Whitening and Bleaching
Sustainability in Bleaching
“Health” means different things to different people. Labels like good, bad or indifferent are often attached. Youth (no consequences) and age (preserve health) are common perspectives. My definition of health involves caring for oneself in a way that will provide a lifetime of strength, function, comfort, and appearance. Avoidance of things harmful and nurturing one’s self esteem are important aspects as well, and somewhere between these two is where teeth bleaching resides today in many individual’s overall health picture. The concept of sustainability emerges when we consider that no bleaching process is inherently good for the health of our teeth; we do it for our emotional health through our self esteem.
One fundamental of oral health is that our teeth are at their healthiest when the enamel surfaces are fully mineralized and are coated with a natural protective protein layer known as the pellicle. Enamel needs to be fully calcified to be at its protective best in resisting the acids that leach minerals out, softening it and leading to cavity formation. On the other hand, when the pH or acid/alkaline status of our mouths is in the alkaline range, minerals in our saliva will go back into the enamel and strengthen it. The pH of our mouths is affected greatly by the drinks, foods and nonfoods we put in our mouths and by the level of acid-producing oral bacteria present. Because our modern western diet tends to be on the acidic side in general, many people are predisposed to having gradual enamel breakdown regardless of how well they clean their teeth.
So the concept of sustainability in bleaching involves an approach that delivers maximum durable result with minimum negative health impact. Some of the concerns have already been mentioned above, but here is a summary of the principles involved.
- Limit how often you lighten. This sounds obvious, but it’s important to realize that all lightening products lift or strip the protective protein coating from the surface of the teeth, leaving the enamel surface vulnerable to losing minerals. Because this coating is where most food stains are embedded, people will often see a noticeable effect when it is removed, but your tooth pays a price. Allow time between lightening treatments for the pellicle to recover.
- Bleach initially with a product such as a professional tray/gel setup that will penetrate the tooth deeply enough to lighten the dentin layer and give you a durable and stabile effect, but avoid using the strongest bleach products that are becoming increasingly common. This will allow you to use gentler products like neutral pH strips for periodic touch-ups less often in order to maintain a given level of lightness, even if you get some surface stain over time. Adhesive strips inherently have a limited ability to penetrate deeply enough into the dentin layer to lighten with the durability and stability of professional custom tray/ gel setups.
- Avoid acidic and abrasive whitening products, especially the two together, as this is especially harsh to the surface of teeth. Included in this category are whitening mouthrinses and toothpastes, and most mainstream toothpastes. Whitening pastes contain the coarsest type of hydrated silica available, and can significantly damage tooth surfaces when used routinely.
- During active bleaching periods, treat your teeth as being vulnerable. Avoid acidic and sugary foods and drinks that will pull the minerals out of the tooth surface. Avoid brushing immediately after bleaching, and rinse rather than brush to remove remaining gel after completing a session.