Teeth whitening is a cosmetic dental procedure that lightens teeth and removes stains and discoloration. It works by using bleaching agents, typically hydrogen peroxide or carbamide peroxide, to break down stain molecules in tooth enamel.

Professional whitening can lighten teeth by several shades, restoring their natural brightness or making them even whiter than their original color. The treatment can address both surface stains from foods and drinks, as well as deeper intrinsic stains from aging, medications, or other factors.

Several teeth whitening options are available:

In-office professional whitening: Uses high-concentration bleaching gels applied by Dr. Preston, often with light or heat activation for fastest results.

Take-home professional kits: Use custom-fitted trays and dentist-supervised bleaching gel for gradual whitening at home.

Over-the-counter products: Include whitening strips, gels, and trays available at pharmacies with lower concentrations of bleaching agents.

Whitening toothpastes: Contain mild abrasives and chemicals to remove surface stains.

Natural remedies: Like oil pulling or baking soda provide minimal whitening effects.

Professional treatments are most effective and safest for achieving significant whitening results.

Teeth whitening works through oxidation, where bleaching agents break down stain molecules in tooth enamel. Hydrogen peroxide and carbamide peroxide are the primary active ingredients that penetrate tooth enamel to reach discolored molecules inside the tooth.

These bleaching agents break apart stain compounds, making them colorless and less visible. The process is similar to how bleach works on clothing. Surface stains from coffee, tea, and tobacco are easier to remove, while intrinsic stains from aging, medications, or trauma require stronger concentrations and longer treatment times.

The process is generally safe when performed under professional supervision.

Good candidates for teeth whitening have:

• Healthy teeth and gums
• Realistic expectations about results
• Stains that respond well to bleaching such as those from coffee, tea, wine, or aging
• Don't have extensive dental work on visible teeth
• Aren't pregnant or breastfeeding
• Don't have severe tooth sensitivity
• Are committed to maintaining results through good oral hygiene

People with yellow or brown stains typically see better results than those with gray stains. Those with crowns, veneers, or fillings on front teeth should understand that these restorations won't change color and may need replacement after whitening for color matching.

Teeth whitening costs vary significantly based on the method chosen:

• In-office professional whitening: Typically costs the most but provides fastest and most dramatic results
• Take-home professional kits: Cost less than in-office treatment while still providing professional-grade results
• Over-the-counter products: Are the most affordable option but provide limited whitening compared to professional treatments

Factors affecting cost include geographic location, dentist's experience, extent of discoloration, and number of treatments needed. Most dental insurance plans don't cover cosmetic whitening. Many dental offices offer financing options or package deals that include both in-office and take-home treatments.

Teeth whitening results typically last 1-3 years, depending on lifestyle factors and maintenance. Professional treatments generally last longer than over-the-counter options.

Factors affecting longevity include:

• Consumption of staining substances like coffee, tea, wine, and tobacco
• Oral hygiene habits
• Natural aging process
• Genetics

To maintain results: avoid or limit staining foods and drinks, use whitening toothpaste, maintain excellent oral hygiene, consider periodic touch-up treatments, and use a straw when drinking staining beverages.

Teeth whitening is generally safe when performed under professional supervision or according to product instructions. Professional treatments are safest because Dr. Preston can assess your suitability for whitening, use appropriate concentrations, and monitor for adverse effects.

Common side effects include:

• Temporary tooth sensitivity
• Mild gum irritation, which usually resolve within a few days

Overuse of whitening products can damage tooth enamel and increase sensitivity. People with existing dental problems, pregnant or nursing women, and those with certain medical conditions should consult their dentist before whitening.

During professional in-office whitening:

• Initial consultation: Includes examination of teeth and gums, discussion of goals and expectations, and selection of appropriate treatment
• Pre-treatment: Involves cleaning teeth and protecting gums with a barrier gel or rubber dam
• Application: Involves applying professional-strength whitening gel to teeth, sometimes with light or heat activation
• Treatment: Typically takes 60-90 minutes and may involve multiple gel applications
• Post-treatment: Includes removing gel, evaluating results, and providing aftercare instructions

You may experience some sensitivity during or after treatment. Results are often visible immediately, with teeth appearing several shades lighter.

To manage whitening sensitivity:

• Use desensitizing toothpaste before and during treatment
• Reduce treatment frequency or concentration if sensitivity occurs
• Avoid hot and cold foods and drinks during treatment
• Take over-the-counter pain relievers if needed
• Use fluoride treatments to strengthen enamel
• Consider shorter treatment sessions

Professional treatments can be customized to minimize sensitivity through lower concentrations or shorter application times. If severe sensitivity occurs, stop treatment and consult your dentist. Most sensitivity is temporary and resolves within a few days after treatment ends.

For 24-48 hours after whitening, avoid staining substances as teeth are more porous and susceptible to discoloration:

Avoid:

• Dark beverages like coffee, tea, red wine, cola, and fruit juices
• Dark-colored foods such as berries, tomato sauce, soy sauce, and curry
• Acidic foods and drinks that can weaken enamel
• Tobacco products which cause rapid re-staining

Choose instead: White or light-colored foods like chicken, fish, rice, pasta with white sauce, bananas, and dairy products. Drink water frequently to rinse away potential stains. If you must consume staining substances, use a straw and rinse with water afterward.

Whitening agents only work on natural tooth enamel and won't change the color of crowns, veneers, fillings, or other dental restorations. If you have visible restorations on front teeth, whitening may create color mismatches that require restoration replacement for optimal aesthetics.

It's best to complete whitening before getting new restorations so they can be matched to your whitened teeth. If you already have restorations and want whiter teeth, discuss with your dentist whether the restorations will need replacement after whitening.

Some people choose to whiten despite having restorations if the color difference isn't noticeable or if restorations are only on back teeth.

Over-the-counter products differ significantly from professional treatments:

Concentration: OTC products contain lower bleaching concentrations (3-10% vs 15-35% for professional), making them less effective but potentially safer for unsupervised use.

Customization: Professional treatments use custom trays for even coverage, while OTC products use one-size-fits-all approaches.

Supervision: Professional treatments include dental examination and monitoring, while OTC use is unsupervised.

Results: Professional treatments achieve faster, more dramatic results, while OTC products provide gradual, modest improvement.

Safety: Professional supervision reduces risk of side effects and ensures appropriate use.

Teeth whitening is generally not recommended during pregnancy or breastfeeding as a precautionary measure. While there's limited research on the effects of bleaching agents during pregnancy, most dental professionals advise waiting until after pregnancy and breastfeeding are complete.

The concern is that whitening gel could potentially be absorbed systemically, though absorption is typically minimal with proper use. Pregnancy hormones can also cause increased tooth sensitivity and gum inflammation, potentially making whitening less comfortable.

If tooth discoloration is a concern during pregnancy, professional cleaning can remove surface stains safely, and whitening can be pursued after delivery and breastfeeding.

Tooth discoloration has two main categories:

Extrinsic stains: Affect the tooth surface from external sources like coffee, tea, red wine, tobacco, berries, and curry. These are generally easier to remove with whitening.

Intrinsic stains: Occur within the tooth from factors like:

• Aging (enamel thins and dentin yellows)
• Medications (especially tetracycline antibiotics)
• Excessive fluoride exposure during tooth development
• Trauma to teeth
• Certain medical conditions

Genetics also play a role in natural tooth color. Some people naturally have yellower or grayer teeth. Understanding the cause of discoloration helps determine the most effective whitening approach and realistic expectations for results.

To maintain whitening results:

• Practice excellent oral hygiene with regular brushing and flossing
• Use whitening toothpaste 1-2 times per week
• Avoid or limit staining substances like coffee, tea, wine, and tobacco
• Rinse with water after consuming staining foods or drinks
• Use a straw when drinking staining beverages
• Schedule regular dental cleanings every 6 months
• Consider periodic touch-up treatments as recommended by your dentist
• Quit smoking or tobacco use

Touch-up treatments are typically less frequent and shorter than initial whitening. Many people need touch-ups every 6-12 months to maintain optimal brightness, depending on lifestyle factors and natural tooth color changes.

Common side effects of teeth whitening include:

• Tooth sensitivity: Usually temporary and resolves within days of stopping treatment
• Gum irritation: Can occur if whitening gel contacts soft tissues, but typically resolves quickly
• Enamel damage: Overuse of whitening products can damage tooth enamel and increase sensitivity permanently
• Throat irritation: Some people may experience this if gel is swallowed
• Uneven whitening: Can occur with improper application or ill-fitting trays

Rare risks include chemical burns from high-concentration products or allergic reactions to ingredients. Professional supervision significantly reduces these risks through proper assessment, appropriate product selection, and monitoring. Most side effects are minor and temporary when whitening is performed correctly.

Whitening timelines vary by treatment method:

• In-office professional whitening: Shows immediate results, with teeth typically 3-8 shades lighter after a single 60-90 minute session
• Take-home professional kits: Show gradual improvement over 1-2 weeks of daily use, with significant results after completing the full treatment cycle
• Over-the-counter strips or gels: May take 2-4 weeks of consistent use for noticeable results
• Whitening toothpastes: May take 2-6 weeks for minor improvements in surface stains

Factors affecting timeline include severity of staining, natural tooth color, treatment concentration, and consistency of use. Most people see some improvement within the first few treatments, with maximum results achieved after completing the full treatment protocol.

Teenagers can generally undergo teeth whitening, but timing and supervision are important considerations. Most dental professionals recommend waiting until all permanent teeth have fully erupted, typically around age 16-18, as younger teeth have larger pulp chambers that may increase sensitivity risk.

Teen teeth also tend to whiten more easily and quickly than adult teeth due to less intrinsic staining. Professional supervision is especially important for teenagers to ensure safe and appropriate treatment. Parents should be involved in the decision and follow-up care.

Dr. Preston prefers conservative approaches like professional cleaning and whitening toothpaste for younger teens before considering bleaching treatments. The psychological benefits of improved smile confidence should be weighed against potential risks.

The terms whitening and bleaching are often used interchangeably, but technically have different meanings:

Whitening: Refers to any process that removes stains and restores teeth to their natural color, including professional cleaning, whitening toothpastes, and surface stain removal.

Bleaching: Specifically refers to treatments that use hydrogen peroxide or carbamide peroxide to chemically lighten teeth beyond their natural color.

True bleaching can make teeth whiter than their original shade, while whitening may only restore natural color. Professional treatments typically involve bleaching, while some over-the-counter products only provide whitening through abrasive action or surface stain removal without chemical bleaching agents.

Natural whitening remedies have limited effectiveness compared to professional treatments:

• Baking soda: Can remove surface stains through mild abrasive action but won't change intrinsic tooth color
• Oil pulling: With coconut oil may reduce bacteria and surface stains slightly
• Strawberries: Contain malic acid that may help remove surface stains, but the effect is minimal and fruit acids can potentially damage enamel
• Hydrogen peroxide rinses: Can provide mild whitening but at much lower concentrations than professional treatments
• Activated charcoal: Lacks scientific evidence for whitening and may be abrasive to enamel

While these remedies are generally safe when used occasionally, they're not effective substitutes for professional whitening for significant color change. Some natural remedies may even damage enamel with overuse.