Whitening and Bleaching
If ever there was a professional dental procedure that gained meteoric success and acceptance, it would be teeth bleaching. It has the ability to add sparkle to a young but yellowish smile or brightness to one that has lost its luster. It can easily take 10 years off a smile that has naturally grown darker with increasing age. Bleaching has evolved from an in-office procedure applied and managed by dental professionals to a commodity that can be found at shopping malls, county fairs, online, and the local drugstore. Today we commonly see people with teeth that are so bright white they appear anything but natural. Over-bleaching is becoming the norm for a segment of society. I fully expect that in time dentists will begin to see the emergence of consequences, likely in the form of problems with the nerves of teeth, increases in root canals, root resorption, etc. Bleaching has the potential of going from a relatively innocuous appearance-enhancing procedure to something that induces early aging problems in teeth. We advise moderation in its use and recommend an approach based on sustainability. This will yield brighter but still natural looking teeth and minimize the risk of problems long term.
Satisfying this high demand for bleaching has led to the introduction of in-office techniques based on luring patients with the promise of high tech, quick, spectacular results with minimum effort. With the advent and tremendous success of lasers in eye surgery, people expect lasers to deliver miracles. However, recent studies have reconfirmed what has been known for some time, that light (laser, LED, or otherwise) does not lighten teeth; bleaching products do. Lights are said to “activate” bleaching products—gels and solution applied to teeth—implying they are inactive without light. The truth is bleach gels are always active, and they are always used. Refrigeration extends their shelf life because it slows their inherent activity, and thus their chemical breakdown, and preserves potency. Warming them to body temperature is sufficient to get their full effect. The heat produced by lights might have a small effect, but multiple studies have found it insignificant. It is more likely to cause inflammation in the tooth nerve, increase sensitivity, and dry the teeth out than accelerate lightening. If lights bleached teeth then they would be used without bleach gels, and patients doing in-office bleaching would not be sent home with gel/tray setups to continue their treatment. So this is one place where the profit motive is readily evident in the business of dentistry. The bottom line is you can pay a lot of money to the dental laser marketer or “Zoom” system provider, less at the booth in the mall, but if you want the most efficient and proven professional technique, custom fit trays with light to moderate strength neutral pH bleaching gel in a take-home system is still the professional gold standard