Is the pursuit of a whiter smile the new American dream? Since the 1980s, when the first at-home teeth bleaching product hit the shelves, Americans have turned teeth whitening into the hottest thing in cosmetic dentistry. In 2007, Americans spent $1.4 billion on over-the-counter products to whiten their smiles [source: Mapes]. And according to the American Academy of Cosmetic Dentistry, the number of patients seeking whiter pearly whites is expected to keep rising.
There are three popular ways to whiten your teeth: at home using over-the-counter whitening kits and products, at home using products prescribed by your dentist, or professionally at your dentist's office. And there are two types of teeth stains: extrinsic, which are stains on the tooth's surface, and intrinsic, which are stains deep within the tooth. If that wasn't enough staining to worry about, our teeth naturally begin to look a bit yellow or dingy as the years go by -- consider it another perk of aging.
The surface of the tooth is called the enamel, and because it's the outermost part of the tooth, it's the layer most susceptible to the staining effects of foods and beverages (including curries, tomato sauce, coffee, tea and wine) as well as tobacco use. Extrinsic stains are the most common, and are usually the easiest types of stains to remove -- usually nothing more than some bleach and some patience is needed to lift them. At-home, over-the counter (OTC) bleaching kits often work well for this type of stain removal, and many dentists recommend them for people who have healthy teeth and gums and no dental restorations (important because your restorations won't bleach).
For some people, OTC tooth whitening products or simple made-at-home smile boosters such as baking soda and a toothbrush may be efficient and effective for brightening teeth, but some smiles whiten best when in the hands of a professional.
Wondering how professional teeth whitening is different than store-bought, and if it's right for you? Let's break down profession teeth whitening options.
How is Professional Teeth Whitening Done?
There are currently two flavors of professional teeth whitening treatments: One is an at-home whitening option prescribed by your dentist, and the other is a light-activated whitening option (also called chairside or power whitening) performed by your dentist (or cosmetic dentist or other dental health professional) during an office visit. Both use bleach to whiten teeth.
Hydrogen peroxide is the active ingredient in most bleaching gels, including OTC and professional treatments, although some at-home whitening systems use carbamide peroxide. Carbamide peroxide can be a less effective option because it can take a while to break down into hydrogen peroxide, which means it has to stay on your teeth much longer to work. The whitening gel in at-home kits usually contains between 3 and 10 percent hydrogen peroxide [source: American Dental Association].
Professionally-prescribed at-home whitening options are similar to OTC at-home bleaching kits in that you use a bleaching gel and mouth trays daily for a specific period of time, usually a few weeks to a month. Both types of at-home kits are meant to remove extrinsic tooth stains -- remember, those are stains on the tooth's enamel. The only major difference between the two is how the trays fit in your mouth. While OTC kits have a one-size-fits-all whitening system, your dentist will take impressions of your mouth to give your professional at-home whitening trays a custom fit. Custom-fitted whitening trays not only help to ensure more bleaching gel gets on the surface of your teeth for even whitening, but the fitting also helps to ensure the trays stay put.
For more powerful teeth whitening action you'll need to make an office visit. In-office whitening treatments -- chairside whitening -- use higher concentrations of hydrogen peroxide, typically between 15 and 38 percent [source: American Dental Association]. But the secret ingredient isn't the high concentration of bleach -- it's light.
During a chairside whitening treatment, a bleaching gel is brushed onto the teeth and a special light, such as a diode laser, light-emitting diode (LED) or plasma arc, is placed in front of your open mouth to activate -- speed up -- the bleaching agent. You can expect two or three whitening sessions during one hour-long chairside treatment, depending on the whitening system and the amount of whitening to be done. No anesthesia is needed for chairside whitening, but temporary tooth sensitivity during and after the treatment is a common complaint.
When it comes to deciding if professional teeth whitening is right for you, it's important to consider your individual whitening needs and wants, along with the effectiveness, safety, and cost of the treatment options.
Pros and Cons of Professional Teeth Whitening
First things first: your safety. Having a professional whiten your teeth can help minimize risks or side effects.
One of the most common side effects of bleach-based teeth whitening is tooth and gum sensitivity. Incorrect use -- especially overuse -- of OTC at-home teeth bleaching products has been shown to cause tooth sensitivity and pain along the gum line. The custom-fitted trays of professionally-prescribed at-home kits help minimize the amount of bleach that comes in contact with the gum tissue, lessening the sensitivity that can happen at the gum line. Similar considerations are taken during in-office whitening: During the intense bleaching of chairside whitening treatments, gums are protected from bleach, light and heat with a rubber shield or protective gel.
It's also hard to deny the effectiveness of in-office bleaching. The fastest way to the whitest smile is chairside whitening. It immediately whitens teeth, up to several shades during a one-hour treatment.
And also unlike a teeth whitening kit you buy at the local pharmacy, professional tooth whitening treatments take your individual needs into consideration. For example, are your teeth deeply stained by antibiotics or tobacco, or do you have any fillings?
Light-activated teeth whitening is successful in whitening teeth in patients with stubborn stains, such as teeth that have been stained by tetracyclines (a type of antibiotic) or teeth with deep-rooted gray or brown-ish hues. With this type of treatment, your dentist can also treat unevenly stained teeth or just a single dark tooth. OTC products can't do that.
OCT products also can't change the color of any teeth that have tooth-colored fillings, bonding, crowns or any dental work that is made with resin composite materials. Only your dentist can recommend options such as dental bonding or veneers to change the color of these teeth to match your new whiter smile.
The bright, immediate results of chairside whitening come at a cost, though, and professional teeth whitening can be pricey. Even if you have dental insurance (plans differ but many don't cover cosmetic procedures), chairside treatments can cost anywhere from hundreds to thousands of dollars. In comparison, over-the-counter whitening kits typically cost less than $100 -- many less than $50 -- and most whitening toothpastes, mouth rinses, flosses and chewing gums are priced under $10.
The high costs can be hard to swallow if you're one of the many people with yellowing teeth. Nearly all (96 percent) of people with teeth yellowed over the years by tea, coffee, wine, tobacco and aging see some level of whitening with OTC at-home bleaching kits [source: American Dental Hygienists' Association]. The trade-off? No instant gratification here -- those kits can sometimes take up to a month to show any noticeable whitening effects.
No whitening product or procedure is perfect. The degree to which your teeth whiten depends on a few things: how badly stained your teeth are before you begin to whiten them, how powerful the whitening ingredients are in the products you use, the amount of time the whitening product is in contact with your teeth and how often you use products to maintain your white smile.
And once you've perfectly whitened your whites, remember that keeping teeth white takes some at-home maintenance. Your dentist may prescribe whitening products such as custom-fit trays to help you keep your professionally-whitened smile bright after chairside whitening. Also, over-the-counter whitening toothpastes, mouth rinses, chewing gums and kits may help extend the whiteness and brightness of your smile. When in doubt about stains, remember this common advice from dental professionals: If it can stain your shirt, it can stain your teeth.
More Great Links
- ABCNews -- Good Morning America. "What Is the Best Way to Get Your Teeth Whiter?" 2006. (Jan. 15, 2012) http://abcnews.go.com/GMA/Cosmetic/story?id=3096650&page=1#.TxCNIW9SQ9A
- American Academy of Cosmetic Dentistry. "Teeth Whitening." (Jan. 15, 2012) http://www.aacd.com/index.php?module=cms&page=568
- American Academy of Cosmetic Dentistry. "Wanted: Whiter, Brighter Teeth." 2010. (Jan. 15, 2012) http://www.aacd.com/index.php?module=cms&page=726
- American Dental Association. "Oral Health Topics: Tooth Whitening." (Jan. 15, 2012) http://www.ada.org/2754.aspx
- American Dental Association. "Statement on the Safety and Effectiveness of Tooth Whitening Products." 2008. (Jan. 15, 2012) http://www.ada.org/1902.aspx
- American Dental Association -- ADA Council on Scientific Affairs. "Tooth Whitening/Bleaching: Treatment Considerations for Dentists and Their Patients" 2009. (Jan. 15, 2012) http://www.ada.org/sections/about/pdfs/HOD_whitening_rpt.pdf
- American Dental Hygienists' Association. "Tooth Whitening Systems." (Jan. 15, 2012) http://www.adha.org/oralhealth/whitening.htm
- Colgate Oral and Dental Health Resource Center. "How Does Tooth Whitening Work?" (Jan. 15, 2012) http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Cosmetic-Dentistry/Tooth-Whitening/Tooth-Whitening-Basics/article/How-Does-Tooth-Whitening-Work.cvsp
- Colgate Oral and Dental Health Resource Center. "Tooth Discoloration." (Jan. 15, 2012) http://www.colgate.com/app/CP/US/EN/OC/Information/Articles/Oral-and-Dental-Health-Basics/Common-Concerns/Tooth-Discoloration/article/Tooth-Discoloration.cvsp
- Kugel, Gerard; Ferreira, Susana; Sharma, Shradha; Barker, Mattew L.; and Robert W. Gerlach. "Clinical Trial Assessing Light Enhancement of In-office Tooth Whitening." Journal of Esthetic and Restorative Dentistry. Vol. 21, no. 5. Pages 336-347. 2009. (Jan. 15, 2012) http://onlinelibrary.wiley.com/doi/10.1111/j.1708-8240.2009.00287.x/full
- Mapes, Diane. "Blindingly white: Teeth bleaching gone too far." MSNBC.com. 2007. (Jan. 15, 2012) http://www.msnbc.msn.com/id/15309784/ns/health-oral_health/t/blindingly-white-teeth-bleaching-gone-too-far/#.TxL7l29SQ9C
- MedicineNet.com. "Teeth Whitening." 2005. (Jan. 15, 2012) http://www.medicinenet.com/teeth_whitening/article.htm
- Shulman, Matthew. "Tooth Whitening Leads in Cosmetic Dentistry." U.S. News & World Report. 2008. (Jan. 15, 2012) http://health.usnews.com/health-news/managing-your-healthcare/bones-joints-and-muscles/articles/2008/02/06/tooth-whitening-leads-in-cosmetic-dentistry
- Stronghard, Tiffany. "Wanted: Whiter, Brighter Teeth." American Academy of Cosmetic Dentistry. 2010. (Jan. 15, 2012) http://www.aacd.com/index.php?module=cms&page=726
- Tavares, Mary; Stultz, Jacyn; Newman, Margaret; Smith, Valerie; Kent, Ralph; Carpino, Elizabeth; and Jo Max Goodson. "Light augments tooth whitening with peroxide." The Journal of the American Dental Association. Vol. 134, no. 2. Pages 167-175. 2003. (Jan. 15, 2012) http://jada.ada.org/content/134/2/167.abstract
- WebMD. "Teeth Whitening." 2010. (Jan. 15, 2012) http://www.webmd.com/oral-health/guide/teeth-whitening