Last month, I started a two-part series on tooth whitening. I described why natural teeth do not look totally white but have a tint of yellow in them. I also delved into the causes of tooth discoloration and the solutions for certain forms of tooth discoloration. In today’s segment, I will take you through the types, processes, indications and contraindications of tooth bleaching.

Your dentist suggests tooth bleaching as an option to get your teeth whiter and your mind suddenly wanders to the time you saw an advertisement online that suggested coconut oil, charcoal powder, apple cider vinegar, sea salt, lemon juice and wood ash to whiten your teeth. According to scientific literature, the ideal bleaching agents that have been proven to work are hydrogen peroxide-based bleaching agents. In reality, the above-stated home remedies do not contain this bleaching agent.

Tooth bleaching could either be vital (tooth is alive) or non-vital (tooth is dead). There are three (3) fundamental approaches for bleaching vital teeth. They are the in-office/power bleaching, the at-home/dentist-supervised night-guard bleaching and the over-the-counter (OTC) products. The common factor in all these three fundamental approaches is hydrogen peroxide/carbamide peroxide which has varying concentrations in each approach.

Bleaching done at the dental clinic utilizes a high concentration of 25-40% hydrogen peroxide and the dentist has complete control throughout the procedure to attain the desired effect. The dentist first performs a cleaning procedure to remove any food stains or debris on the teeth, followed by protecting the gums with a gum protecting material and finally applying the whitening gel on the teeth. A special light is then placed above the whitening gel to accelerate the whitening effect. This type of approach can produce results after only one session but several visits are required for more significant results.

The second approach, which is the at-home/dentist supervised night-guard bleaching involves a very low concentration of hydrogen peroxide (10-20%) or carbamide peroxide (3.5-6.5%) about three to four times daily and it is mainly carried out by the patients at home and supervised by dentists during regular review visits. The bleaching gel is applied in a special teeth tray and inserted in the mouth. Patients start to see effects after at least two weeks. The advantage to this approach is that it is low cost and the fact that the clients do this themselves at the comfort of their homes. However, patients forget to use the tray everyday so the results are less ideal.

The third approach is the over-the-counter (OTC) bleaching products which are quite popular lately. The products contain a very low concentration of hydrogen peroxide (3-6%) which is self-applied in the form of whitening strips, whitening toothpastes and special trays. They are usually applied twice daily but take a long period of time to improve the teeth shade.

The side effects of tooth bleaching include teeth sensitivity which diminishes over a period of time, irritated gums which occurs when the whitening agent comes in contact with your gums, and lastly the fact that tooth bleaching is not permanent. The whitening effect can last from a few months to up to three years and it does not last as long if you smoke or take acidic or tannin-rich foods and beverages such as coffee, tea, red wine, carbonated drinks, berries, curry-based foods and soy sauce. You should also be mindful that tooth bleaching does not bleach dentures, crowns, tooth fillings or veneers so the color of such prosthesis may stand out if you decide to bleach your remaining natural teeth.

Tooth bleaching is indicated in clients who have some form of problem with teeth aesthetics. Generally, tooth bleaching is contraindicated in pregnant/lactating women, children under 16 years, people with gum recession and untreated gum disease, active tooth decay, pre-existing sensitive teeth and individuals allergic to peroxide.

I hope I was able to manage your expectations when it comes to tooth whitening. You should always seek a dentist’s advice before undergoing any whitening process. In contrast to several home remedies touted on social media, hydrogen peroxide-based bleaching agents are the best and they have been used for several decades to make your pearly whites sparkle. There has been little evidence that coconut oil, charcoal powder, apple cider vinegar, sea salt, lemon juice and wood ash will actually improve the shade of your teeth. Care must be taken when using the above-mentioned home remedies because some of these may cause the excessive wear of your tooth enamel leading to tooth sensitivity and also cause damage to your gums.

Thanks for reading.

Stay connected to the Vine. Stay Gorgeous and Stay Professional.

Credit: Dr Michael Awua-Mensah

(@Dr_Awua on Instagram)

A member of the Ghana Dental Association (GDA)