Teeth Whitening| Stains| Cost |Teeth Whitening at home| Risks
- Dr Abi
- Feb 14, 2023
- 11 min read
Updated: Jun 14, 2023
Table of Contents
What is Teeth Whitening?
Teeth whitening is also called teeth bleaching.
Teeth whitening is any process that lightens the existing color of your teeth by several lighter shades and we can achieve it by changing the intrinsic or extrinsic color of the teeth in a few minutes by using various teeth whitening options.
Teeth whitening is done when you would like to lighten the color of your teeth. It is done when teeth become yellow over time due to various reasons. It is a practical way of lightening the yellow color of your teeth without removing any of the tooth surfaces and without making any unnecessary changes to the shape, and size of the tooth.
What are the reasons for tooth discoloration?
Stains on the teeth could be due to many reasons:
1. Extrinsic Teeth Stains
found on the outer surface of teeth.
stains get attached to the tooth surface due to attractive forces and for this reason, can be easily removed.
Extrinsic Teeth Stains examples
Cigarettes, pipes, cigars, chewing tobacco, and marijuana, the color of teeth will be yellow-brown to black color and dark brown to black rings.
Coffee, tea, food, and the color of the teeth will be brown to black.
Poor oral hygiene, the color of the teeth will be yellow or brown shades.
2. Intrinsic Teeth Stains
Intrinsic stains are present from within the teeth.
Intrinsic discolorations are due to the presence of chromogenic material within the enamel or dentin, incorporated either during periods of tooth development or they may be acquired after completion of tooth development.
Intrinsic stains are not removable or extremely difficult to remove with chemicals alone.
The color of the intrinsic stain will be brown, blue, black, and gray.
Intrinsic Teeth Stains Examples
Fluorosis.
Aging.
Genetic conditions like Amelogenesis imperfecta, Dentinogenesis imperfecta.
Systemic conditions like Jaundice, Porphyria.
Medications during tooth development like Tetracycline, Fluoride.
Body by-products like Bilirubin, Hemoglobin.
Tooth changes like Tooth pulp canal obliteration, Tooth pulp necrosis with hemorrhage/without hemorrhage.
Iatrogenic causes( happened due Dental related treatments like filling or Root Canal treatment) like Trauma during pulp extirpation, Tissue remnants in the pulp chamber, Dental Filling materials, and RCT materials.
Teeth Whitening Options
TEETH BLEACHING AGENTS
The goal of the bleaching procedure is to get the normal color to a tooth by decolorizing the stain with a powerful oxidizing agent known as a bleaching agent.
Teeth bleaching materials are:
A. Hydrogen peroxide
B. Sodium perborate
C. Carbamide peroxide
D. Over-the-counter (OTC) agents- OTC bleaching agents that are being marketed include tray systems, tray-less systems, chewing gums, toothpaste, bleaching strips, and paint-on products. These materials work by removing extrinsic surface stains only.
Option 1: Teeth Whitening At Home
Herbal Teeth Whitening Toothpaste
Ayurvedic teeth whitening toothpaste is made from natural ingredients like neem, bromelain, Meswak, papain, bromelain, enzymes present in Papaya and Pineapple, Miswak, Menthol, Almond, Papaya, and Clove. Cinnamon, Curcuma longa (turmeric) rhizome juice, coconut oil, stevia, neem leaf extract, pomegranate, vidanga) fruit extract*, amla, salt, citrus fruits, etc.
Examples of Herbal Teeth Whitening Toothpaste- are Glodent, Himalaya Sparkling White, Charcoal Based, Rocksalt based, Glizer, etc.
Chemical-Based Teeth Whitening Toothpaste
Conventional whitening toothpaste contains abrasives and bleaching agents such as silica, pyrophosphates, hydrogen peroxide, or carbamide peroxide, which remove the extrinsic stains, thereby lightening the teeth' color.
Examples of Chemical-Based Teeth Whitening Toothpaste- are Colgate optic white, Sensodyne gentle whitening, etc.
Teeth whitening chemicals are kept less in toothpaste as compared to what is being used in the dental clinic for professional teeth whitening services, you might see the results with these toothpaste if you brush with them three times a day.
But, Regular use of such teeth whitening toothpaste at home can result in teeth sensitivity to hot and cold, and also abrade your teeth.
Also, such teeth whitening toothpaste at home doesn't give the desired results faster.
The benefits are, it is handy, with fewer chemicals.
Herbal vs Chemical Teeth whitening toothpaste
Both have similar whitening effects.
Herbal toothpaste has less surface defects to the enamel (less adverse effects).
Teeth-whitening mouthwashes commercially available as
Hydrogen peroxide mouthwash 3%
To be used in a 3(water): 1(hydrogen peroxide) ratio.
Hydrogen Peroxide Mouthwashes are easy to use on a daily basis and are easily available.
Hydrogen Peroxide is a mild antiseptic as well. It is not only used to whiten the teeth but also to relieve mouth ulcers, and gum irritations (such as due to canker/cold sores, gingivitis, dentures, and orthodontic appliances).
Few teeth whitening mouthwashes examples - Hydroxyl Mouthwash 3 %, Parachem Hydrogen Peroxide 3%, etc
It is advisable to use teeth whitening mouthwashes only 3-4% on a daily basis as a mouth rinse. If used more than 6% or more, then it may result into
-weakening of the tooth structure
-hot, cold sensitivity
-burning of gums
3. Teeth whitening chewing gums (Optic White)
4. Teeth whitening Bleaching pen (Brite Smile)
5. Teeth Whitening Home Kits
At-home teeth bleaching is the commonly used technique.
Easily done by patients and are less expensive. It uses a custom-fit tray with 10% carbamide peroxide. Carbamide peroxide is more stable than hydrogen peroxide and can be active for up to several hours.
The usual concentration of at-home teeth bleaching is 10% carbamide peroxide, which is relatively safe in contact with the soft tissues. Due to the differences in concentration, at-home bleaching would require more sessions of bleaching than the in-office technique.
Steps in Teeth whitening at home
Step 1-Customized Tray is fabricated by teeth bleaching Dentists.
Step 2-Brush your teeth prior to the application of the tray.
Step 3-Place enough bleaching agent into the tray to cover the facial surfaces (only the front surface) of the teeth. After seating the tray, excess bleaching material extruding onto the gums should be carefully wiped away.
Step 4- The tray should be worn for a time period of 4 hours for every session
Step 5- Reduce the time if sensitivity is experienced. Conversely, if sensitivity is not an issue, you can repeat the bleaching session for the second time on the same day.
Step 6- After every teeth bleaching session, rinse off the bleaching agent from the surfaces of the teeth. Wash off the bleaching agent from the tray and store the bleaching material at a cool temperature.
Results can be seen as early as 2–14 days or may take as long as 6–12 months, depending on the level of teeth discoloration.
Home-based teeth whitening kit must be used under the supervision of a dentist.
After Effects of Teeth Bleaching at home kit use
Tooth Sensitivity.
Enamel damage.
Gum irritation.
Option 2: Teeth Whitening in Dental Clinic
You will notice the most effective Teeth whitening results in professional teeth whitening procedures.
Professional Teeth Whitening / In-office teeth whitening (dentist visit)
This technique generally uses a 35% hydrogen peroxide solution that is directly placed on the teeth. Effective results can be obtained in one, two, or three visits.
Teeth whitening materials are commercially available in the form of a gel.
With Laser or Light-Assisted Power Bleaching
Dental lasers and other powerful light sources have been used to enhance the bleaching action. The light source systems generate heat to activate the bleaching agent. The heat causes rapid dissociation of hydrogen peroxide potentiating the bleaching effect. These Light assisted teeth bleaching systems should be used with caution since they can induce severe postoperative sensitivity.
Without Light or Laser
After applying the gum protective barrier, 30–35% hydrogen peroxide in gel/ liquid form is applied directly on the front surface of the teeth. Teeth whitening material is allowed to remain on the tooth surface for 8-10 minutes or as per the manufacturer's guidelines. No light is used. Generally, two to three sessions of 8 minutes will show significant results. Slight post-tooth whitening sensitivity can happen but is not much more severe than in light-based teeth whitening.
Note: The usual concentration of at-home teeth bleaching is 10% carbamide peroxide, which is relatively safe in contact with soft tissues. 10% carbamide peroxide is considered a safe teeth whitening system. Due to the differences in concentration, at-home teeth bleaching would require more sessions than the in-office teeth whitening technique.
Walking Bleach Teeth Whitening (Internal Bleaching)
It is also called Intracoronal teeth Bleaching and non-vital teeth bleaching techniques. It is the bleaching of a tooth that has turned brown-black-bluish-gray over a period of time due to trauma, or in a previous root canal-treated tooth.
Sodium perborate alone, or in conjunction with hydrogen peroxide, should be used as the primary bleaching agent. Sodium perborate bleach slowly, it is considered safe for the tooth.
External root resorption and chemical burns in gums are some of the adverse effects.
Cost of professional teeth whitening
It is a one-appointment procedure.
Per session is 8-20 minutes depending on the material.
It will cost 3000/ 4000 / 6000/ 8000/12000/15000/20000/25000/30000 in rupees per session (all depending on what whitening system is used, what material and technique is used, and what percentage of material used)
The procedure is done completely in-office and only by a Registered Dentist.
Note : Cost of professional teeth whitening also depends on the area where you live, the experience of the dentist, condition of teeth.
The posh the area is, the more will be the charges.
The more experienced the dentist is, the more will be charges and less complications.
Who should go for Teeth whitening treatment?
Superficial tooth enamel discolorations.
Mild yellow discolorations.
Brown fluorosis discolorations.
Age-related discolorations.
Mild fluorosis.
Mild tetracycline stains.
In order to match the existing color of the crown that is lighter than the natural teeth.
Who should not go for Teeth whitening treatment?
Severe tooth enamel damage.
Hypersensitive teeth.
Bruxism/ severe teeth clenching habit/ severe attrition.
Presence of caries.
Defective fillings.
Allergy to bleaching gels.
Children below the age of 16 years due to a large tooth pulp chamber.
Superficial stains that can be removed with scaling and polishing.
Multiple silver-amalgam fillings.
Pregnant and lactating women.
Exposed root surfaces.
Are there risks of teeth whitening?
weakening of the tooth structure.
postoperative sensitivity.
weakening of the tooth enamel.
surface porosities.
laser or light-based teeth whitening causes severe tooth sensitivity and irreversible tooth pulpal damage.
Gums irritation (burning sensation in gums).
Mercury release from silver-amalgam restoration.
Teeth whitening agent hydrogen peroxide causes a chemical burn. It is especially painful if it comes in contact with the nail bed or the soft tissue under the fingernail.
Teeth whitening in Tetracycline-stained teeth
Dark blue–gray, tetracycline-stained teeth are considerably more difficult to treat than are the teeth with mild yellow–orange discolorations.
Long-term exposure to minocycline can lead to graying discoloration in permanent teeth.
Teeth discolored by tetracycline may also be bleached to some extent with hydrogen peroxide, but the bleaching effect is very less or no effect because the chemical cannot reach the tetracycline discoloration into the dentin.
Tetracycline-stained teeth typically are resistant to bleaching and may take several months to show any results. Some clinicians advocate intentional root canal therapy along with the use of an intracoronal non-vital bleaching technique to overcome this problem. Veneers with composite resins or even porcelain-veneer full-crown restorations are indicated instead of intentional root canal treatment.
What to do after Teeth Bleaching?
Use desensitizing toothpaste like Shynm, sensodyne rapid relief, thermoseal, sentium, etc.
Use desensitizing mouthwashes like sanqual-ad , sensodent f, etc.
Use a fluoridated mouth rinse like amflor, etc
Use tooth creme containing amorphous calcium phosphate in casein phosphopeptide (ACP-CPP) like GC Tooth Mousse which is used to promote remineralization of the enamel surface.
Teeth whitening Dentist?
Teeth whitening treatment should be performed strictly by a registered dentist.
Teeth bleaching is a technique-sensitive procedure. It can damage the tooth enamel, and lead to extreme sensitivity and chemical burning when performed by an unskilled professional. So it should always be performed by a registered dentist who has experience and skill in doing this procedure.
You can also buy Do it yourself home teeth whitening kits but these may also carry risks.
Some beauty salons and not registered professions offer teeth whitening which is illegal and it may put your oral health at risk.
Frequently Asked Questions about Teeth Whitening
1. Are teeth whitening permanent?
Bleaching generally has an approximate life span of 1–3 years, although the change may be permanent in some situations. The whitening effect won't last long if you smoke or drink red wine, tea or coffee, or tobacco, which can all stain your teeth.
2. What are the risks of home kits teeth whitening?
Home kits don't contain enough whitening products so you might not see the effective change in the tooth shade. Results can be seen as long as 6–12 months.
Bleaching gel may escape out onto gums and into your mouth, causing mouth blistering and teeth sensitivity.
Since the tray is worn for a longer time, there are chances of tooth enamel damage, tooth sensitivity, and gum irritation.
3. Do teeth whitening damage tooth enamel?
On the basis of numerous research studies, carbamide peroxide bleaching materials are considered safe and effective.
Hydrogen peroxide bleaching beyond a point results in the breakdown of the organic matrix resulting in the weakening of the tooth enamel and surface porosities.
4. Do teeth whitening damage dental fillings?
10% carbamide peroxide is safe in existing fillings.
When bleaching was done on extensive silver amalgam filling it was found that mercury was released from silver- amalgam filling.
In composite fillings, the bond strength of the composite decreases for a temporary period of time. If planning composite filling then it should be delayed at least 1 week.
5. Do teeth whitening damage dental crowns?
Bleaching agents are known to cause the etching and weakening of ceramic crowns.
In severe discolorations, bleaching could be performed to lighten the tooth color before restoration with composite or porcelain veneers or crowns.
6. Do teeth whitening cause sensitivity in the teeth?
Hydrogen peroxide has such a low molecular weight that it easily passes through the enamel and dentin and is considered to be the reason for mild tooth sensitivity occasionally experienced during treatment.
7. Do teeth whitening damage a tooth's nerve?
The mild tooth sensitivity effect is transient and no long-term harm to the tooth nerve has been reported.
8. Why do I have yellow stains on my teeth?
Yellow stains on teeth found on the outer surface of teeth.
Yellow stains due to-
Cigarettes, pipes, cigars, chewing tobacco,
Coffee, tea, foods.
Poor oral hygiene, heavy plaque and calculus level .
9. What is yellow teeth treatment?
Since yellow stains are extrinsic stains they can be easily removed by scaling and polishing.
If you are not satisfied with the color of your teeth after scaling and polishing , then you can always use over the counter teeth whitening products like teeth whitening toothpaste, mouthwashes, whitening strips,chewings gums, and pens.
If you are still not satisfied with the color of the teeth and want a faster result then Professional teeth whitening or in-office teeth whitening by the registered dentist is recommended.
10. What is the quickest way to whiten teeth?
Quickest and fastest way is Professional teeth whitening or In-office teeth whitening.
Only by the registered dentist.
It will take 8-20 minutes of procedure.
11. What is In-Office Bleaching?
It means you must visit the dental clinic near you. And teeth whitening procedure is done in the office of the registered dentist and that is why it is called In-office teeth bleaching.
12. Is herbal whitening toothpaste/ayurvedic whitening toothpaste better than other teeth whitening toothpaste?
If you talk about the whitening effect then herbal toothpaste’s whitening effect is the same as a chemical-based whitening toothpaste.
Adverse effects of chemicals can be minimized or avoided when substituted with herbal products which offer teeth whitening without damage to the enamel
13. I have sensitivity in all the teeth. Can I do teeth whitening?
It is contraindicated in Hypersensitive teeth.
14. Can tobacco stains be removed by teeth whitening?
Yes, tobacco stains are extrinsic stains and can be removed by Teeth whitening. Normally, It lasts for 1-3 years but teeth may get stained early if you continue taking tobacco.
15. Can I use baking soda or lime for cleaning my yellow stains on the teeth?
No, rather you can buy over the counter herbal teeth whitening toothpaste or ayurvedic whitening toothpaste. They are made from natural ingredients like neem, bromelain, Meswak, papain, bromelain, enzymes present in Papaya and Pineapple, Miswak, Menthol, Almond, Papaya, and Clove. Cinnamon, Curcuma longa (turmeric) rhizome juice, coconut oil, stevia, neem leaf extract, pomegranate, vidanga) fruit extract*, amla, salt, citrus fruits, etc.
A Few examples of Herbal/ Ayurvedic Teeth Whitening Toothpaste- are Glodent, Himalaya Sparkling White, Charcoal Based, Rocksalt based, Glizer, etc.
It has minimal to no side effects and the same whitening effect as any other chemical based teeth-whitening toothpaste.
16. I have naturally yellow teeth. Can I get teeth whitening?
Yes, you can. First, we will need to find out the reason behind yellow teeth. Teeth whitening in extrinsic yellow teeth will give you amazing results but may show resistance in intrinsic yellow teeth. So combined teeth whitening option is to be chosen. All under the dentist.
Other types of extrinsic discolorations, such as silver nitrate stains, are difficult to remove by chemical means alone.
Some extrinsic discoloration, such as the green discoloration associated with the Nasmyth’s membrane in children and tea and tobacco stains can be removed by scaling and polishing during tooth prophylaxis.
References
2. www.ncbi.nlm.nih.gov National Library of Medicine
3. Grossman's Endodontics Practice ed 14 "Teeth Bleaching".
Author-
Dentist
10 + years of experience
Certification in Practical Implantology
Certification in Rotary Endodontics
Associate Fellowship in Laser Dentistry Certification in Laser Treatments Diploma in Practical Occlusion and Restorative Dentistry Course Advanced occlusion appliance therapy, TMD Comprehensive Course in Veneers - Ceramic & Composite Aesthetic Certified - Europe, Germany WHO Health Program Certified Certification in Laser Dentistry Fellow of the Academy of General Education (FAGE) Member of the Indian Dental Association (IDA)
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