The teeth whitening treatment has become one of the most sought-after procedures in dental medicine. Throughout history, and even today, the level of tooth whiteness has subjectively indicated the level of oral health. In the media, we can see perfectly white teeth of famous people, which has influenced the population to become more interested in the teeth whitening procedure. However, are we fully informed about the procedure itself and what is needed to be done before, during, and after?
Before starting the teeth whitening procedure, it is necessary to determine the dental status and the level of oral health. Cavities should be treated, dental infections should be identified, and if there are any prosthetic replacements, those parts will not be whitened, as the effect wouldn’t not be the same like on the tooth tissue. For better results, it is extremely important to perform prophylaxis – professional teeth cleaning, even a few days before the teeth whitening procedure to remove deposits from the surface of the teeth and establish healing of the gums if there is an infection, which is very important not only for whitening but also for oral health. Also, after the procedure, regular check-ups with prophylaxis in a dental medicine office are necessary to keep the whitening effect lasting as long as possible.
Teeth whitening is any procedure that lightens the color of the teeth. This can be achieved by physically removing stains through prophylaxis or by a chemical reaction to lighten the color. The active ingredient in most whitening products is hydrogen peroxide. Faster whitening can be achieved through in-office whitening as the products deliver higher concentrations of peroxide. The procedure is performed by isolating the oral cavity with a rubber retractor and sterile cotton, to ensure a dry working field. The gingival tissue is protected with an isolation gel that hardens before the application of the whitening agent. Then, a whitening gel is applied to the teeth and covers the front surfaces of the teeth for a certain period of time. The results of teeth whitening are visible after one treatment of 30 to 60 minutes, depending on the cycles of the applied whitening gel, and the initial indication.
The risks usually cited in teeth whitening include tooth sensitivity and mild gum irritation. These two phenomena can begin during the whitening process and can last for several days.
Recent research has shown that there are also other risks, especially with at home teeth whitening attempts, such as roughness and softening of the tooth surface, increased risk of demineralization, degradation of dental replacements and unacceptable changes in the color of dental replacements due to frequent and aggressive whitening. To avoid the aforementioned complications, it is recommended to seek professional teeth whitening under the supervision of a dental doctor. One of the frequent questions patients ask is “How long will the effect last?” It is difficult to predict the longevity of a whitening regime as the patient may routinely expose their teeth to foods or drinks that are known to stain teeth, resulting in re-staining within a month. However, if the teeth are not exposed to chromogens such as coffee or black wine, it would be reasonable to assume that the whitened teeth could last up to a year.
When used in accordance with the manufacturer’s instructions, teeth whitening based on hydrogen peroxide is safe and effective. However, as with other therapies, there are risks and the practices should be tailored to the needs of each individual patient, based on the type and degree of staining, dietary habits, previous restorations, and other intraoral conditions. Patients should be informed of the risks associated with teeth whitening and, if using home-based products, instructed on how to recognize harmful side effects, so that they can seek professional help when necessary. Supervision of the teeth whitening strategy by oral healthcare professionals will minimize potential risks and optimize the benefit of teeth whitening.
Journal by dr. Leonarda Bratuš
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