Professional Tooth Whitening Offers Whiter, More Youthful Teeth by Dr. Lenonardo T. Fazio DDS

     Do you have discolored teeth? Don't despair! A visit to your dentist can determine whether professional tooth whitening is for you, after making sure the discoloration is not due to anything more serious, like periodontal disease, tooth fluorosis, decay (cavities) or trauma. Tooth discoloration happens when the mineral structure of the tooth changes and the enamel portion becomes less porous. Teeth can also become stained by bacteria, tea, coffee and tobacco.

     Our culture tends to associate white pearly teeth with youth, making whitened teeth more desirable to have as well as improving personal appearance and boosting self-esteem. In order to lighten teeth, oxidizing agents like hydrogen peroxide or carbamide peroxide are used to reduce discoloration. The oxidizing agent permeates the porosities in the rod-like crystal structure of enamel and the oxygen molecules interact with the stain-causing molecules, causing them to release. Eventually, the dentin layer beneath the enamel layer, is also whitened. Tooth bleaching usually lasts from 5 to 7 years depending on whether the patient continues to smoke, or chew tobacco and how much tea and coffee they consume.

     Mostly every adult has some form of tooth discoloration. There are plenty of over-the-counter (OTC) tooth whitening kits on the market, but often, these are not as effective as what a dentist can do with a professional tooth whitening system performed in the office. Concentrated levels of hydrogen peroxide found in OTC kits can cause irritation, burning and discomfort to the teeth and gums when used improperly at home. In addition, the OTC bleaching is a much slower process and the results are usually not as effective as what a dentist can do because the strip or mouth-guard (dental tray) is a "one-size-fits-all" and does not fit everyone's mouth perfectly.

     Most in-office bleaching procedures use UV light to accelerate the process and a light-cured protective gel is carefully painted on the gums and the tips of the gums between the teeth (papilla) to protect the gums against ultra violet radiation and the irritating effects of the concentrated hydrogen peroxide. The bleaching agent is either carbamide peroxide, which breaks down in the mouth to form hydrogen peroxide, or hydrogen peroxide itself. The bleaching gel usually contains up to 35% hydrogen peroxide.

     Not all people are good candidates for tooth whitening. Discoloration due to Tetracycline staining (tetracycline is an antibiotic) could require prolonged bleaching, since it takes longer for the bleach to reach the dentin layer. Decalcifications, or white spots, may also be accentuated after the whitening procedure and become more noticeable. Bleaching is not recommended for people with periodontal disease or for teeth that have a grayish tint. Tooth whitening will not change the color of certain filling materials (porcelain ceramics) and sometimes, certain restorations will need to be changed in order to match the new, whiter color of the bleached teeth. That's why it's important to consult a dentist and have the procedure done professionally rather than do it your self at home.

     Anyone allergic to peroxide should not use a bleaching product. Most importantly, prolonged exposure to bleaching agents may damage tooth enamel. This is especially the case with some home remedy whitening ingredients that contain fruit acids, since daily consumption of acid-type foods can wear down the enamel layer and make discoloration even worse. (The same reason why you should not consume chewable Vitamin C tabs on a daily basis).

     Children under the age of 16 should not have their teeth whitened. This is because the pulp chamber, or nerve of the tooth, is enlarged until this age and teeth whitening can irritate the pulp or cause it to become overly sensitive. Teeth whitening is also not recommended in pregnant or lactating women.

     Tooth whitening is not just a simple cosmetic procedure. It's imperative that the dentist diagnose the cause of the staining and determine whether the stains can be removed or not, diagnose any other oral health problems, and counsel patients about the best method for dealing with their tooth discoloration.

     Recently, efforts have been made to accelerate the bleaching process by the use of light. Studies have shown varying results as to the efficacy of light-activated bleaching. In my office, I use the Sapphire Whitening System with a Sapphire Plasma Arc Light which is a non-ultra violet light. Light helps to speed up the oxidization of the hydrogen peroxide, but ultra violet light, which is used in some other tooth whitening systems, is known to create free radical damage and so this concern is eliminated. Also, the use of protective sunscreen and a face mask is eliminated. With this system, there is also no tooth or gum sensitivity.

     Each patient is different and results will vary. Lengthier whitening sessions, higher concentrations of peroxide, or multiple treatments will help to achieve better results. If whitening does not produce the desired results, Cerinate Lumineers may be a better option. (See the December 2007 article in New Living Magazine)

     After the procedure, the patient is given a Sapphire Professional Take-Home Kit which contains a whitening formulation with carbamide that is 1/3 the strength of hydrogen peroxide as well as toothpaste. In no time, you can have the white pearly Hollywood smile you've always dreamed about!

     From January 1, 2008 through February 14, 2008, if you buy one Sapphire Whitening Procedure for $495 (normally $695), the second person who books at the same time gets their procedure for $395. Sapphire Whitening makes a nice Valentine's gift for you, or a loved one. For more information on how professional tooth whitening can help you and for a free consultation, please contact me at the number below.

     To arrange a dental consultation, please contact Dr. Len T. Fazio, DDS, c/o Atlantic Dental Wellness, 1303 Main Street, Suite 2, Port Jefferson, NY 11777; (631) 474-7477;;