Teeth whitening is a relatively affordable cosmetic dental procedure that for some can improve and even anti-age a smile and face. This post explores the facts surrounding this process and discusses aging teeth, cosmetic dentistry, cosmetic teeth whitening, and whitening options including at-home vs in-office. Product recommendations are also included.
Cosmetic Teeth Whitening
“It seems to me that what we call beauty in a face lies in the smile” – Leo Tolstoy
“Life is short, smile while you still have teeth” – Unknown
I have always been a sucker for a big white smile full of chiclet teeth. I guess that’s why I have voluntarily submitted myself to the pain of braces more than once and if I’m honest, more than twice. My theory is that a beautiful smile works magic not only on one’s own confidence but also and on a less conscious level, on how others positively respond to you.
Whether we like it or not, or if we even notice for that matter, our teeth change and age along with the rest of our bodies. Years of chewing, teeth grinding, effects of some medications, and basically living life can result in everything from shifting teeth to tooth discoloration.
We have at our disposal today a variety of aesthetic dental procedures that can reverse or lessen the effects of the hands of tooth time. Anti-aging one’s teeth has become big business and no less so for an older over 50 crowd. Given the importance we indisputably place in this area of the face, it could even be considered by some as more important and relevant than plastic surgery.
One of the most widespread and financially accessible cosmetic teeth procedures is teeth whitening. Over the recent past, it has become ubiquitous. Whitening can be done at home or in a dental office. It exists in all sorts of forms and as part of nearly every single dental product we buy.
In fact, its very pervasiveness naturally raises the question of what really works and what doesn’t. If it is everywhere, then why isn’t everyone walking around with brilliant white teeth? For those of us who are older, the question also might be, will any of it really work for me?
A lot of information and misinformation exists out there, and this post explores the realities of teeth whitening and the options that do and don’t work.
As always, I thought it important to get and give real facts. To help me sift through it all, I sat down with Christopher Pescatore, DMD, a long-time expert, pioneer and teacher in the field of Aesthetic Dentistry. We discussed Cosmetic Dentistry as a whole and teeth whitening specifically. Dr. Pescatore has a specialized cosmetic dentistry practice here in the San Francisco Bay Area.
Let’s first place teeth whitening in context.
What is Cosmetic Dentistry
Teeth whitening may be the most well-known procedure, but it really is only a piece of Cosmetic Dentistry. This area of dentistry began as a recognized offshoot in the late 1980s, gained steam in the 1990s, and is now a multi-billion-dollar industry slated to reach revenues of $43 billion within the next couple of years. Most dentists, in fact, now have a cosmetic component to their practices.
This area of dentistry specializes in improving the appearance of your smile. In addition to teeth whitening, some other procedures include veneers (porcelain overlays to the tooth), gum lifts (removing and shaping the gums to be more aesthetically pleasing), and various “alternative” types of tooth natural fillings: implants and inlays and more.
In case you were wondering, orthodonture is considered a separate specialty area from Cosmetic Dentistry although it is a critical contributing component to it.
9 Cosmetic Teeth Whitening Facts
Here are some of the takeaways from my teeth whitening discussion with Dr. Pescatore. I was surprised by some of them. Maybe you will be too.
There is no bleach in teeth bleaching.
The terms bleaching and whitening are used interchangeably. None of the whitening products contain any actual bleach as we think of it (nor should there be). The active whitening ingredient is hydrogen peroxide delivered either through hydrogen peroxide itself or carbamide peroxide which ultimately releases hydrogen peroxide.
The percentage of bleaching agents within a whitening product varies. In general, the percentage is higher in an in-office product than in an at-home product.
Bleach works by whitening enamel and only enamel.
Bleach will not whiten anything other than the enamel on the outside of the tooth. Porcelain crowns or veneers, for instance, will not get whiter from bleaching.
Teeth will only get as white as they naturally can.
It is important to be realistic. According to Dr. Pescatore, “teeth will only get as light as our enamel will let it”. Our teeth have their own natural color, and no one’s teeth are as white as the driven snow.
Additionally, as one ages, enamel naturally thins. As this happens, dentin, the inner darker core of the tooth, becomes more visible, and our teeth take on a more yellow cast. Bleaching will not eliminate this. This brings us to our next point.
Not everyone is a good candidate for teeth whitening.
A few examples of this are: patients with exposed roots who will likely experience sensitivity and/or pain to the whitening agent; patients who have certain genetic conditions that prevent teeth from whitening; patients who may have varying levels of enamel on the teeth causing them to bleach in a variegated manner.
Consistent daily flossing, brushing, and cleaning can whiten teeth.
Good oral hygiene can help offset tooth stains and improve the whiteness of the teeth. Dr. Pescatore explained that enamel is a smooth surface. As a result, it is the “plaque on the teeth that picks up food stains, not the enamel”.
a professional cleaning prior to whitening will yield the best results.
Since bleach cannot whiten plaque, the best whitening outcome requires as much enamel exposure as possible.
teeth whitening is a relatively safe procedure.
The biggest risk is damage to gums and/or sensitivity to teeth.
In-office and at-home procedures can be equally effective.
While an at-home procedure is a less expensive option, it can yield a similar or same result compared to the more expensive in-office process. Both use the same active ingredients. There are differences in the delivery method, and I have covered this in more detail in the section below.
any type of teeth whitening requires ongoing maintenance.
Depending on many variables, this procedure will last possibly up to a year and will require ongoing maintenance.
In-Office vs At-Home Whitening
So, what are the differences between in-office and at-home whitening? The differences are notable and may very well affect which you choose. I have detailed them below.
An at-home procedure will have less hydrogen peroxide in its formula compared to in-office. The result is a much longer length of time to get the teeth white. Additionally, the by-product of this extended duration is the necessity to establish and maintain a dedicated daily whitening regimen over a longer period of time (typically 2-4 weeks at home).
Finally, with so many choices on the market, it is critical to understand what the most effective choices are, or whitening success will be elusive. To help in this area, I have made a few product suggestions below.
Speed: one visit and the teeth are “done”. At-home will take a minimum of 2-4 weeks or so. The in-office speed is a result of a higher concentration of hydrogen peroxide along with the manner in which it is delivered.
Better Whitening Delivery System: Anything that holds the bleach closer to the teeth will be more effective and faster. In-office can make well-fitting snug custom trays for your teeth.
Whitening Agent Customization: In-office can offer varying levels of hydrogen peroxide in the formula which can help to lower the risk of tooth and gum sensitivity.
Additional Desensitization: Dr. Pescatore addresses the risk of tooth and gum sensitivity in his practice by giving patients fluoride over the course of about 2 weeks prior to the actual teeth whitening.
Instruction: Ongoing consultation for the most effective maintenance.
Best At-Home Teeth Whitening Systems
As Dr. Pescatore explained, the best teeth whitening system is something that holds the bleach closer to the teeth for an extended period of time. The best delivery system therefore is anything with trays or strips that adhere closely to the teeth.
What does not work are:
Whitening toothpastes: the combination of very low levels of hydrogen peroxide combined with no time on the teeth results in little to no whitening power.
Whitening pens/gels: the product is not on the teeth as securely or snugly as needed to whiten.
Ultraviolet lights or bleaching systems with lights: the bleach is chemically activated not light activated. It has not been proven that lights do anything to improve whitening. If anything, the light may cause the tooth to dehydrate which in turn could make it appear lighter in color. The tooth, however, will ultimately rehydrate and darken the following day or so.
crest 3d whitestrips professional effects
Crest 3d whitestrips sensitive at-home teeth whitening kit
This product comes in several different hydrogen peroxide strengths. If you have sensitive teeth, consider starting at a lower strength. Video on how to use it:
If you are or have considered teeth whitening, I hope you feel better armed with information on how to proceed. Should you not be a candidate for teeth whitening for any reason and are interested in other options, I expect to do a follow-on post in a few months.
This post was all about the facts and myths of cosmetic teeth whitening. Topics discussed included aging teeth, cosmetic dentistry, teeth whitening, teeth whitening options including in-home vs in-office, and teeth whitening product recommendations.
If you are interested in other The Beauty Maestra posts on cosmetic and aesthetic procedures, take a look at:
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