In my final post concerning tooth whitening, I'm going to discuss the issue of relapse. Relapse is the steady darkening of teeth after the whitening process is complete, and its inevitable to a certain extent. Your teeth became dark over time for a reason, and they will regress back to that shade at a rate that is determined by your continued ingestion of foods and beverages that cause extrinsic stain (remember that term? Check my previous posts if you don't.). So the obvious solution is to cut back on these things. However, it seems like the best food and drink out there causes staining, so do we really have to make that kind of sacrifice? I, for one, could never do that. Luckily, there is a solution -- continued whitening at an interval that maintains a level of whiteness you are comfortable with. After most in-office whitening is completed, the dentist will provide you with plastic whitening trays customized to your teeth. These trays serve two purposes: to continue to whiten your teeth beyond the level the in-office whitening attained, and to be used to boost your teeth's whiteness when they begin to relapse. This second purpose will be an ongoing process for as long as you want to maintain your achieved level of whiteness. Once your teeth begin to stain again, use those trays, white strips, or some other whitening agent for a few days until the dinginess is gone. The amount of time and whitening agent it will take to re-whiten your teeth is dependent on the amount of relapse your teeth experienced. For most people, re-whitening every month or two usually does the trick.
There are two more points I want to include in this post before I bid you farewell. First, though all whitening systems will eventually relapse, in office-whitening systems can be perceived as having significant relapse after their completion. Often people will tell me that their teeth were really white after in-office whitening treatment for a day or two but then got darker overnight (though were still whiter than when they began the process). The reason for this involves the process of the in-office treatment itself. During treatment your mouth stays open and no water/saliva is allowed to touch your teeth for 45 minutes or so while the whitening agent does its thing. As a result your teeth become dehydrated. And what's the most notable indication of dehydrated teeth? They become whiter. And how long does it take for teeth to totally rehydrate? About a day or two. It all makes sense when you have the facts.
The second point I want to make is that some people believe having red wine, coffee, or other stain causing foods/beverages right after whitening will have a larger than usual impact on their teeth's whiteness due to increased enamel permeability after treatment. Studies conflict concerning whether or not this increased permeability actually occurs. For that reason I'd recommend holding off on consuming staining food and drink for a few days after whitening to be on the safe side.
Happy New Year everyone!
-DRS
Wednesday, December 30, 2009
Wednesday, December 23, 2009
Teeth Whitening Sensitivity
In what will probably be my final posts on teeth whitening for a while (though I'm always open to questions), I'll discuss two of the biggest issues with whitening that practitioners sometimes ignore: teeth sensitivity and relapse. Lets begin with sensitivity.
Though teeth sensitivity from whitening is almost always transitory, it can be quite annoying for some people. This sensitivity typically manifests itself during and/or for a few days after whitening treatment. The symptoms generally include sharp pain to hot or cold things upon tooth contact, and the spectrum of pain can be anywhere from mildly annoying to, on occasion, downright unbearable . It is unclear whether teeth dehydration during treatment or the hydrogen peroxide in the whitening agent plays a larger role in causing this transient sensitivity. Younger people (below the age of 40 or so) are typically more prone to sensitivity due to the higher nerve activity within their teeth, as are people whose teeth are already somewhat sensitive to hot or cold liquids. In reality, though, it is difficult to predict whose teeth is most prone to sensitivity. Options do exist to help prevent sensitivity, and they are as follows:
- Whiten less frequently (every other day as opposed to every day) and/or use a weaker whitening agent. Both of these options will cause your teeth to whiten more slowly, though.
- Use a whitening agent that contains the desensitizer potassium nitrate (active ingredient in Sensodyne) and/or fluoride which has also been shown to reduce teeth sensitivity.
- Inject Potassium Nitrate and/or 1,000 ppm (parts per million) sodium fluoride into customized whitening trays for 10 to 30 minutes before and after each whitening session.
- Brush with a prescription level, 5,000 ppm fluoride toothpaste for a week or so before whitening and during whitening.
- Apply the syringe-delivered desensitizing gel included with some in-office whitening systems.
- FOLLOW THE MANUFACTURER'S INSTRUCTIONS. This is especially true for higher concentration whitening agents. If, for example, the instructions say to leave the whitening agent on for an hour and you use it overnight, your teeth will very likely become sensitive. I have seen this happen and believe me, the people where not happy!
It is important to reiterate that any tooth whitening sensitivity experienced is almost always transitory. Though cases may be out there where permanent damage was done to teeth from whitening, I haven't encountered any in my research. So if your teeth continue to feel sensitive a week or two after whitening without any signs of getting better, see your dentist because there is a reasonable chance the pain's origin is not the whitening agent.
My next post will be on whitening relapse. Happy Holidays everyone!
-DRS
Though teeth sensitivity from whitening is almost always transitory, it can be quite annoying for some people. This sensitivity typically manifests itself during and/or for a few days after whitening treatment. The symptoms generally include sharp pain to hot or cold things upon tooth contact, and the spectrum of pain can be anywhere from mildly annoying to, on occasion, downright unbearable . It is unclear whether teeth dehydration during treatment or the hydrogen peroxide in the whitening agent plays a larger role in causing this transient sensitivity. Younger people (below the age of 40 or so) are typically more prone to sensitivity due to the higher nerve activity within their teeth, as are people whose teeth are already somewhat sensitive to hot or cold liquids. In reality, though, it is difficult to predict whose teeth is most prone to sensitivity. Options do exist to help prevent sensitivity, and they are as follows:
- Whiten less frequently (every other day as opposed to every day) and/or use a weaker whitening agent. Both of these options will cause your teeth to whiten more slowly, though.
- Use a whitening agent that contains the desensitizer potassium nitrate (active ingredient in Sensodyne) and/or fluoride which has also been shown to reduce teeth sensitivity.
- Inject Potassium Nitrate and/or 1,000 ppm (parts per million) sodium fluoride into customized whitening trays for 10 to 30 minutes before and after each whitening session.
- Brush with a prescription level, 5,000 ppm fluoride toothpaste for a week or so before whitening and during whitening.
- Apply the syringe-delivered desensitizing gel included with some in-office whitening systems.
- FOLLOW THE MANUFACTURER'S INSTRUCTIONS. This is especially true for higher concentration whitening agents. If, for example, the instructions say to leave the whitening agent on for an hour and you use it overnight, your teeth will very likely become sensitive. I have seen this happen and believe me, the people where not happy!
It is important to reiterate that any tooth whitening sensitivity experienced is almost always transitory. Though cases may be out there where permanent damage was done to teeth from whitening, I haven't encountered any in my research. So if your teeth continue to feel sensitive a week or two after whitening without any signs of getting better, see your dentist because there is a reasonable chance the pain's origin is not the whitening agent.
My next post will be on whitening relapse. Happy Holidays everyone!
-DRS
Wednesday, December 16, 2009
At Home Vs. In-office Whitening: The Bottom Line
If you've been following my posts, you are probably asking yourself what the difference is between whitening at home with an over the counter product or seeing a dentist for whitening. After all, these products whiten your teeth using the same chemicals. So whats the difference? Lets break it down:
Mechanism of Whitening - Basically the same. See my previous posts to learn how these products whiten your teeth. Sometimes various brands will contain other chemicals that will act as desensitizers, but I'll save my take on these for another post.
Concentration of Active Ingredients - The in-office whitening is almost always much more potent than the stuff you can buy over the counter. This will probably always be the case, though over the counter whitening products are becoming stronger and stronger.
Speed of Whitening - Hands down in-office whitening products win. Due to the caustic nature of their high concentration active chemicals and catalysts (ie the light in ZOOM whitening), special barriers must be placed by dental professionals on the soft parts of your mouth so no adverse reactions occur. The upside to this is the high concentration of hydogen peroxide on your teeth will allow you to achieve a level of whiteness in 45 minutes or so that would require weeks with the OTC stuff.
Amount/Number of Teeth Whitened - Lets face it, we all don't have Hollywood smiles, and our teeth may not line up in perfect neat little rows of ivory. Teeth can be tilted in, tilted out, and even partially rotated. When this is the case, its sometimes difficult to orient a whitening strip on your front teeth that will follow all of their dips and turns. Moreover, though the whitening strips only cover your six front teeth, many people show more than these six teeth when they smile. The solution to both issues lies in the customized plastic tray that you can get at a dental office, and this is a big selling point for in office whitening.
Level of Whiteness Achieved - Hypothetically, any over the counter whitening product containing the proper active ingredients should be able to make your teeth just as white as in-office whitening will. However, the length of time it may take these weaker products to whiten some tougher stains to that high level may be more than people are willing to put up with. We're talking many months of daily whitening instead of one or two dental office visits. Furthermore, in a few cases the lower concentration of whitener in these OTC products is simply not enough to whiten the tougher stains as effectively.
These differences aren't the whole story, though, and I'll discuss this comparison further in my next post.
-DRS
Mechanism of Whitening - Basically the same. See my previous posts to learn how these products whiten your teeth. Sometimes various brands will contain other chemicals that will act as desensitizers, but I'll save my take on these for another post.
Concentration of Active Ingredients - The in-office whitening is almost always much more potent than the stuff you can buy over the counter. This will probably always be the case, though over the counter whitening products are becoming stronger and stronger.
Speed of Whitening - Hands down in-office whitening products win. Due to the caustic nature of their high concentration active chemicals and catalysts (ie the light in ZOOM whitening), special barriers must be placed by dental professionals on the soft parts of your mouth so no adverse reactions occur. The upside to this is the high concentration of hydogen peroxide on your teeth will allow you to achieve a level of whiteness in 45 minutes or so that would require weeks with the OTC stuff.
Amount/Number of Teeth Whitened - Lets face it, we all don't have Hollywood smiles, and our teeth may not line up in perfect neat little rows of ivory. Teeth can be tilted in, tilted out, and even partially rotated. When this is the case, its sometimes difficult to orient a whitening strip on your front teeth that will follow all of their dips and turns. Moreover, though the whitening strips only cover your six front teeth, many people show more than these six teeth when they smile. The solution to both issues lies in the customized plastic tray that you can get at a dental office, and this is a big selling point for in office whitening.
Level of Whiteness Achieved - Hypothetically, any over the counter whitening product containing the proper active ingredients should be able to make your teeth just as white as in-office whitening will. However, the length of time it may take these weaker products to whiten some tougher stains to that high level may be more than people are willing to put up with. We're talking many months of daily whitening instead of one or two dental office visits. Furthermore, in a few cases the lower concentration of whitener in these OTC products is simply not enough to whiten the tougher stains as effectively.
These differences aren't the whole story, though, and I'll discuss this comparison further in my next post.
-DRS
Tuesday, December 8, 2009
How Tooth Whitening Works
Now that we are all tooth stain experts (if you aren't, go ahead and read my last post), we can discuss how tooth whitening works. Guess what? Its really simple. The active ingredient in the vast majority of tooth whitening products, professional or for home, is hydrogen peroxide. Either the product directly contains hydrogen peroxide or stuff called carbamide peroxide which ultimately breaks down into hydrogen peroxide. When enough hydrogen peroxide is applied to your teeth for a long enough period of time, it will diffuse through your enamel and react with any intrinsic staining. The chemical term for this reaction is oxidation, but all that's really necessary to know is that it turns the stain invisible. Its still there, but light will pass through it much more easily.
So what's the difference between at home and in office whitening? Concentration. In office whitening has about twice as much hydrogen peroxide in its at home cousin. This is important, because concentration along with duration of treatment and the type of stain that is present are the factors that determine how white your teeth will become.
My next post will give a detailed comparison of at home whitening vs. in office whitening.
-DRS
So what's the difference between at home and in office whitening? Concentration. In office whitening has about twice as much hydrogen peroxide in its at home cousin. This is important, because concentration along with duration of treatment and the type of stain that is present are the factors that determine how white your teeth will become.
My next post will give a detailed comparison of at home whitening vs. in office whitening.
-DRS
Friday, December 4, 2009
Tooth Whitening Continued
Lets pick up where we left off and talk more about tooth whitening. In order to fully understand how to whiten your teeth, you must understand what discolors them in the first place. There are two general types of staining that can occur with teeth -- extrinsic and intrinsic. Extrinsic staining is the type of discoloration that develops on the outer surface of teeth. Common contributors to this type of stain are tobacco, coffee, red wine, tea, and even spicey foods. I know this sounds like a lot, but luckily this is the exact kind of staining that whitening toothpaste can help prevent or eliminate. This is where those abrasives I wrote about in my last post really come in to play. However, sometimes this stain can be tenacious, and if whitening toothpaste isn't cutting the mustard, a good old-fashioned dental cleaning by a hygienist will usually solve the problem.
Intrinsic, or internal staining, is a little more complicated. The source of this discoloration resides inside your teeth and is impervious to whitening toothpaste. It can be caused by childhood infection or trauma to the mouth, certain childhood disease, or even certain medications disrupting the natural development of adult teeth. Moreover, trauma or an endodontic procedure (a "root canal") can cause gradual darkening of teeth due to the destruction of the bundle of blood vessels within a tooth that aid in giving it a warmer color. There are more specific intrinsic staining that can occur which include tetracycline stain and fluorosis stain, but I think those are beyond the scope of this blog. Finally, through natural development teeth tend to yellow as a person ages. It just happens. Don't worry, though, dentistry has come up with ways to whiten most of these intrinsic stains. How easily that can be accomplished depends on what caused the discoloration in the first place.
I think I'll save the various whitening techniques for my next few blogs. If you've got any questions for me about any dental topic, feel free to e-mail the Northford Family Dental Facebook page. All questions will remain confidential. Have a good one.
-DRS
Intrinsic, or internal staining, is a little more complicated. The source of this discoloration resides inside your teeth and is impervious to whitening toothpaste. It can be caused by childhood infection or trauma to the mouth, certain childhood disease, or even certain medications disrupting the natural development of adult teeth. Moreover, trauma or an endodontic procedure (a "root canal") can cause gradual darkening of teeth due to the destruction of the bundle of blood vessels within a tooth that aid in giving it a warmer color. There are more specific intrinsic staining that can occur which include tetracycline stain and fluorosis stain, but I think those are beyond the scope of this blog. Finally, through natural development teeth tend to yellow as a person ages. It just happens. Don't worry, though, dentistry has come up with ways to whiten most of these intrinsic stains. How easily that can be accomplished depends on what caused the discoloration in the first place.
I think I'll save the various whitening techniques for my next few blogs. If you've got any questions for me about any dental topic, feel free to e-mail the Northford Family Dental Facebook page. All questions will remain confidential. Have a good one.
-DRS
Thursday, December 3, 2009
Tooth Whitening Toothpaste Myths and Facts
Whitening toothpaste...does it work? Well, yes and no. Refer to my previous post concerning whether or not the hydrogen peroxide contained in it does much to whiten your teeth. This additional chemical is what differentiates whitening toothpaste from the standard stuff and is usually displayed prominently on the box. Another difference (usually unadvertised) is the addition of finer, more rounded abrasives in the toothpaste. These abrasives remove superficial stains and smooth out microscopic defects that alter light properties at the tooth surface and can result in a darker appearance. Furthermore, most whitening toothpaste contain more abrasiveness then standard toothpaste, but be aware that some actually contain less, so its hazy as to whether or not this factor plays a large role in tooth whitening. Newer methods of toothpaste whitening are hitting the market though, and these include the addition of amorphous calcium phosphate and silica-containing toothpaste with blue covarine. The calcium phosphate can whiten your teeth via filling in microscopic irregularities on your tooth surface, and silica/blue covarien has been shown to decrease yellowness and and increase whiteness immediately after brushing with it. Sound complicated? This is actually just the beginning. Tomorrow I'll post about the various kinds of staining teeth can have and what the bottom line is concerning using whitening toothpaste. That'll be a good segue into further posts about the best way to whiten your teeth beyond toothpaste.
If you have any topics you'd like me to discuss or any private, dentally related questions, feel free to send me a message on the Northford Family Dental Facebook page (and go ahead and sign up to be a fan while you are at it). Everything will always be confidential.
-DRS
If you have any topics you'd like me to discuss or any private, dentally related questions, feel free to send me a message on the Northford Family Dental Facebook page (and go ahead and sign up to be a fan while you are at it). Everything will always be confidential.
-DRS
Wednesday, December 2, 2009
Our new blog!
This is the first post from Northford family dental's new blog! Though its a work in progress, I hope to use this forum to provide daily facts, jokes, and news about our practice. So lets kick it off with a good fact:
The hydrogen peroxide in over the counter whitening toothpaste bought in any supermarket or pharmacy has little to no effect on the whiteness of your teeth! These toothpastes do not contain hydrogen peroxide in a high enough concentration to be effective and it is not in contact with your teeth for nearly enough time for it to do much of anything. Tomorrow I'll let you know what the benefit of these toothpastes are.
-DRS
The hydrogen peroxide in over the counter whitening toothpaste bought in any supermarket or pharmacy has little to no effect on the whiteness of your teeth! These toothpastes do not contain hydrogen peroxide in a high enough concentration to be effective and it is not in contact with your teeth for nearly enough time for it to do much of anything. Tomorrow I'll let you know what the benefit of these toothpastes are.
-DRS
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