Teeth Whitening options - vital teeth whitening

Which teeth whitening solution is right for you? Well it depends primarily on your available time, and patience.

Generally, there are two types of teeth whitening treatment:

1. • vital teeth whitening (externally applied) - Refers to whitening done on healthy, living teeth - or teeth that have their pulp tissue intact.
     For reference, the pulp tissue is a collection of blood vessels and nerve bundles inside a tooth, responsible for nourishing tooth and giving it the ability to feel changes in temperature.
   • non-vital teeth whitening (internally applied) - Refers to whitening done on a dead, devitalized, necrotic teeth. The pulp within these teeth have died, usually due to dental caries, infection, or trauma. These teeth usually standout among the other vital teeth because of their darker shade.

Vital teeth whitening is done on the majority of teeth, whereas Non-vital teeth whitening is usually done on a specific, affected tooth only.

For vital teeth whitening (externally applied) - We can generally subcategorize it based on how or where the treatment is done:

• "professionally applied" in office/clinic - performed by your dentist
  • applied by the dentist - 35-40% Hydrogen Peroxide solution
• self-applied or take home - performed by you, the patient (the solution used is "milder" than the one used in the clinic)
  • via bleaching trays - 10-45% Carbamide peroxide
  • via whitening strips - Hydrogen Peroxide (undisclosed concentration)

In-Office or Professionally applied teeth whitening procedure

• can be done in one clinic session, or more if desired
• a session usually lasts from 1 to 1.5 hours, consisting of 1-4 applications
• results are immediately visible
• may cause short-term tooth sensitivity and gum burns - usually for 2-3 days and resolving by itself afterwards

Self-Applied or Take Home teeth whitening procedure

• can be done at patient's own pace and time
• each session of take home whitening varies depending on what type is used:
  • bleaching tray - from 15-30 minutes to 8-10hrs/overnight application depending on strength of solution (Opalescence Custom)
  • prefilled whitening trays - 15 to 60 minutes per day for 5-10 days (Opalescence Go)
  • whitening strips - 30-60 minutes daily application for 3-20 days (Crest Whitestrips)
• results are gradual and usually visible after daily continuous application in 7-14 days
• may also cause short-term tooth sensitivity and gum burns, but at a much lesser extent compared to In-Office whitening since the chemicals are milder

Limitations of teeth whitening treatment (In-Office and Self-Applied)

• patient's teeth should be clean and free from tartar and plaque - a prophylaxis is usually necessary prior to whitening treatment
• teeth whitening treatment may not effectively whiten intrinsically/internally stained teeth which are usually caused by:
  • drugs/medication - such as Tetracycline
  • dental trauma - internal bleeding within the tooth may cause staining from blood
  • stains from silver/amalgam fillings
  • dental abnormalities such as Fluorosis, White spot lesions
• restorations such as tooth colored-fillings or crowns will not be affected
• whitened teeth will not last forever -
  • food intake, or habits such as smoking, coffee, tea, wine consumption may stain teeth again
  • have your teeth regularly cleaned by the dentist to prevent too much stain build-up
  • have teeth whitened again if desired

Whatever your choice of teeth whitening is, it's best to consult your dentist especially regarding your tooth color prior to treatment. Thanks for reading!

- Doc Jed

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