender said. "If we feel they can get their teeth lighter, we'll go for a more prolonged period of time."
Teeth require a period touch-up with the at-home trays every six months to a year, lasting one or two nights, to brighten them.
But both in-office and at-home dentist-prescribed procedures can have the same negative effect.
A sensitive subject
Bender said the disadvantage of the in-office procedure is the use of a stronger bleaching agent -- that's then being catalyzed by a light/heat source. This can cause sensitivity to the teeth.
"In probably 20 percent of the cases, patients can have some real discomfort afterward, which can last for a few days," he said. "It's discomfort to the point that they may need to take some Advil or an anti-inflammatory agent because the teeth are so sensitive to temperature."
The problem for dentists: They can't always predict which patients will be prone to that type of sensitivity.
"I prefer not to do the in-office treatment because of the fact I'm going to have one out of five patients feeling pretty uncomfortable after the procedure for several days," Bender said. "There are varying opinions on that with dentists, but that's just my personal opinion."
The at-home bleaching yields the same end result as with in-office bleaching; he said. It just takes more time.
But it also has an advantage.
"If patients start getting some sensitivity from the bleaching process, we can address it before it gets out of hand," he said.
But there are situations where a patient doesn't have the time to whiten teeth at home.
"Sometimes you have someone that has a big occasion coming up and doesn't have two weeks to wait for results from the trays," Bender said. "But we do want to make them understand that they could have that type of sensitivity."